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Helicobacter pylori Eradication Protocol

▸ What is Helicobacter pylori?

Helicobacter pylori (hereinafter to be referred as H. pulori) is a gram-negative, microaerophilic bacterium found usually in the stomach. More than half of world’s adult population is infected with H. pylori. The overall prevalence of H. pylori in Taiwan is 54%. H. pylori is present in the epithelial lining of the gastric mucous layer. It is reported that the highly toxic strains of H. pylori cause gastric or duodenal ulcers. 95-100% of persons with duodenal ulcers gastric ulcer and 80% of persons with gastric ulcers are associated with H. pylori infection.

H. pylori eradication is the very important step to treat patients with chronic peptic ulcers. More than 50% of the world's population harbor H. pylori in their upper gastrointestinal tract. Infection is more prevalent in developing countries, and incidence is decreasing in western countries. H. pylori is commonly transmitted person-to-person by saliva , the acquisition of H. pylori infection occurs primarily in early childhood.

H. pylori's helical shape (from which the genus name is derived) is thought to have evolved to penetrate the mucoid lining of the stomach. It is also linked to the development of chronic gastritis, stomach and duodenal ulcers, and stomach cancer. 

▸ Diagnosis of H. pylori

1 C13 urea breath test (UBT): is the most commonly used method for detecting H. pylori infection. Prior to testing, the patient may take H2 antagonists (Tagamet, Zantac, Pepcid, Axid) or Antacids (Tums, Rolaids, Maalox). If H. pylori is present in the stomach, the urea is broken up and turned into carbon dioxide by urenase. The detection of isotope-labelled carbon dioxide in exhaled breath indicates that H. pylori bacteria is present in the stomach.
2 Blood antibody test: Blood tests for H. pylori can only tell if the blood serum sample has H. pylori antibodies. The positive result indicates that the subject has a current infection or used to have the infection.

▸ Helicobacter pylori Eradication Procedure

1 H. pylori Testing
The blood serum antibody test and urea breath test are recommended for the diagnosis of an H. pylori infection and for the evaluation of the necessity of H. pylori eradication.
2 Start treatments
Treatment to eradicate H. pylori infection involves taking medications for consecutive 14 days. People with gastric or duodenal ulcer should be taking antacid for additional 5 to 7 weeks after the treatment
3 End treatments
One month after the treatment, a follow-up UBT test is required to make sure the complete eradication of H. pylori .
4 Find Results
If the first round of treatment failed, another round of medication is required according to doctor’s prescription.