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Vitamin B6 Needed for Chronic Helicobacter Pylori Infection

Chen Sirkis — Thu, 26 Aug 2010 02:52:07 GMT

According to scientists, Helicobacter pylori, a bacteria linked to ulcers and some types of stomach cancer, requires vitamin B6 to thrive and keep up chronic infection. In research published recently in the online journal mBio™, scientists also identified the enzymes needed to use the vitamin. This finding could help scientists develop a new type of antibiotic for treating helicobacter pylori. Innovative antibiotics, especially tailored for eradicating H. pylori, would be a welcome improvement as successful eradication has been gradually decreasing and current antibiotic treatments may have a success rate as low as 70%.

To understand how H. pylori causes disease, the researchers used in vitro attenuation to produce low-infectivity variants of the bacteria; they then compared that with the original highly infectious microbes. This led them to identify two enzymes in vitamin B6 biosynthesis as significant factors in the chronic colonization of mice by H. pylori.

"Approximately half the world's population is infected with H. pylori, yet how H. pylori bacteria establish chronic infections remains elusive”, says researcher Richard Ferrero of Monash University, Melbourne, Australia.

Of course, the first step in eradicating infection is testing for infection. While there are several testing methods for detecting H. pylori, the urea breath test (UBT) accurately identifies active H. pylori infection before antibiotic therapy as well as post therapy; UBT is the preferred non-invasive testing method for diagnosis and follow-up testing after treatment.

Hospitalizations Decline for Peptic Ulcer Disease: Due to H. pylori Treatment?

Chen Sirkis — Tue, 17 Aug 2010 02:25:58 GMT

Have the antimicrobial drugs used to eradicate Helicobacter pylori been responsible for the decrease in hospitalization rates for peptic ulcer disease (PUD) and Helicobacter pylori (h. pylori)? This was the question posed by researchers from the Centers for Disease Control and Prevention, Atlanta, Georgia. Their findings are to be published in the September 2010 issue of Emerging Infectious Diseases.

PUD is a common illness, with over 6 million Americans affected each year. H. pylori infection significantly increases the risk for PUD and related complications.

Using the Nationwide Inpatient Sample, the researchers analyzed PUD and H. pylori hospitalizations from 1998 to 2005; both rates decreased, with H. pylori rates dropping from 35.9 to 19.2 per 100,000 and PUD rates decreasing 21 percent.

The authors believe the decline in PUD hospitalizations may be related to a birth cohort effect plus the subsequent declines in H. pylori infection and the successful use of antibiotics to eradicate H. pylori infections. “To facilitate further declines in hospitalizations for PUD,” the authors wrote, “patients and clinicians should continue to be educated about the association between H. pylori and PUD.”

H. pylori infection is treatable, and a number of methods exist for testing for H. pylori infection as well as eradication. These include endoscopy, urea breath testing, and blood and stool tests. The American College of Gastroenterology states that the urea breath test (UBT) accurately identifies active H. pylori infection before antibiotic therapy as well as reliably documents eradication of H. pylori infection post therapy; UBT is the preferred non-invasive testing method for diagnosis and follow-up testing after treatment.

Increased Failures in H. pylori Treatments Demand Post Treatment Retesting

Chen Sirkis — Thu, 29 Jul 2010 02:20:53 GMT

With antibiotic resistance an increasingly common medical issue, professionals need to change the way they treat infections.

Published first online in GUT on 4 June 2010, Helicobacter pylori treatment in the era of increasing antibiotic resistance looks at the success of traditional H. pylori treatments and offers suggestions for the future.

“With few exceptions, the most commonly recommended triple Helicobacter pylori regimen (proton pump inhibitor (PPI), amoxicillin and clarithromycin) now provides unacceptably low treatment success. A review of worldwide results suggests that successful eradication using a triple regimen is not consistently observed in any population.” Studies have shown that “triple-therapy” treatment used frequently today as the standard therapy demonstrates only a 70 to 80% success rate. This means that up to a quarter of all patients treated for H. pylori are still infected with the bacteria at the end of treatment.

The authors recommend only regimens with success rates of over 90 to 95%. New regimens should only be compared with the most effective local treatment “and ignore consensus statements and society guidelines if they are not consistent with local results.”

Because of the high rate of resistance to traditional treatments, physicians must adapt a strategy that includes testing, treating and retesting, which is highly recommended by society guidelines. Without a successful method of eradication, patients may rebound after treatment, have repeat H. pylori infections and suffer long term.

The Urea Breath Test is a highly recommended method for detecting H pylori both pre- and post-treatment.

