Division of Gastroenterology
Stomach Cancer, Gastric Adeoma, Benign Stomach Tumor, Endoscopic Therapy, Gastrointestinal Diseases, Esophageal Diseases
It is believed that most bacteria cannot survive inside the stomach because the highly acidic gastric acid kills them when they enter the stomach. However, Helicobacter pylori can survive between the gastric mucous membrane and the mucus, and is considered to be one of the major causes of stomach cancer.
The size of the bacteria is about 1/300 mm and it has a curved shape. Unlike other bacteria, Helicobacter pylori has the unique ability to protect itself in a strongly acidic environment. As it has a lot of urease, it can survive inside highly acidic conditions such as the stomach. More than half of the world's population is infected with Helicobacter pylori, making it is one of the most common bacterial infections in humans.
Person-to-person transmission through the feces, saliva, or vomitus is the most common transmission route. Infection rates are high among the poor, living in cramped and crowded spaces. The infection rate is low in developed countries, but high in the developing and underdeveloped countries. In South Korea, it is so widespread that almost two-thirds of the adult population is infected by it. The infection rate increases among people in their twenties, is highest among people in their forties (79.8%), and decreases somewhat in the elderly. It is expected that the infection rate in South Korea will decrease to a level similar to that of developed countries within the next several decades.
There are two types of investigations that detect the presence of H. pylori. One type is the invasive method which requires endoscopy. The other type is non-invasive and does not require endoscopy. Invasive methods include biopsies, culture tests, and urease tests while non-invasive methods consist of serological tests and urea breath tests. These methods have various advantages and disadvantages, so different investigations are used depending on the test purpose, the disease(s)state of the patient, and the specific clinical situation in question.
Nowadays, many people see the doctor to check whether they are infected with Helicobacter pylori. If infected, they are treated to prevent stomach cancer. It is a fact that stomach cancer is seen more often in countries with higher Helicobacter pylori infection rates, and stomach cancer patients usually have this bacterium in their systems. As a result, the World Health Organization considers Helicobacter pylori to be one of the carcinogenic factors that contribute towards stomach cancer.
However, there are no studies yet showing a reduction in the rates of stomach cancer with treatment. Based on the current guidelines for treating Helicobacter pylori , eliminating the harmful bacteria is recommended in preventing the recurrence of stomach cancer, if the patient has already undergone endoscopic surgery. There is currently a larger-scale study being implemented to determine whether treatment is required to prevent stomach cancer in other cases. Therefore, it is necessary to monitor the medical developments in this area.
Patients with peptic ulcers should be treated to prevent recurrence. The recurrence of peptic ulcers is very common. However, it has been found that the treatment of Helicobacter pylori significantly lowers recurrence rates.
Also, the recurrence rate of duodenal ulcers within one year of treatment is over 50%. However, the treatment of H. pylori can reduce the recurrence rate to approximately 10%.
The treatment for a Helicobacter pylori infection is medication consisting of a mixture of several antibiotics and a gastric acid secretion inhibitor. Patients need to take them for one or two weeks. 70% of patients usually eliminate the bacterium after their first course of medication. However, the remaining 30% fail to eradicate it because of antibiotic resistant bacteria. In such cases, they need to take a secondary course. Smoking is another factor that can result in the failure of treatment.
Side effects associated with Helicobacter pylori eradication therapy are relatively common. More than 50% of patients who take the medicine complain of side effects such as nausea, vomiting, diarrhea, abdominal pain, or a bitter taste in their mouth. In most cases, the side effects are not severe. However, in some cases, patients have to stop taking the medicine due to the side effects.
The probability of Helicobacter pylori eradication is more than 95% when the appropriate measures are taken, regardless of when the bacterium is discovered. Therefore, taking the appropriate medicine for one or two weeks is more effective in removing Helicobacter pylori than eating yogurt, which is advertised as an effective means of controlling the bacterium for an extended period of time. In addition, a special diet is not necessary to prevent a Helicobacter pylori infection. However, various lifestyles or communal dining should be avoided.