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For Your Health: Half of Older People Address H. Pylori Infection | Community Life

For Your Health: Half of Older People Address H. Pylori Infection | Community Life

 


Dear Dr. Cockroach: H. Please give me additional information about Helicobacter pylori infection. I was recently diagnosed with a biopsy taken during endoscopic surgery. I was instructed to take antibiotics and continued to do so. When I consulted with my doctor’s assistant, I asked him what caused the infection to prevent recurrence. There was a very rough reaction, such as maybe it came from a meal at a “Mom and Pop” restaurant. From subsequent investigations, it seems that it may exist for a long time without being noticed, and the cause is often unknown. After using the antibiotics, I was told to take a follow-up test to make sure they were effective. I was given the option of a stool or breathing test. I chose the breathing test. I was surprised at how easy it was. Are these tests also used to first detect an infection without a biopsy? — AJY

Answer: Helicobacter pylori is an important cause of chronic gastritis (inflammation of the stomach), the most important cause of gastric ulcer, and an important cause of gastric cancer and intestinal lymphoma. 50% to 66% of the world’s population is affected.

Older people are more likely to get infected. In the United States, it is about 10% for people aged 18-30, but 50% for people over 60. This may represent an improvement in hygiene. Most infections develop in childhood and last a lifetime. Most infections are thought to occur from person to person, probably through water or due to inadequate hand washing before food preparation.

H. pylori is much more common in developing countries. In the United States, infections are common in people with low socioeconomic status. Not all people with H. pylori have symptoms and do not need treatment. People with ulcers and gastritis are generally treated with some antibiotics for 10-14 days with antacids.

Diagnosis can be made by biopsy, as you were, or by stool or breath test. Breath tests are at least 95% specific (if the test is positive, it is very likely to be true positive), but 90% sensitive, so 1 in 10 people with bacteria is false negative I will be inspected. The stool test has a sensitivity and specificity of nearly 95%. Blood tests are more likely to give false positive and false negative results. In addition to making a diagnosis, a stool or breath test is recommended to confirm the eradication of the infection.For more information, we recommend starting with https://medlineplus.gov/ helicobacterpyloriinfections.html.

Dear Dr. Cockroach: Can Chlamydia be easily cured with antibiotics? — Anon.

Answer: There are several different species of Chlamydia, including the important ones that cause pneumonia, but I think it means the type of Chlamydia trachomatis that causes genital disease in both men and women. Yes, it’s easy to cure.

The cure rate with either the primary antibiotic doxycycline or azithromycin is 96% to 100%. The infection can be clinically silent, but it can still be transmitted, so the difficult part is making a diagnosis. Unfortunately, unless all partners are treated at the same time, they can be re-infected. Gonorrhea often coexists with chlamydia, and it is important to test for the infection.

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