H. pylori and Reflux Esophagitis: A Strong Negative Association

Chen Sirkis — Thu, 15 Jul 2010 02:27:25 GMT

A new study published online in the American Journal Gastroenterology and reported by Medwire News evaluates the correlation between H. pylori infection and reflux esophagitis, including how H. pylori eradication effects reflux esophagitis. The researchers found that there appears a strong negative association between the two.

Based on a study of over 10,000 subjects, with 4,007 participating in a follow-up after a median of two years, the researchers found that 3.3 % of the patients with active H. pylori infection had reflux esophagitis. In subjects without h. pylori infection, the prevalence of reflux esophagitis was 6.4 %. Eradicating H. pylori infection increased the prevalence of esophagitis to the same level of those patients without H. pylori.

The team of researchers claims that its findings imply a strong negative association between reflux esophagitis and an existing H. pylori infection. In addition, they found that the protective consequence of H. pylori infection on reflux esophagitis disappeared after the successful eradication of the bacteria.

More information on the relationship between GERD and H. pylori can be found on BreathID's Learn Much More section.

Urea Breath Testing Still The Non-Invasive Test Of Choice For Detecting H. pylori

Chen Sirkis — Tue, 13 Jul 2010 02:45:50 GMT

The Journal of the American Association of Physician Assistants recently published Helicobacter pylori Infection: An update on diagnosis and management; the findings confirm that Urea Breath Testing is still the non-invasive test of choice for diagnosing H. pylori. H pylori, a bacteria that is responsible for a number of medical conditions affecting the gastrointestinal tract, including peptic ulcer and cancer, can be diagnosed with invasive or non-invasive testing.

Invasive tests examine the stomach lining via endoscopy. Non-invasive tests are performed on expired breath, blood (serum), or stool samples. Endoscopy with biopsy is an important diagnostic tool, yet in many cases, it is recommended that younger patients get treated for infection before performing endoscopy. Older patients and those with red-flag symptoms often undergo endoscopy.
 
Non-invasive H. pylori tests can be performed on expired breath, serum, and stool. For diagnosing H pylori, the non-invasive test of choice is the urea breath test. Both 13C-urea or 14C-urea can be used. When urea is ingested, it is hydrolyzed to labeled CO2 – and then it is exhaled. The amount of labeled CO2 suggests the likelihood of infection. 13C-urea has several advantages over 14C-urea: in addition to not generating ionizing radiation, it is approved for use in children and pregnant women.

Serologic, or blood, tests detect IgG antibodies to H pylori. There are a number of appropriate testing mechanisms available, including Western blot testing, immunochromatography, and enzyme-linked immunosorbent assay (ELISA). However, some blood tests will appear positive for patients with a history of H. pylori infection. In these cases, blood tests are not indicated.

A stool antigen test is an alternative to the breath test, as they both have high sensitivity and specificity and can be used to assess treatment success. 

Studies aiming to determine the best test for diagnosing H pylori infection showed that stool and urea breath tests were both very accurate. One study performed in the UK revealed that 77% of patients would choose a urea breath test or stool antigen test if they knew that these are more accurate than blood tests; about 65% preferred the urea breath test. 

Salt + H. pylori = increased risk of stomach cancer?

Chen Sirkis — Wed, 30 Jun 2010 23:51:50 GMT

High salt intake, which is linked to a plethora of medical conditions including hypertension, stroke, and osteoporosis, is now linked to the fourth most commonly diagnosed cancer worldwide: stomach cancer. Recent clinical studies have looked at the relationship between H. pylori, salt intake and stomach cancer.

A few of the studies are worth mentioning. A 2008 study published in the Journal of Bacteriology has demonstrated that “H. pylori responds to temporal changes in sodium chloride (salt) concentration and that growth, cell morphology, survival, and virulence factor expression are all altered by increased salt concentration". Furthermore, in a 2009 review of salt consumption and stomach cancer risk, published in the World Journal of Gastroenterology, scientists suggest that reducing salt intake combined with the eradication of H. pylori infection is a promising approach for stomach cancer prevention in all parts of the world, especially in developing counties.

Reducing salt consumption is a wise choice. Current Dietary Guidelines and recommendations by the Food and Nutrition Board of the Institute of Medicine recommend a daily intake of 1500 mg of sodium; most Americans consume about double that amount. Not only will lower salt intake reduce the risk of osteoporosis and stroke, it may also lower ones chance of contracting stomach cancer.

