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Helicobacter Pylori (H. Pylori)

Dec 18, 2016 - 0 comments

What are symptoms of H. pylori infection?

The majority of people who are infected with H. pylori are symptom and disease free.

For those who do have symptoms, gastritis and ulcers are the results of an H. pylori infection. These illnesses are characterized by:

    upper abdominal pain;
    loss of appetite;
    nausea and vomiting; and
    if severe enough, bleeding into the gastrointestinal tract.

Abdominal pain is usually described as a burning sensation in the central upper abdomen below the ribs. It may be associated with bloating, burping, and loss of appetite. Often the symptoms occur after eating, and many times patients waken in the early morning hours with abdominal pain.

If there is enough inflammation, bleeding is possible from the stomach lining or from an ulcer, a small crater-like area in which the inflammation has caused the protective lining of the stomach to wear away. Symptoms of bleeding include vomiting blood and passing black, tarry stools. The black stools are a result of blood that has been metabolized and partially digested.

Note: that iron and bismuth subsalicylate (Pepto-Bismol, Pink Bismuth) will also turn the stools black.

What causes H. pylori infection?

While the exact mode of transmission H. pylori is not known, it seems to be spread from person to person by saliva, and most people who are infected become infected as children. It also has the potential to be spread by fecal contamination. This may explain why the rate of infection is so high in poorer countries and in socio-economic groups characterized by crowded living conditions, poor sanitary conditions, and lack of clean water. Personal hygiene is also very important since food preparers who may not perform adequate hand washing may be potential sources of infection.

As mentioned previously, most people who become infected do so in childhood. After being ingested, the bacteria burrow through the protective mucosa that lines the stomach to attach to deeper layers of the stomach, where they can reside for years without causing symptoms.

When should you seek medical care for H. pylori?

It is always appropriate to see your health-care professional for abdominal pain. Symptoms of diseases of many organs in the abdomen can be upper abdominal pain, nausea, and vomiting. For example, gallbladder, liver, pancreas, and kidney ailments may have abdominal pain as the presenting symptom. Upper abdominal pain and nausea may be an atypical presentation of angina, or pain from coronary artery disease.

Vomiting blood or passing black, tarry, or bloody stools are medical emergencies and should not be ignored. Accessing care at an emergency department or by activating the emergency medical system (call 911 if available) is appropriate. Sudden, severe pain is also an indication to seek urgent or emergent care.

Which specialties of doctors treat H. pylori infections?

H. pylori infection may be treated by primary care providers including internists and family medicine specialists. Specialists in gastrointestinal diseases, known as gastroenterologists, often treat patients with H. pylori infection.

What tests diagnose H. pylori?

Testing for the H. pylori infection may be performed on blood, stool, or breath samples. Also, biopsies or small bits of tissue from the lining of the gastrointestinal tract obtained during endoscopy can be tested for the presence of H. pylori.

Usually this testing is done after the diagnosis of gastritis or ulcer is made. Diagnosis depends upon the health care practitioner taking a patient history and asking specific questions. Aside from the infection, there are other, lifestyle-related causes of gastritis and ulcers including smoking, alcohol consumption, and nonsteroidal anti-inflammatory medication use, for example, aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve).

Physical examination will yield more information regarding the diagnosis of abdominal pain. In addition to examining the abdomen, a rectal examination may be performed to test for blood in the stool.

In addition to testing to testing for the presence of the H. pylori bacteria, other blood tests may be performed to screen for anemia (low red blood cell count) and other diseases. A urine sample may be taken to look for infection.

If there is a concern that an ulcer is present, arrangements may be made for a consultation with a gastroenterologist and possible endoscopy, in which the gastroenterologist uses a thin tube containing a camera to examine the lining of the esophagus, stomach, and duodenum.

Alternatively, an upper GI series may be performed to look for an ulcer. In this test, X-rays of the abdomen are taken after the patient swallows barium or another type of contrast material. If a gastric ulcer is found, endoscopy is usually recommended, since some ulcers have the potential to become cancerous. Ulcers in the duodenum typically do not have this potential.

What medications treat H. pylori infection?

The therapy for Helicobacter pylori infection involves multiple steps. In addition to antibiotics to eradicate the bacteria, another goal is to decrease the amount of acid secretion in the stomach and remove risk factors for further stomach irritation.
Antibiotic therapy

A two week course of combination antibiotic therapy is recommended.

    clarithromycin (Biaxin)
    metronidazole (Flagyl)
    tetracycline (Achromycin)

Antacid therapy

Proton pump inhibitors and H2 blocker medications decrease acid secretion in the stomach and are often prescribed for a minimum of two weeks.

    Proton pump inhibitors
        lansoprazole (Prevacid)
        omeprazole (Prilosec)
    H2 blocker
        ranitidine (Zantac)
        famotidine (Pepcid)

Bismuth therapy with Pepto- Bismol is sometimes recommended, especially if the first round of antibiotic therapy failed. Please remember that this treatment will cause stools to turn black.
Lifestyle changes

    Avoid alcohol
    Take aspirin, ibuprofen (Motrin, Advil), naproxen (Aleve) only with approval of your health-care professional
    Stop smoking

Can H. pylori infection be prevented?

