Ulcer: No wonder your stomach hurts

The Helicobacter pyfori bacterium, is known to cause up to 80 percent of all ulcers. By the looks of the bacterium, it’s no wonder ulcer patients suffers so much. H. pyfori causes up to 80 percent of all gastric ulcers. The only way you can be cured of H. pyfori and your ulcers is by medical testing followed by multiple-drug treatments. Fortunately, the tests and treatments are simple, basically painless and quick.

What is H. pyfori, and what does it do? Until H. pyfori was isolated and identified, scientists believed the stomach was a naturally sterile environment where no bacteria could survive. In 1983, however, two doctors debunked that "tentacles" (called flagellae) to burrow into the wall of the stomach, can survive the unthinkable: The acidic environment of your upper GI system, where even metal can be digested.

It took several years to convince the physicians to change their beliefs about ulcers and their treatments. After decades of treating ulcers with acid blockers, everyone – including ulcer sufferers who had for years taken these drugs as maintenance therapies – was to believe that while stress and spicy foods might exacerbate an existing ulcer, they don’t cause ulcers, and more importantly, they probably never did. A sudden paradigm shift occurred in the medical field when doctors began prescribing for their patients a course of antibiotics along with the acid reducers.

Who is most likely to carry H. pyfori? Amazingly, H, pyfori is believed to live in the stomachs of about half of the world population, with an incidence as high as 80 to 90 percent in developing countries. According to its famous discoverers, if you were born before the 1940’s, if any of your family members has been diagnosed with ulcers, if you grew up in overcrowded or poor conditions or if you’ve ever lived abroad, particularly in developing country, you most likely carry H. pylori. Socioeconomic factors are better indicators of H. pyfori infection than race or ethnic background.

While most people’s bodies are able to "shrug off" the effects of this bacterium with no ill effects, the rest of us have GI problems ranging from mild heartburn to bleeding ulcers and even stomach cancer. In addition, as scientists have continued to study and treat H. pyfori, more and more medical conditions are believed related to its presence in the body. Related conditions range from Crohn’s disease and ulcerative colitis to skin rashes such as acne rosacea.

These findings are still in the preliminary stages, however, and they remain highly controversial.

How do doctors test for H. pyfori? Several tests are available to detect H. pyfori. The most direct (and the most invasive) is endoscopy. In this test, a gastroenterologist uses a long tube to collect tissue samples (biopsies) from the lining of the stomach. A campylobacter-like organism (CLO) test is performed on the tissue samples at a laboratory to find traces of urease, a substance that indicates that H. pyfori is present. The results of the CLO test are available within 24 hours.

A blood test is a less invasive way to detect H. pyfori. Your doctor takes a sample of your blood to see if you carry H. pyfori antibodies. The presence of these antibodies means you either currently have an H. pyfori infection or you have had one in the past three years. The results of this test can take up to a few days to return, depending on facilities. It’s not a good test if you’ve been treated for H. pyfori before.

The least invasive test is a breath test, which involves swallowing a small capsule containing radioactive carbon-14. The carbon-14 has been determined by the FDA to be safe because it contains only a tiny amount of radioactive material. After swallowing the C-14 capsule, the patient waits a few minutes then blows into a balloon. The contents of the balloon are then analyzed for H. pyfori. The test is non-invasive, it’s easy for both patients and technicians, and it’s inexpensive. Results are available the same day.

How is H. pyfori treated? If your doctor finds that you have an H. pyfori infection, curing it is usually relatively simple – a 14-day course of two antibiotics, such as clarithromycin and amoxillin, in combination with an acid reducer such as esomeprazole or lansoprazole will end most people’s symptoms or even cure their ulcers. An acid reducer enables the antibiotic to do its job in the acidic environment of the stomach. If your symptoms persist after the 14-day treatment, you and your doctor will decide whether to repeat a course of the same drugs or other combinations of antibiotics and acid reducers to find which treatment works for you. Drug-resistant strains of H. pyfori do exist, so another course of treatment may be necessary. Usually, however, only one or two treatments are needed.

Once you’ve been treated for an H. pyfori infection, the only way to know if the bacteria have been eradicated is by a new biopsy or breath test. A blood test can yield a false positive for months or even years after the bacteria have been killed, so the breath test should be used to confirm a cure.

Is the treatment effective?

Here’s what for sure: It worked. After 14-day course of treatment, not only could stop all these acid-reducing drugs, you could go back to normal diet. Could even eat the spicy Mexican foods you had been craving.