NSAIDs May Prevent Stomach Cancer, Especially in H. Pylori-Infected Individuals with Gastric Ulcers

Chen Sirkis — Tue, 15 Jun 2010 00:01:31 GMT

In a recent study, published online in the May Journal of Clinical Oncology, researchers looked at NSAID (Non-Steroidal Anti-Inflammatory Drugs) use as a method to prevent gastric cancer in patients with gastric ulcers. The study principally focused on subjects who were H. pylori infected.

Data from the Taiwan National Health Insurance Database, containing information from more than 50,000 patients diagnosed with peptic ulcer disease, was evaluated.

Findings show that patients with gastric ulcers who used NSAIDs had a lower risk of developing gastric cancer when compared to the general population. More interesting is that an even lower risk of gastric cancer was present in the patients with gastric ulcers who were H. pylori positive.

While NSAIDs seem to offer protection against cancer in patients with gastric ulcer, they do not protect patients with duodenal ulcer.

The study concluded that regular use of NSAIDs may be an effective tool in preventing stomach cancer in H. pylori-infected patients with gastric ulcers.

Gastric cancer has been linked to infection with Helicobacter pylori, a bacteria responsible for ulcers and a variety of other medical conditions. Several methods exist for detecting H. pylori including urea breath tests.

Earlier Colorectal Screening for Blacks Recommended

Chen Sirkis — Sun, 06 Jun 2010 00:04:37 GMT

The American Society for Gastrointestinal Endoscopy (ASGE) advises black men and women with average risk factors to begin screening for colorectal cancer at age 45.

These new guidelines issued by the society’s standard of practice committee, were published in June’s GIE: Gastrointestinal Endoscopy and reported in Medpage Today. The recommendation is consistent with those from the American College of Gastroenterology.

Prior studies have shown differences along racial lines. These include greater mortality from colorectal cancer, a younger age at onset, a larger proportion of cancers appearing before age 50, and screening rates that are lower in black adults when compared to white adults.

The guidelines’ authors noted that there are many possible reasons for the phenomenon, including societal and biological differences. The ASGE issued the guidelines to bring attention to the differences in GI disease patterns along ethnic lines.

Other suggestions of the report include further studies of ethnicity-based Helicobacter pylori screening (to reduce the risk of gastric cancer) before making recommendations based on race and ethnicity.

Stomach Cancer on the Rise in Young, White Adults

Chen Sirkis — Sun, 30 May 2010 02:39:38 GMT

A recent report published in the Journal of the American Medical Association and reported by Healthday found that while gastric cancer has been declining in most groups in the United States, cancer rates in young, white adults is rising.

The researchers looked at the rates of stomach cancer from 1977 through 2006 using data from the National Cancer Institute. They compared stomach cancer rates by age, race and other factors over the 30-year period.

The reasons for the increase in gastric cancer in young, white adults is still not understood, as gastric cancer as a whole has been declining for the last 30 years. While the increase is thought to be less than 3 percent annually, lead researcher Dr. Charles Rabkin said over time that rate can grow “like compound interest on a loan.”

Dr. Ahmedin Jemal, strategic director for cancer occurrence at the American Cancer Society, wants further study of the increase.

"Anything that occurs in the younger age group indicates a burden in the future," Jemal said. Understanding the factors contributing to the increase “can avert the future cancer burden."

Stomach cancer, usually found in adults over 65, is linked to infection with Helicobacter pylori, a bacteria responsible for a variety of medical conditions, including ulcers. H. pylori can be detected easily; one method, which can be performed in a doctor’s office, is the urea breath test.

The 13C breath testing is the preferred testing method for H. pylori

Chen Sirkis — Sun, 07 Mar 2010 04:39:47 GMT

The availability of several tests for detecting the presence of Helicobacter pylori requires the physician to choose the best testing method. Several studies over the last decades compared a few different modalities including urea breath tests, serology tests (serum IgG and IgA antibodies to H. pylori), and endoscopic biopsy. The data of these studies showed that the urea breath test is an accurate noninvasive test for H. pylori infection. The urea breath test has positive predictive values of more than 95 percent for detecting H. pylori and more than 97 percent in patients with active peptic ulcer.

Our experience with the BreathID System, which is based on non-radioactive 13C breath testing, has shown it to be the easiest and fastest testing method. The device provides an effective means for noninvasive testing for H. Pylori at the point of care. It is easy to operate and does not require any expertise from medical staff. Results are provided immediately upon test completion, enabling treatment decisions within minutes. Compared to all the other methods, it provides an easy-to-perform, fast, and accurate means for detecting H. Pylori infection.