Helicobacter Infection
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ANSWERING YOUR QUESTIONS ABOUT HELICOBACTER

WHAT IS HELICOBACTER?picture of helicobacter bacteria

"Helicobacter" is a genus of spiral bacteria that amazingly are able to survive the severe acidity of the stomach.  We have known of the existence of such bacteria since 1889 but it wasn't until nearly 100 years later that the significance of these bacteria was realized.

Until the 1980's, stomach ulcers were treated with an assortment of antacids with the idea that excess acid had caused the ulcer.  In fact, most stomach and duodenal ulcers of humans stem from infection with Helicobacter bacteria.  Currently, this ulcerative infection is treated both with antacids as well as antibiotics specifically directed against Helicobacter.

HOW DOES HELICOBACTER CAUSE DAMAGE

Very few organisms can withstand the extreme acidity of the stomach.  The tissue of the stomach is protected by a later of mucus into which bicarbonate is secreted as an acid neutralizer.  The integrity of this mucus lining keeps us from being burned by our own stomach acid.

Helicobacter survives by using enzymes to create its own layer of protective bicarbonate.  This little "safety suit" allows the bacteria to burrow into the stomach's mucus layer. Its presence generates inflammation in the stomach tissue. Many patients are colonized by Helicobacter and do not develop symptoms; however, if Helicobacter penetrates deeply enough, it will bind to the mucus secreting cells of the stomach disrupting their ability to produce normal mucus.  Ultimately, the mucus lining is disrupted, stomach acid gains access to the stomach tissue, and burning results.  Ulcers are thus formed.  Making matters worse, Helicobacter organisms are able to stimulate extra acid secretion by the stomach tissue. More burning and more ulcers result and soon the patient is experiencing pain, nausia and/or vomiting. It is possible that without additional stomach disease or other factors, Helicobacter causes no trouble.

Some Helicobacter species are also capable of producing toxins but the role of such toxins in this disease process is not clear. 

DOES HELICOBACTER INFECTION CAUSE CANCER?

In humans, it appears that Helicobacter infection may indeed cause cancer.  We know that Helicobacter infection represents a 400% risk increase for the development of stomach cancer for people.  Pets, however, get infected with different Helicobacter species and the same association with cancer in these species has not been made.

DOES MY PET HAVE HELICOBACTER OVERGROWTH?

There are many excellent ways to determine if a pet's chronic gastrointestinal problem is being complicated by Helicobacter infection.

  • BIOPSY - While it is possible to miss Helicobacter if only certain areas of the stomach are colonized, biopsy is by far the most accurate test.  This method not only detects the infection but also assesses the degree of inflammation and checks for cancer.
     
  • THE RAPID UREASE TEST - Some gastroenterologists will keep a special broth handy during the biopsy procedure.  A spare tissue sample can be dropped in the broth and incubated for an hour.   The presence of urease, the enzyme that creates Helicobacter's protective bicarbonate layer,  induces a color change in the solution.  In this way, Helicobacter can be detected in an hour rather than after the 2 days it takes to obtain biopsy results.
     
  • PCR TESTING - This especially sensitive DNA testing can be used but is only available in a few centers.
     
  • BLOOD TESTS - antibodies against Helicobcter can be detected but their levels take months to decline even after the Helicobacter organism is long gone.  This limits the usefulness of such testing.
     
  • BREATH TESTING - A radio-isotope labeled meal is fed and the patient's breath is tested for Helicobacter metabolytes.  This form of testing is easy to use for monitoring the eradication of Helicobacter plus it is non-invasive.  In humans, Helicobacter eradication is usually confirmed 4-8 weeks after treatment has been completed.

WHAT IS THE TREATMENT?

There are many medication combinations used to treat Helicobacter:

  • Amoxicillin
  • Tetracycline
  • Peptobismol (the bismuth actually accumulates
  • in the Helicobacter cell wall and destroys the cell)
  • Flagyl
  • Omeprazole - an antiacid
  • Pepcid AC
  • Clarythromycin

CAN MY PET INFECT ME?

We do not currently know the answer to this question. We do know that there is at least one Helicobacter species capable of infecting both humans and cats.  We know that cat ownership does not seem to represent an increased risk for Helicobacter infection in humans.

 

Page last updated: 2/18/03