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Gastroenterology Clinic of San Antonio

Helicobacter pylori

Helicobacter pylori (H.pylori) is a bacteria which lives only in the lining of the stomach and is one of the most common chronic infections in humans. The importance of H. pylori was unrecognized until 1982, when an Australian physician, Dr. Barry Marshall, discovered that the germ was almost always present in patients with gastritis (inflammation of the stomach) and ulcers. Doctors now believe that H. pylori is associated with most stomach ulcers and almost all duodenal ulcers.

DOES HELICOBACTER PYLORI ALWAYS CAUSE ULCERS?

H. pylori does not always cause ulcers to form but almost always produces inflammation of the stomach lining. Some people with H. pylori infection do not have any symptoms, but many report nausea, gas, bloating, and burning stomach pain. The symptoms occur twice as often in people with H. pylori compared to those who are not infected. Doctors believe that H. pylori may be responsible for many of these symptoms.

HOW COMMON IS HELICOBACTER PYLORI INFECTION?

H. pylori infection occurs throughout the world, in every part of society, and in every age group. About 30% of the United States population has the infection, which is more common with advancing age (50% will have it by age 60) and is rare in children. Once infected with H. pylori, a person usually continues to carry the germ unless certain medications are used to cure the infection.

HOW DID I GET IT AND CAN I SPREAD IT?

H. pylori appears to be passed from person-to-person. It is more common in spouses of infected patients than in the general population. It is also common in places where sanitation is poor and where crowded living conditions exist. It is not clear exactly how a person gets H. pylori, but it may be through swallowing infected food or water. H. pylori is not found naturally in animals, so pets do not seem important in the spread of the infection. Careful personal hygiene (through hand washing, use of separate personal items such as eating utensils, glassware, etc.) probably is the best way to reduce person-to-person spread of H. pylori.

HOW IS HELICOBACTER PYLORI INFECTION DIAGNOSED?

There are several very accurate ways to determine the presence of H. pylori:

Blood test can be used to determine the presence of antibodies to the bacteria. These tests tell if a person has ever had the infection but do not tell if the infection is active.
A biopsy of the stomach can be used to determine the presence of H. pylori. A biopsy is obtained during an examination of the stomach with a flexible scope. The biopsy is examined by a pathologist under a microscope to look for the presence of H. pylori, or more easily by a Rapid Urease Test such as the CLOtest*. This slide test checks for the presences of an enzyme (urease) produced by H. pylori. A simple color change in the CLOtest* confirms that H. pylori is active in the stomach. The PYtest* C Urea breath test (i.e., the PYtest*) can determine the presence of H. pylori without the use of a scope. It is safe, accurate, easy to perform, and much less expensive than a scope and biopsy for diagnosis.

HOW DOES THE PYTEST* WORK?

The PYtest*capsule contains sugar beads coated with small amounts of a chemical called urea. Urea is naturally found in the human body, and the amount in the capsule is much smaller than the head of a pin. The urea in the PYtest* has been “labeled” with a naturally occurring radioactive tracer called carbon-14, so it can be detected after it is taken into the body.

After the capsule is swallowed, it takes about three minutes to dissolve in the stomach. If the C-urea comes into contact with H. pylori, it is immediately broken down into C-carbon dioxide and ammonia. The carbon dioxide enters the bloodstream and is exhaled by the patient.

Ten minutes after ingesting the capsule, a breath sample is collected in a balloon. The breath sample is then analyzed; if enough of the C is present, the patient has H. pylori.

If H. pylori is not present, the C-urea simply washes through the stomach and is passed in the urine.

WHAT RISK ARE INVOLVED WITH THE PYTEST*?

There have been no reported adverse reactions to the PYtest* capsule. Although the PYtest* does contain a tiny amount of radiation, it is no more than an average person receives every day (background radiation).

GENERAL PREPARATION INSTRUCTIONS

Do not eat or drink anything after midnight before the procedure.
No escort is required because this test does not use anesthesia.
Wear comfortable clothing; You will be at the office for 30 to 45 minutes.
No smoking or teeth brushing the morning of the exam.
No mechanical bowel cleansing or antibiotic use one month prior to exam.
Eat a low lactose, low carbohydrate, low fiber dinner and avoid any fruit the day prior to the exam.

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