by Pam Fadem
CCWP and The Fire Inside have been getting a lot of questions and hear concern about what seems to be a rising infection among women in California State prisons, Helicobacter pylori (H. pylori). We decided to do some research and here is what we found out.
H. pylori is a type of bacteria believed to be responsible for the majority of peptic (or stomach) ulcers in the US–almost nine of every ten. One in ten adults is affected by peptic ulcer disease. An ulcer is a sore or hole in the lining of the stomach or duodenum (the first part of the small intestine). The opening from the stomach to the duodenum is called the pylorus. H. pylori bacteria got its name from the place the bacteria settles and causes ulcers. Many people have been exposed to the bacteria in childhood, but many people never get sick from it.
Transmission–Who gets it and how?
Researchers are not certain how people contract H. pylori, but they think it may be through food or water contaminated with fecal matter (human waste). People who work in food preparation are reminded to wash their hands after they use the bathroom to help prevent transmission of diseases like H. Pylori or Hepatitis A, and everyone should wash their hands before eating. H. pylori has also been found in the saliva of some infected people, so the bacteria may also spread through mouth-to-mouth contact such as kissing. Crowded and unsanitary living conditions make it easier for illnesses to spread. Because of prison overcrowding and inadequate health care, prisoners may be more exposed to epidemics of infectious diseases like pneumonia and tuberculosis–and now H. pylori maybe joining this list. We could not find information on infection rates of H. pylori from the California Department of Corrections or from prisons in other states.
Symptoms of an Ulcer–What it feels like
The most common ulcer symptom is burning pain in the stomach, but not all stomach pain means you have an ulcer. Sometimes spicy foods or stress can irritate an ulcer, but they do NOT cause ulcers. A common symptom is a dull, gnawing ache: that comes and goes for several days or weeks or that occurs 2 to 3 hours after a meal; occurs in the middle of the night (when the stomach is empty); is relieved by eating; is relieved by antacid medications (like Tums, or Pepto-Bismol). Other symptoms include weight loss, poor appetite, bloating, burping, nausea, vomiting. Emergency symptoms (you need to get to a hospital right away if you have these!) are: sharp, sudden, persistent stomach pain; bloody or black stools; bloody vomit or vomit that looks like coffee grounds.
Diagnosis–How to tell if you have H Pylori infection
H. pylori is diagnosed through blood, breath, stool, and tissue tests. Blood tests are most common and effective, and only require a finger stick blood sample. They detect antibodies to H. pylori bacteria. Blood tests are not used to detect H. pylori following treatment because a person’s blood can show positive results even after H. pylori has been eliminated.
Breath tests are an effective diagnostic method for H. pylori. They are also used after treatment to see whether it worked. A person is given a special solution to drink and then your breath is tested. X-rays or endoscopy (an endoscope is a thin tube that carries a tiny camera, inserted down the throat and into the stomach) may be used to see if you have an ulcer. These tests are more invasive and used less often.
Treatment
Most of the ulcers caused by H. pylori can be cured by a 1-2 week course of 2 antibiotics to kill the bacteria, plus bismuth (bismuth is the medicine in Pepto-Bismol) or a medicine that suppresses the natural stomach acid. This combination, called “triple therapy,” means taking a large number of pills every day. There may be side effects from the medicines, but H. pylori infections can be cured 90% of the time. The antibiotics commonly used are: amoxycillin (Amoxil), clarithromycin, tetracycline and metronidazole (Flagyl). Which antibiotics used depends on the strain of bacteria and what a person can tolerate. For more info, write to us or to:
National Digestive Diseases Information Clearinghouse (NDDIC)
2 Information Way, Bethesda, MD 20892-3570
E-mail: nddic@info.niddk.nih.gov
1-800-891-5389