H Pylori: how do you manage it?

Kenyans are alarmed by an increasing number of patients diagnosed by a now common condition known as Helicobacter pylori (H. pylori). The infection, caused by a bacteria, infects your stomach.

Experts do not know exactly how H. pylori spreads but the following may increase your risk for developing H. pylori infection:

—Eating food that is not properly cleaned or well cooked. —Drinking unclean water. —Contact with fecal matter, vomit, or saliva that is infected with H. pylori.

How do I know I have H. pylori?

Most people with H. pylori infection will never have any signs or symptoms, but some people may be born with resistance to the harmful effects of H. pylori. Signs or symptoms may include: —Nausea —Abdominal pain that’s worse when your stomach is empty —Unintentional weight loss —Loss of appetite —Bloating —Frequent burping

Seek medical attention if you have severe or persistent abdominal pain, difficulty swallowing, bloody or black tarry stools and bloody or black vomit or vomit that looks like coffee grounds.

Different tests and procedures will be done to determine whether one has the infection. These tests include; blood test, stool test, breath test and scope test.

A blood test may reveal evidence of an active or previous H. pylori infection in one’s body.

In a stool test, a laboratory test called a stool antigen test looks for foreign proteins (antigens) associated with H. pylori infection.

For the breath test, one swallows a pill, liquid or pudding that contains tagged carbon molecules. If you have H. pylori infection, carbon is released when the solution is broken down in your stomach.

Finally, for the scope test, one is sedated. This is known as the upper endoscopy exam. During the exam, the doctor puts a long flexible tube equipped with a tiny camera (endoscope) down the patient’s throat, oesophagus and into his/her stomach and duodenum.

This instrument allows the doctor to view any irregularities in the patient’s upper digestive tract and remove tissue samples (biopsy).

Complications of H. Pylori

Complications include; ulcers, inflammation of the stomach lining(gastritis) and stomach cancer. For the ulcers, H. pylori can damage the protective lining of your stomach and small intestine. This can allow the stomach acid to create an open sore known as an ulcer.

H. pylori can cause irritation in the stomach causing inflammation known as gastritis. It is also a strong risk factor for certain types of stomach cancer.

H. pylori infections are usually treated with at least two different antibiotics at once, to help prevent the bacteria from developing a resistance to one particular antibiotic. The doctor may also prescribe or recommend an acid-suppressing drug, to help the stomach lining heal.

The doctor may recommend that you undergo testing for H. pylori at least four weeks after treatment. If the tests show the treatment was unsuccessful, you may undergo another round of treatment with a different combination of antibiotic medications.

For many people infected with H. pylori, their infections never cause any complications. If one is experiencing symptoms and receives treatment, your long-term outlook is generally positive. At least four weeks after finishing your treatment, the doctor will check to make sure it worked.

Depending on the one’s age and other medical issues, the doctor may use a urea or stool test to check whether the treatment worked.

How do I protect myself from getting H. pylori?

One can protect yourself from getting H. pylori infection, take the same steps one takes to keep other germs at bay.

These steps include washing hands after using the bathroom and before preparing meals or eating meals, avoiding food or water which is not clean, avoiding eating foods that are not cooked thoroughly and avoiding foods served by people who have not washed their hands.

Can I drink alcohol with H. pylori drugs?

A list of foods to avoid when treating H pylori would not be complete without mentioning alcohol. Alcohol is an irritant to the digestive system and on its own is associated with stomach ulcers and cancer. It also interacts in a bad way with antibiotics.

It is therefore recommend you completely avoid alcohol when treating your H pylori infection.

What if I miss taking my drugs for two days?

It is really important to take everything that your doctor prescribes and to follow dosage instructions.

However, if you don’t take antibiotics the right way or skip dosage, the H. pylori bacteria in your body can become resistant to drugs, which makes infections harder to treat.

Dr Mwai is a consultant family physician, Aga Khan University Hospital, Nairobi