Helicobacter Pylori – Controversy and Consensus

Helicobacter Pylori – Controversy and Consensus

Helicobacter pylori is a common bacterial infection among humans. Some studies show it infects the stomach lining of over 60% of the world’s population, and in some areas up to 90% of the population. Up until 1982, most scientists clearly saw a relationship between stomach ulcers and stress. Then it was suggested that maybe the ulcer was the result of a bacterial infection. Since then we have found that over 80% of people suffering from duodenal ulcers are infected by H. pylori, as well as 70% of people with gastric ulcers.

We also know that these bacterial infections are:

  • more prevalent in poverty stricken societies
  • commonly infect both adults and children
  • more prevalent in people with low stomach acid
  • there are many different variants of the bacteria, almost uniquely so to each individual
  • found to be associated with a thinning of the stomach lining
    • which is a precursor to some types of duodenal and stomach cancers

Diagnosis is usually made by a breath test, which measures carbon dioxide and urea metabolites, that are produced by the bacteria in the stomach. Treatment is typically an aggressive triple or even quadruple antibiotic strain course, which has showed results of around 70% success in eradicating the infection.

Controversies

However, not all scientists are convinced that H. pylori is the cause of gastric disease. They point out that:

  • Over 60% of the population that tests positive for H. pylori have no gastric problems
  • The incidence of stomach cancers is much higher in developed countries even though they have significantly lower levels of H. pylori than underdeveloped countries
  • While it is believed that H. pylori overgrows in response to high stomach acid levels, in reality most gastric problems, including chronic symptomatic H. pylori infections are associated with low stomach acid (hypochlorhydria)
  • H. pylori bacteria secrete the enzymes oxydase, catalase and urease – all of which are beneficial to stomach function.
    • Oxydase is an enzyme that leads to production of hydrogen peroxide – used widely by the body to break down unwanted cells
    • Catalase modulates the breakdown of hydrogen peroxide
    • Urease is used to determine the rate of breakdown of  proteins into digestible amino acids.

So the production of these enzymes may be a reaction by the bacteria to improve poor protein breakdown – especially as the stomach’s own acid production becomes poorer. It is interesting to note that acid production decreases significantly after the age of 50, which coincides with the increase in symptomatic gastric illnesses.

Other observations include:

  • The prevalence of H. pylori in gastric cancer patients is higher in women and black people, suggesting that factors other than simply being infected are at play
  • Antibiotic treatment of H. pylori causes an increase in symptoms of Gastroesophageal reflux disease (GERD) and other chronic debilitating gastric and oesophageal illnesses
  • Observable associations of H. pylori with other conditions such as migraine, PMS, chronic fatigue, autoimmune disease and osteoporosis does not in any way mean that H. pylori causes them
  • Even after treatment, there is a tendency to recur, given contact with other people who are carriers

Furthermore, the widespread overuse of antibiotics in the treatment of this disorder has led to:

  • rapidly adapting resistance of H. pylori to treatment
  • a general increase in bacterial resistance to antibiotics
  • Substantially higher risk of disruption and damage to beneficial intestinal bacterial colonies (i.e. damage to friendly bacteria)

Also, diets high in trans fats have been shown to provide H. pylori with resources to adapt and become more resistant to antibiotic therapy, which suggests that dietary modification may play a significant role in influencing gastric recovery.

So what can we say about Heliobacter pylori?

  • It has been around for a very long time
  • The way we get infected is not known
  • It exists across all ethnic, age, sex and economic boundaries
  • It is associated with poor gastric function (not necessarily the cause of it)
  • It usually exists without any ill effects in the majority of people who carry it
  • It is hard to eradicate permanently

 

In the next instalment we will explore how to manage stomach problems naturally. Stay tuned!

 

 

 

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