There are many people who suffer and have suffered from recurring ulcers. In the past the only available treatment was acid reducing treatment and patients often had to take these for many years. At that time, the medical profession never associated ulcers with bacteria, as the acid environment of the stomach did not provide a comfortable environment for bacteria. Then in 1994 scientists discovered that there was one bacterium that could survive and thrive not just in the human stomach but also in the stomach of any warm blooded animal. The name of this organism is Helicobacter pylori commonly referred to as H pylori.
H pylori can invade the stomach because nature has equipped it with protection against stomach acids. This organism can produce urease in very large quantities. Urease is an enzyme capable of generating ammonia. The ammonia produced by this enzyme neutralizes the acids produced by the stomach. So H pylori encloses itself in ammonia formed walls and then penetrates the mucous layer protecting the stomach from gastric acids. Once embedded into the protective layer, it thins it out and poisons the nearby cells with various toxins including ammonia. H pylori infection is more common in the elderly and low income people. It occurs far more frequently in developing countries than in the United States.
Doctors use three methods to diagnose H pylori infections. One is a blood test. The test will measure the antibodies against the bacterium that are present in your blood. Another test requires you to swallow a substance that is broken down from the urease produced by H pylori. Your blood will absorb this substance and when you exhale it will be detected by testing your breath. The test that is slightly more accurate involves an endoscopy. Here a sample is removed from the stomach lining and viewed through a microscope. When the urease produced by H pylori is found and the bacterium is visible the diagnosis is certain.
Ulcers due to an infection by H pylori can be and are treated by antibiotics. Several medications have to be used together. The combination heals the ulcer and significantly reduces the chance that the infection will recur. There are three treatments commonly used to treat H pylori infections. Two involve the use of the antibiotics clarithromycin with metronidazole or clarithromycin with amoxicillin. In one the chosen antibiotic combination is paired with a proton pump inhibitor. The second involves the use of the chosen antibiotics with a pill combined of ranitidine and bismuth citrate instead of the proton pump inhibitor. Neither treatment has significant side effects however the treatment using the proton pump inhibitor is more expensive.
The third treatment is the least expensive but does have side effects such as diarrhea, nausea and vomiting and one has to take the medications more often. Again, two antibiotics are prescribed. Metronidazole is combined with either amoxicilin or tetracycline. One of the pairs is given with bismuth citrate and an H2 blocker. There are also regimens available that use only two kinds of medications but they have not been found to be as effective as those using three types of medicines.
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