Helicobacter pylori (H. pylori) is a spiral-shaped, Gram-negative bacterium that possesses a unique ability to survive in the acidic environment of the stomach. It uses flagella for motility and secretes the enzyme urease, which breaks down urea into ammonia, thereby neutralizing the acid around the bacterium. Due to these characteristics, H. pylori can colonize the human stomach lining. The bacterium is prevalent worldwide, with particularly high incidence rates observed in developing countries.
Modes of Transmission
H. pylori is most commonly transmitted through oral-oral or fecal-oral routes. Infection can be transmitted through contaminated food, water, or close contact with an infected person. Poor hygiene conditions, overcrowded living spaces, and the use of shared dishes or utensils increase the risk. The incidence of infection is higher in childhood, but infection can occur at any age.
Pathogenesis and Impact on the Body
Upon entering the stomach, H. pylori damages the mucosa, causing local inflammation. The immune system reacts to the infection, but complete eradication of the bacterium is often not achieved. Over time, chronic gastritis can develop, and prolonged infection increases the risk of gastric and duodenal mucosal damage and cancer.
Associated Diseases
H. pylori is a major risk factor for chronic gastritis and peptic ulcers of the stomach and duodenum. This bacterium is also associated with gastric adenocarcinoma and MALT lymphoma. Not all infected individuals develop diseases, but the presence of the bacterium significantly increases the risk of these pathologies.
Symptoms and Clinical Signs
Common symptoms include abdominal pain, discomfort, nausea, bloating, heartburn, and loss of appetite. Some people experience no symptoms – the infection can be asymptomatic. In cases of complications, gastrointestinal bleeding, weight loss, or anemia may occur.
Diagnostic Methods
Non-invasive tests are used to diagnose H. pylori infection: serological blood tests, breath (urease) test, and stool antigen test. When indicated, endoscopy and gastric mucosal biopsy are performed, allowing direct identification of the bacterium and evaluation of the mucosal condition. Different tests have varying sensitivity and specificity.
Treatment Principles
Treatment involves a combination therapy of several antibiotics, usually together with proton pump inhibitors, which reduce stomach acidity and improve treatment effectiveness. The course of treatment typically lasts 10–14 days. A follow-up test is recommended after treatment to assess effectiveness.
Antibiotic Resistance
H. pylori strains resistant to certain antibiotics, especially clarithromycin and metronidazole, are becoming increasingly common. Resistance develops due to irrational use of antibiotics and incomplete treatment courses. Responsible use of medicines and adherence to treatment regimens are important for prevention. Alternative treatment methods are being investigated, but are only widely applied in cases of resistance.
Prevention and Prophylaxis
The main preventive measures include thorough hand hygiene, consumption of safe food and water, and use of personal utensils. Public health measures that improve sanitation and education about infection transmission routes are also important. Early diagnosis and treatment also help reduce the prevalence of infection.
Epidemiology in Lithuania
In Lithuania, H. pylori infection is more commonly diagnosed in older people, but children can also be infected. Epidemiological studies show that the prevalence of this bacterium is decreasing nationwide, but it remains higher than in some Western European countries. Significant attention is paid to monitoring and prevention in risk groups.
Quality of Life and Psychological Consequences
Chronic H. pylori infection can lead to long-term abdominal pain and discomfort, poor sleep quality, and reduced work capacity. Persistent symptoms cause anxiety, stress, and sometimes depression. Chronic illness can reduce social activity and quality of life.
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