What is H. pylori?
By Laura Greaney MSN Nutritionist
When undergoing bariatric surgery you are sent for several tests. Some tests you may not understand why you even need them. To create a baseline for your vitamin and mineral levels we take blood work. This helps to determine if taking more vitamins are necessary and any deficiencies after surgery. We ask for a cardiac clearance to ensure your heart and body can withstand undergoing anesthesia as well as healing from surgery. Furthermore, we ask patients to have an esophagogastroduodenoscopy performed. This is better knows as an EGD or endoscopy. Though there are several reasons that having an endoscopy is beneficial before surgery, one thing it will help us test for is the bacteria Helicobacter pylori. Most will know this as H. pylori, a bacterium that infects the stomach. Several of our patients are detected with H. pylori and need medication. However, most patients have no idea what this bacterium is or where it came from. In this article we will dive a little deeper into understanding this bacteria.
The bacteria H. pylori may be present in half of the world’s population according to the Mayo Clinic. However, most will not know they have it. There are several cases where people show no symptoms of being infected with this bacteria. How it is transmitted is still being studied but there are a few concepts. This bacteria may be transmitted from person to person by direct contact with saliva, vomit or fecal matter. This would help support the theory that it is mostly contracted during childhood. Environment plays a roll in contracting this bacteria. If you live in a crowded space you’re more likely to contract the bacteria as well. That can also be true now of college dorms. If you are living with someone who has H pylori you most likely have it as well. People in developing countries are more likely to contract the bacteria due to limited clean water or contaminated food. If you believe you have H pylori some symptoms you may experience are burning pains in your stomach, nausea, decreased appetite, burping, bloating or unintentional weight loss. For bariatric patients, the bacteria can increase the chance of infection right after surgery when healing and as well as a greater likelihood of developing an ulcer. It will also cause inflammation of the stomach lining and possible stomach cancer. According to the Mayo Clinic 10% of the population with H. pylori will end up with an ulcer. Bariatric patients are put at an even higher risk.
Now that many are probably fearful they have H pylori, how can you test for it? In past years, doctors have used blood tests to detect the bacteria but there are more effective ways now. One of the best tests is to have an endoscopy done. That is when a doctor puts a long flexible camera down your throat, esophagus, stomach and into your small intestine while you’re sedated. The camera will help to pick up any irregularities so the doctor can remove the tissue and test it for H pylori. Moreover, you can have a breath test done. This is where you will swallow a pill, liquid or pudding substance that contains carbon molecules. If you are infected with H pylori, the carbon molecule will be released when you breathe after the solution is broken down in your stomach. It can also be detected in a stool sample. With both the breathing and stool test you will be asked to stop any proton pump inhibitors (PPI) as they may interfere with the results. Proton pump inhibitors are more commonly referred to as acid suppressing drugs such as omeprazole, Prilosec and so on.
In most cases, H. pylori is not severe but there are preventative measures you can take. You should always wash your hand after using the bathroom as well as before eating. Make sure that your foods are properly prepared, such as washing your produce. Finally, only drink water from a clean, safe source. If you happen to have H pylori, doctors will likely prescribe an antibiotic (PrevPac) to treat the bacteria along with an acid suppressant to reduce the acid being produced in the stomach.
When you begin your bariatric surgery journey, there are a lot of medical terms you may have never heard of, often leading to confusion. You may be treated for something you didn’t even know you were getting tested for. If you are ever confused or don’t understand something please ask your provider to explain further. Hopefully, this article helps explain one of the possibly many things that can be confusing.
References: The Mayo Clinic, Diseases and conditions H pylori infection