Personal hygiene is the first step in decreasing human to human transmission. This is especially important for those involved in food preparation, either in the home or in public places. Vaccines to prevent the infection are being developed but are still in the research phase and not available for human use.

Helicobacter pylori is a worldwide epidemic, and the bacteria have infected humans for thousands of years. It is seen more frequently in populations afflicted with poverty and lack of access to clean water and sewage removal. Increasing basic living standards and providing clean water should decrease the potential for infection.

The diagnosis of Helicobacter pylori infection usually follows the diagnosis of gastritis or ulcer disease. With adequate antibiotic therapy, the bacteria should be eradicated and the risk of future complications decreased. While the infection may be gone, it is important to continue behavioral modification to prevent stomach inflammation from non-infectious causes.

Update on Auntie

Sep 27, 2011 - 5 comments

Here we are a week after Auntie's hip fracture/replacement surgery, and we finally got her moved into a rehab center today, after thinking she'd be taken daily since last Friday.  I couldn't get anyone to even tell me why she wasn't being moved until yesterday; I finally found a nurse "willing to talk" -- yes, I am Auntie's health care surrogate AND her POA, but for some reason, they thought I "didn't need to know".

Anyway, this wonderful nurse finally told me that the reason Auntie had not been transferred was because they'd noticed that every morning, when they took her blood pressure, it was sky high (something like 180-210/90-110), and they had to keep her until she was stabilized.  They gave her a new blood pressure med last night, in addition to the 2 bp meds she takes in the morning to see if that would help.

Of course, they change nurses, like we all change underwear, so you never get to talk to the same one twice, unless the conversations can take place within no more than an hour of each other.  The nurse I talked to this morning said that, again this morning, Auntie's bp was 200/100, so once more, her transfer goes up for grabs.  They had it scheduled for 1:00 this afternoon, "just in case", but it hinged on the bp reading, just prior to the move.  

The nurse promised that she'd call to let me know when/if the transfer took place, so I'd know whether to go visit Auntie at the hospital or the rehab center, when I got off work.  1:00 came and went and no phone call, so I figured the transfer got scrapped; but lo and behold --- she called me about 1:30 and said Auntie's bp had come down nicely (it always has after her morning med) and she had been transferred.  

After work, I came home and picked up hubby and we went to visit Auntie, take her some clothes, etc and help get her settled in.  Just as I was getting ready to take care of the paperwork for her admission, a physical therapist came to Auntie's room to introduce herself and maybe get started with an assessment.  I was talking with nurses, when the physical therapist went into the room, so my husband brought her out to me, because he felt like I needed to be there when she did her assessment (good job, hubby).  I told her I had to get the "important" (aka financial) stuff done, but would be right back; she was good with that; said she'd come back in a few minutes, which gave me time to do what I needed to do.

We met up a short time later in the hallway and went together to Auntie's room. I have to say -- this little gal is the most refreshing thing I've run across all week. Auntie is one of the most incredibly stubborn people I've ever run across (her whole family agrees that she got "mega doses" of the stubbornness), so my husband and I explained some "facts" to the PT and by the time this "assessment" was over, Auntie had actually sat up (which she'd been determined not to do);  gotten to the side of the bed (which she'd been determined not to do); stood up (which she'd been determined not to do); took a step (which she'd been determined not to do), then had to stand up again (which she'd been determined not to do).  I think it will be a race to see who's the most tenacious....... Auntie or the PT....... Right now, I'm not going to speculate, because I think they will give each other a good run for their money.

At any rate, Auntie is now installed in rehab and I thank God that we found a nice place, just down the road from our house, so it's close and easy to get to. That means I, or my husband, can bop in for a few minutes "whenever"...... without having to carve out huge amounts of time for travel.  

This is one more hurdle we've gotten over; we know there are a lot more to go, for now, Auntie is safe and I know she will be in the same place for a while, so I won't be on pins and needles waiting for her to be moved, wondering if the information will be relayed to me, etc.  From here on out, we take each hurdle, in its own time.  I'm hoping that I will sleep peacefully, again, for at least a while - until it's time to jump the next hurdle....  

As hard as the past 3 months have been, I'm SO thankful that we had Auntie here with us when she "tumbled", so we could get her into a hospital and rehab center that are close by, rather than having to drive the hour and 1/2 to get to the facilities in her own area.  

One day at a time......

To all my friends (and foes)

Sep 20, 2011 - 18 comments

This journal is written to all my friends (and foes) on MH, to let you know what's been going on.  Many of you know that I've been caring for my elderly aunt for some time now, with the past few months, having her in my home, with my husband and I sharing the care according to our work schedules/abilities to deal with her.

Anyway, last night I'd gone to bed fairly early, since I get up at 3:30 am...... about 9:30, hubby woke me up to tell me that Auntie had fallen.... This has been my worst fear for months.... I jumped out of bed and sped to Auntie's room, only to find her lying on the floor beside a small pool of blood..  there's a cut on the back of her head, that has already stopped bleeding; however, we called 911 anyway, just to be sure. The paramedics came, looked, thought it might not be bad, but as always suggested that it be checked out in case there was more damage than was visible.  We had them take her to the nearest hospital......

