EXPLAINING YOUR MEDICINES
H Pylori is an abbreviated name for the commonly found bacteria called helicobacter pylori which live in the stomachs of many persons worldwide inclusive of our Guyanese people. The incidence of the hosts increases with age and it is estimated that 1 in 5 persons below 40 years old (or 20%) have this bacteria attached to the lining of their stomachs while 1 in 2 persons above 60 years (or 50%) are hosts. One of the medical mysteries unto today is how the bacteria get into the stomachs of so many persons. “No one knows how H. pylori gets into the stomach–it may be through eating, touching or even kissing” – 2005 Time Magazine Health by Dr. Sanjay Gupta.
The presence of this spiral-shaped microscopic organism (see Picture 1 above) is only confirmed via tests using the breath, stool or blood. The breath test maybe the easiest way to verify the presence of this bacterium since a certain gas is given off and is found in the breath of the individual. The stool of the infected person also gives some indication of the bacterial infection as well as the blood which show the presence of antibodies to H pylori, which is the body’s natural mechanism to fight off the bacteria. There is also another procedure called endoscopy which involves letting a camera down the stomach using a tube.
Picture 2 above shows a normal stomach and a gastric stomach due to H pylori infection as viewed through an endoscope. Since gastritis can be caused by a number of different ways a sample of the stomach lining may be removed and tested to confirm that the gastritis seen via the endoscopic method is due to the Helicobacter pylori bacteria.
Gastritis (which is inflammation of the stomach lining) and ulceration (which is a sore in the protective lining either of the stomach or the upper part of the small intestine called the duodenum) are two of the most common effects of the condition. In very severe but rare cases stomach cancer could be developed especially if this disease is left untreated over a long period. Other associated symptoms are weight loss, loss of appetite, bloating, burping, nausea, vomiting or black tarry stools.
Although 80 %of infected H pylori cases do not develop into ulcer of the stomach or the duodenum, 8 out of 10 times when such cases are presented the causative factor is this particular organism.
The treatment of this infection can be a triple drug therapy or a quadruple therapy depending on the choice of drugs. A convenient H pylori kit is assembled on a single card with three pills in the morning and three in the evening for a minimum duration time of 10 days. The names of the drugs are clarithromycin, tinidazole (antibiotics which kill the helicobacter pylori bacteria attacking it in two different ways) and lansoprazole (a drug to inhibit the production of acid in the stomach). Although in the years gone by there was tremendous success with similar combinations of different drugs this particular trio seem to be the most potent.
The key to successful treatment is sticking with the treatment period to eradicate the bacteria. Persons who do not complete the treatment regimen may have recurrence.
Some 14 years ago a small study was conducted in Guyana by our local experts Dr. Clarence Charles, Dr. Dobay et and published in the West Indian Medical Journal in 1997 where 115 out of 322 patients were treated and reviewed after a six (6) month period, with two different triple drug combinations (AOC – Amoxicillin, Omeprazole and Clarithromycin versus MOC – Metronidazole, Omeprazole and Clarithromycin) which basically apply the same principle – antibiotic to kill the bacteria and a drug to stop the acid production (there are different types). The study was incredibly successful with 85% complete eradication and 10% withdrawn after testing negative at the end of the study using the breath test. There was a minute dropout rate of 5%.
So we know for a fact that H pylori is present in Guyana but many persons may not be aware of it since the symptoms vary in severity from person to person or simply some persons may not experience any symptoms at all. If you think that you are one of the five persons below age 40 or one of the two persons above age 60 then you can simply put your suspicion to rest by seeking assistance from a qualified medical professional and get treatment immediately.
At Medicine Express on Camp Street, between Lamaha and New Market Streets, the pharmacist will provide a professional and friendly service. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg.
Tel #225-5142.