Gastroenterology

Helicobacter pylori infection. Diagnosis of Helicobacter pylori

Written by med

Helicobacter pylori (Helicobacter pylori) and ulcers. Now in the minds of doctors and patients are almost synonyms. However, it was not always so.
The content of the article

  • The history of Helicobacter pylori
  • What are the implications of H. pylori infection?
  • How Helicobacter pylori can harm humans?
  • Diagnosis of Helicobacter pylori
  • Sampling and analysis of biopsy material
  • A blood test for Helicobacter pylori
  • Breath test for Helicobacter pylori
  • Related video: “H.pylori infection”

The history of Helicobacter pylori

Helicobacter Helicobacter on pilliteri became known in the 19th century, when this spiral bacterium found in the stomach of dogs. In the early twentieth century researchers a thought about the relationship of this bacterium with pathology of the gastrointestinal tract. In 1913, the Danish scientist Dzh. Fibiger possible to obtain in experiment stomach cancer in mice when introduction them with food of the organism, which he called “cancerous pallidum”. For these works Fibiger was awarded the Nobel prize.

In those years there have been many papers and studies by scientists from different countries, in which it was revealed the presence of “spirochetes” in the stomach, pathological wreathofpalmaria selected strains. However, only at the end of the twentieth century, two scientists, Robin Warren and Barry Marshall have been proven relationship “spirochaetes” with gastritis and gastric ulcer and duodenal ulcer. They proved that this microorganism, named them helicobacteria piloris, is present in all patients with duodenal ulcer and with gastric ulcer. Sowing the biological material with the mucosa of such patients and grow a colony of microorganisms, Barry Marshall infected himself himself of this bacteria to prove its leading role in the development of antral gastritis which is due to samsarajade and sick.

I must say that the 70 years of the twentieth century dramatically increased the incidence of people of different ages peptic ulcer disease, not all cases could be explained by the increased acidity. Revolutionary in gastroenterology opening R. Warren and B. Marshall made him look at the problem of ulcerogenesis (ulceration) with a new point of view, and most importantly, to develop new and effective principles of therapy of this disease. For this discovery, scientists in 2005 received the Nobel prize, and doctors of all countries have become much better to fight against peptic ulcer disease. The principle of eradication (destruction) of the infection has allowed to reduce the time of cicatrization of gastric and duodenal ulcers, to reduce the percentage of bleeding from ulcers, to stop them retidivirovania.

There is another, very important aspect: Helicobacter pylori infection is recognized as the medical experts to be carcinogenic, i.e., cancer-causing of course the stomach. Usually from the moment of infection (usually in childhood) to development of severe complications are years, decades. Cancer does not occur immediately, but through a chain of “serious diseases”.

What are the implications of H. pylori infection?

Helicobacter pylori under electronic microscoping the first place, chronic gastritis, which may have clinical manifestations, and may not have to develop secretly for many years. Subsequently, some of these people to have peptic ulcer disease, part of the lymphoma (tumor) of the stomach or atrophic gastritis with low acidity already, but he opens the way for cancer. According to statistics, approximately 8% of people with atrophic gastritis occur malignant change of the mucosa of the stomach. Russia belongs to the countries with high levels of infection with helicobacteria, about 80%, so that the issues of therapy of Helicobacter-associated diseases and prevention of serious complications for us very important.

Helicobacter pylori is cause of chronic gastritis, gastric ulcer and duodenal ulcer.

How Helicobacter pylori can harm humans?

As Helicobacter pylori damages jeludockam from that of the strains (raznovidnostei) helicobacteria a lot, not all of them harmful, pathogenic. Threat those that secrete the enzyme urease. Urease by the bacterium protects itself from hydrochloric acid and damage the lining of the stomach. Due to the high motility and spiral shape it penetrates the mucosa and multiplies. Colony helicobacteria excrete their waste products and specific toxins that cause chronic inflammation of the stomach or duodenum, inhibit the reparation (recovery) of cells, alter the secretion. With long-term inflammation of the inevitable atrophy of the gastric mucosa.

Diagnosis of Helicobacter pylori

On current medical and therapeutic standards for all patients with peptic ulcer disease should be performed for identification of H. pylori infection. There are several solutions.

Sampling and analysis of biopsy material

When gastrofibroscopy is the fence pieces of the mucous membrane, which were studied morphologically and the presence of helicobacteria:

Rapid urease test of biopsy material.
Right in the endoscopy room a piece of mucosa was placed in a medium with urea and an indicator. If helicobacteria it is present, it begins with urease to break down urea, is changing the acidity of the environment within a few hours the indicator changes color and the test is considered positive. Simple, cheap and at the same time, a very informative method, but it is possible and false positive results.

Microscopy.
Pieces of mucosa immediately after taking a look under the microscope. If bacteria in the stomach a lot, you can see them, so to speak, alive. This approximate method, it does not work with a small number of bacteria to determine the strain (species). Often the material is first fixed, stained, and then studied. It increases the information content of the method.

The seeding material on the mucosa culture medium.
Performed medical laboratory and requires special facilities and expensive equipment. Helicobacter grows only in malacolite environment, rich in nitrogen. It takes time – 3 to 7 days. This is the only method that gives 100% correct result, and in addition, will help to determine what antibiotic sensitive bacteria.

Immunohistochemistry.
Pieces of mucous record and process highly specific to pathogenic Helicobacter antibody, allowing you to see it. Allows you to detect the bacteria even with their small numbers, to decide controversies of diagnosis.

Polymerase chain reaction.
PCR-diagnostics allows not only to detect the DNA (genetic material) of Helicobacter in the biopsy, feces, saliva, but also to distinguish pathogenic strains from less harmful.

A blood test for Helicobacter pylori

The biopsy, we can determine antibodies to Helicobacter in the blood. They appear about a month after infection and can be detected. But after the treatment the antibodies remain positive for a long time (up to years), so for control of eradication (treatment) this method is not used. This method is also approximate, possible errors in diagnosis.

Breath test for Helicobacter pylori

There are still respiratory urease test. During this test, the patient (fasting, not Smoking, not taking alcohol, antibiotics, antisecretory drugs) breathing into a special tube. First, he take a sample of the exhaled air, then allowed to drink urea solution with labeled carbon. After 15 minutes and again allowed to breathe into a tube. Helicobacteria breaks down the urea and the labeled carbon is emitted light with the breath, and test system fixes its concentration. Simple for the patient, but costly. In Europe, respiratory urease test is often used to monitor therapy i.e., destroyed the bacterium within the patient, or to continue treatment.

As you can see, methods of diagnosis of Helicobacter pylori quite a lot. Which method to choose is decided by the doctor depending on patient characteristics, diseases, the purpose of the study (primary or control treatment) and the technical possibilities of the hospital. Not always revealed helicobacteria definitely should be treated. It occurs in healthy people who are carriers of this bacterium, but is not sensitive to her, and she can’t cause disease of the gastrointestinal tract. But if a person suffers from symptomatic gastritis, peptic ulcer disease, or close relatives, there are cases of malignant tumors of the stomach, intestine, in this case, the eradication therapy is necessary.

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