Little Known Facts about Helicobacter Pylori

By Marina Gafanovich, MD

Helicobacter pylori, commonly known as H. pylori, is a gram-negative microaerophilic bacterium that is found in the stomach. It is helix-shaped and approximately 3 micrometers long with a diameter of 0.5 micrometers. This particular bacterium was identified in 1982 by two Australian scientists, Barry Marshall and Robin Warren. Further research by a British scientist Stewart Goodwin revealed that H. pylori was present in patients with chronic gastritis and gastric ulcers and was also associated with the development of duodenal ulcers and stomach cancer.

H. pylori is classified as a eubacteria because it has no nuclear membrane and no organelles. The genetic material of H. pylori is found within a single strand of circular chromosome. It is also a unicellular microorganism that lacks a nucleus.

It might be hard to believe but approximately 50% of the world’s population harbors H. Pylori in the upper gastrointestinal tract but a majority of those infected by the bacterium are asymptomatic. It is also believed that H. pylori may actually play a critical role in the natural stomach ecology.

An interesting fact about H. pylori is that it was cultured by accident. Warren and Marshall accidently left some culture plates over the Easter holiday and returned to find colonies had emerged. All the more interesting is the fact that Marshall inoculated himself with H. Pylori to prove it would cause ulcers. He developed gastritis. According to the International Agency for Research into Cancer, H. Pylori is a Class-I-Carcinogen. It is thus in the same class as cigarette smoke.

H. pylori is transmitted from host to host through a fecal-oral route. It is more commonly found in third world countries because of low health and hygiene standards. It is usually passed through contaminated food or water as well as through an oral-oral route. The bacterium can be transmitted from food that has not been washed well or cooked properly as well as water that has come from an unclean source. Contact with stool or vomit of an infected person can also spread the infection as can direct contact with the saliva of some infected people.

It was initially thought that peptic ulcers are caused by stress or spicy foods but it was then discovered that nine out of ten peptic ulcers are caused by H. pylori. There is still a need to create awareness about the association between H. Pylori and peptic ulcer disease. The Centers for Disease Control and Prevention is actively working to provide healthcare providers and consumers more information about this fact. Their goal is to improve diagnosis and treatment of peptic ulcer and to decrease overall costs and patient health.

Data shows that one out of ten Americans suffers from peptic ulcer during their lifetime. Nearly 1 million hospitalizations and 6500 deaths per year occur due to ulcers. It is estimated that the annual cost of peptic ulcer disease in the United States is approximately $6 billion. This includes $3 billion in hospitalization, $2 billion in physician office visits and $1 billion in decreased productivity and days lost from work.

Marina Gafanovich M.D., an internist in New York City, advises that H. pylori infections are generally treated with a tri-microbial regimen that includes bismuth subsalicyclate, tetracycline and metronidazole. This combination of drugs is known to be effective in nearly 90% of patients. While these antibiotics will cure the infection, there is also a possibility that the patient develops a bacterial resistance to the drugs. This can be prevented through restrictive use of the drugs. H. Pylori infections can be treated quickly at a cost tha is less than one-tenth of the amount that would be needed to treat ulcer symptoms over a lifetime. Antibiotics are considered to be the most effective treatment for infections caused by H. pylori. 80% of patients are cured with a two-week regimen of antibiotics and the ulcer does not recur in these patients.