4 hrs, multiple tests (including a brain CT), later, the doctor told us that there's nothing to worry about and we can bring her home.  Super, we're good to go.  We got home about 1:30 this morning and I put Auntie to bed, then my husband and I went to bed.  

I had decided to take today off work, in spite of the fact that my husband was off today, because I didn't want him to have to deal with Auntie alone under these circumstances....not to mention the fact that since I'd gotten up at 3:15 am yesterday and didn't get to bed until 1:30 this morning, there was no way I could get up again at 3:15 today and go to work........ even super people have to sleep sometimes and there's nothing "super" about me....

Anyway, I got up this morning about 6:00, fed the dogs and put them out, went online for a bit, then went to get Auntie up at 7:00 to give her breakfast and her morning meds.  I knocked on her bedroom door, opened it enough to see that she was awake, asked if she could get up by herself, etc. She said she felt good and I watched her starting to get out of bed, looked like she was doing well, so I went off to prepare her meds and breakfast, just like we've been doing for the past 3 months.... About the time, I got to the other end of the house to get her meds, I heard a "thud" and muted yell.........

My heart sank and I took off for Auntie's room, only to find her on the floor (again).  We tried to get her up, but her left hip was causing issues.  LEAVE IT ALONE....... Again, within 12 hrs, paramedics are called........ got some of the same nice guys we had last night..  All said and done, Auntie is in the hospital with a fractured hip (and maybe broken arm).  

My husband and I have spent the majority of the past 24 hrs (2 trips) at the hospital. which is much worse than putting in a full day's work because there's so much waiting, but you're afraid to leave in case doctor comes in or something... it's exhausting...

Last we heard, Auntie is to have a pin put into her hip, either tomorrow or Thurs.......more time to spend at the hospital......  

I think I'm going to go to work in the morning -  I start at 5:30 and nothing at the hospital is to begin before that; they can call me and I will come at the drop of a hat......

Some of you also know that my retirement is only a couple weeks away, so I've been using my sick leave for days off, in order not to lose it, and to spend more time caring for Auntie .... now, I only have 1.5 days left...  20/20 hindsight says I should have kept some for emergencies, but when you get this close, you don't want to lose it either..  That's really just a minor irritant, simple because our human resources "scum hopper" was such an *** about this last year when Auntie was dx'd with breast cancer and I wanted to take time without pay to deal with her treatment - when I could have afforded it.

At any rate....... I wanted to let my friends/foes know what's going on since I  haven't been online much.  Plus, I wanted to tell everyone that has sent me PM's/notes, looking for comments on your posts....... I'm not ignoring you; I hope you understand that I will try to respond to PM's/posts as I can.......

This is a difficult time for me, but I know that with your support and that of my husband and family, it will all be okay.

Thanks to all.........

To All of my Friends........

Jun 10, 2010 - 17 comments

Well, some of you know now, that I've got some really tough things going on in my life -- my dear aunt, who I journaled about at the beginning of the year, is back to # 1 position in my life right now - not that she ever left it, because for the past 6 months, I've spent a good share of my "free" time (what's that?) dealing with her issues.

Well, just to bring you all up to date -- I took her to see her pcp on Sat and while there, she nonchalantly informed us that she "has a 'lump' for the doctor to look at.........let me tell you, this is no "lump".  After the doctor discovered it and made me aware of it, the ball began rolling and all I could do was jump on and bounce with it.

Monday, I tried all day to get an appt for mammo and u/s, with no luck.  I went to work on Tues, only to have to leave and make a flying trip to Auntie's (hour and 1/2 from me) in order to get her to the imaging place to fulfill "stat" orders (still haven't figured out what happened to these orders on Monday, since they were faxed on Sat)...........spent all day Wed trying to get results; finally got them last night about 7:00, but before that, I'd been informed that I had to have Auntie back to the imaging place today for biopsy --I do have a job that I'm supposed to be at 5 days/week for 8 hrs/day......well, so much for that, because I'm getting pretty "hit and miss" for work these days!!

Anyway, it's been confirmed that my darling has breast cancer; I took her for biopsy today, which according to the doctor will tell us what type of cancer we are dealing with.  

I'm absolutely terrified with all of this.  My dad (Auntie's brother) died from prostate cancer; another of her brothers died from lung cancer; this doesn't look well to me, but this is one time, I'd love to be proven wrong.........

Over the coming days/weeks, we will be sent to other doctors, etc and I'm assuming that eventually a treatment plan will be devised.  

My point here now, is to express my heartfelt appreciation for my friends here on MH...........what would I do without you all??

This shows me how we can all come together for the good of another person, whether we agree with them in all aspects or not................none of you will ever know how much I appreciate the fact that you "circled the wagons" in my behalf - someone you've never met, but still care for.............

My older sister taught me years ago that when someone does/gives something really nice for/to you, that you don't expect, you should "say thank you and accept it gracefully".  

Thank you.

(hugs) to all