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Helicobacter pylori Jayli Schmidt History • Discovered in 1982 by Barry Marshall and Robin Warren – They won the Nobel Prize in 2005 for this discovery • Discovery proved that several diseases of the stomach were of microbial cause when no microorganism was thought to be able to survive in there before the discovery • Previously named Campylobacter pyloridis Example of the Disease Sara started coming down with the symptoms of a burning stomach that worsened when it was empty and felt better after she ate. She also had abnormal burping and bloating. It was so bothersome that she went to the doctor and had an endoscopy performed. The tissue was cultured and proved to be Helicobacter pylori bacteria. The doctors gave her two different antibiotics (commonly including Amoxicillin) which she took for three weeks straight. cont. After finishing the course of antibiotics she returned to the doctor and was retested for the presence of H. pylori which was proved that there were still remaining bacteria. She was then given more antibiotics for another duration (which is common) and returned again for retesting. Once the absence of the bacteria was proven she was free from infection and told to watch for recurring symptoms. Characteristics of H. pylori • • • • • • • Bacteria (gram negative) Spiral “s” shaped (some are also rods) 2 to 5um in length Motile Microaerophillic Contain multiple flagella Virulence factors: multiple flagella to help with burrowing, ability to live in extreme acidity (beneficial in the stomach) , enzyme urease (to weaken the acidity) Facts • Over half the people in the world are living with Helicobacter pylori in there stomachs and will never come down with an infection • It is the first formally recognized bacterial carcinogen and is one of the most successful human pathogens Characteristics • Mode of transmission is thought to be food, water, or airborne, mostly starting in childhood • Infection can occur after 3-4 days or can take the span of childhood to adulthood • Symptoms: burning of the stomach, excessive burping, bloating, vomiting, bloody or black stool, prolonged abdominal pain • Most cases are asymptomatic Pathophysiology Helicobacter pylori enters the stomach and begins to burrow into the mucosal lining. Their unique spiral shape and multiple flagella help them penetrate it. Once inside, they produce the enzyme urease which makes the mucosal layer more basic. The alkalinity changes the environment, causing the lining of the stomach to weaken and ulcers can result because it can no longer handle the stomach acid or pepsin produced. Once the bacteria burrows, the immune system cannot stop it or reach it. Diagnostic Process • The patient can come in for a number of tests including: – Breath tests (testing for Urea in the breath which is produced by the bacteria in the stomach) • Patient commonly blows up a balloon or bag – Blood test • Blood is checked for antibodies that stick to H. pylori which would reveal a current infection – Endoscopy • Doctors sends utensil into stomach to retrieve a tissue sample to be cultured in the lab and identified as H. pylori – X-ray of the upper GI tract Treatment • If an infection of Helicobacter pylori is proven then the patient is treated with one or more antibiotics (type depending on culture and what works best) • Treatment usually lasts from a few weeks to long term and may have to be repeated if not successful or if reoccurrence happens • A repeat test is always performed after treatment to test for the absence of H. pylori Treatment cont. • There is not a certain method of prevention due to the fact that there is not a specific determined mode of transmission • If the infection becomes severe enough and causes ulcers, surgery may be necessary to correct the damage Statistics Due to the fact that Helicobacter pylori is not a communicable disease (such as influenza), number of cases could not be specifically found and most people that actually carry it are asymptomatic and are completely unaware. Importance • This is a very important disease to study because there is thought to be a link between Helicobacter pylori infections and a number of other diseases such as gastritis, ulcers, and cancer of the stomach. • If we continue to research and links are made, maybe prevention and treatment would be much easier, or cancer may be possible to avoid. References Carranza, Walli. “Helicobacter Pylori Virulence Factors.” Livestrong.com. 24 Sept. 2010. Web. 29 Oct. 2012. <http://www.livestrong.com/article/257630-helicobacterpylori-virulence-factors> Virulence factors of H. pylori are covered on this website. “H. Pylori.” Wexner Medical Center. Web. 29 Oct. 2012. <http://medicalcenter.osu.edu /patientcare/healthcare_services/digestive_disorders/h_pylori/Pages/index.aspx> This site covers the entire spectrum of the disease. Marshall. “Diagnosis of Helicobacter Pylori.” The Helicobacter Foundation. 2012. Web. 29 Oct. 2012. <http://www.helico.com/?q=Diagnosis %20of%20Helicobacter%20Pylori> This site is about the different tests used to determine an infection. It also includes all other pertinent information like treatment and symptoms. Seibert, Andrew, MD. “H. pylori.” WebMD. 16 June 2012. Web. 29 Oct. 2012. <http://www.webmd.com/digestive-disorders/h-pylori-helicobacter-pylori> WebMD basically has everything you need to know about the infection from symptoms, tests, diagnosis and treatment.