Helibacter pylori
Helicobacter pylori is a Gram-negative microaerophilic bacterium found for the first time in the stomach. Not surprisingly, more than half of the world's population is home to Helicobacter pylori in the upper gastrointestinal tract.
Electronic photography of Helibacter pylori
This bacterium was identified for the first time in 1982 by Australian doctors Barry Marshall and Robin Warren (who won the Nobel prize in medicine for this), analyzing the gastric mucosa of patients suffering from chronic gastritis and gastric ulcer, diseases that up to then it was not imagined they could have a microbial origin
Helicobacter pylori has also been attributed a role in the development of duodenal ulcer and some cases of stomach cancer. However, more than 80% of infected people are completely asymptomatic. H.pylori infection is greater in developing countries and is instead declining in developed (western) countries.
The morphology of Helicobacter pylori resembles a curved stick on itself, and therefore appears helical (hence the name Helicobacter); it is thought that the bacterium penetrates the mucosa that covers the stomach causing lesions that lead to ulceration of the mucosa, consequently the ulcer.
Diagnosis
The diagnosis of Helicobacter pylori infection is placed in different ways, but the typical dyspeptic symptoms caused by the bacterium are usually sought. Tests to diagnose H.pylori are divided into invasive and non-invasive. Non-invasive tests are the Breath Urea Test, the "breath test" and the bacterium antigen research test in the faeces, while invasive tests require endoscopic examination and the collection of biological samples.
The most reliable test to diagnose the presence of Helicobacter pylori is precisely the endoscopic one, which requires the collection of gastric biological material, which is then analyzed in microbial culture. In some cases, the patient's urine ELISA test can also be used; this test offers good accuracy with a sensitivity of around 95%.
Eradication Therapy
Different therapeutic approaches are used to eradicate Helicobacter pylori but those that are more successful are triple therapy and sequential therapy .
Sequential therapy is nothing more than a dual therapy with amoxicillin and a proton pump inhibitor (IPP, eg omeprazole) for 5 days, followed by a triple therapy for the other 5 days.
The triple therapy is used in all cases of H.pylori infection according to various combinations, used in different cases. The most frequent combinations are:
- amoxicillin 2000 mg / day + clarithromycin 1000 mg / day + IPP (eg omeprazole) standard dose;
- or clarithromycin 500 mg / day + metronidazole 1000 mg / day + IPP standard dose;
- or tetracycline 2000 mg / day + metronidazole 1500 mg / day + bismuth subcitrate 480 mg / day + IPP standard dose.
