You’ve surely heard that irregular meal time might cause you to have gastritis. While there may be some truth in that, the underlying causes of gastric pain is more complex than we previously thought.
As a gastritis sufferer myself, I know exactly how the detrimental effects of gastritis can affect our ability to carry out daily activities. Apart from that, gastritis also made me feel anxious for as long as I could remember. It was a terrible experience.
What can we say about the cause of gastritis?
The development of gastritis is multifactorial. Ultimately, the protective mechanism of your gastrointestinal system has to be compromised for gastritis to take place. But in this post, I am only going to focus on talking about one of the major causes, the helicobacter pylori infection.
Many recent studies have shown that h.pylori infection is the major cause for chronic gastritis. The microorganism that lives within our body is said to have infected nearly half the human population around the world. It has also been associated with the development of gastric cancer in some individuals.
See this flagellated microorganisms? They can reside in your stomach for decades, sometimes without you realizing if they decide to remain in the state of dormant.
H.pylori can be easily spread from one person to another through the sharing of contaminated food or water, kitchen utensils, or saliva from an infected person. The answer to whether or not kissing can cause disease transmission still remains obscured, though some studies have been carried out in regard to this.
What we know is that most of the organisms reside in the gastric lining, with only about 30% found in the oral cavity. Even that can be attributed to the reflex mechanism from gastroesophageal reflux.
Who is at high risk?
Generally, the disease is more prevalent in developing countries with poor sanitary measures. The people are more likely to contract the disease because of the crowded living conditions. Hence, when one family member is infected, the other members are also exposed to getting the disease.
Personally, I think the issue extrapolates beyond the control of the victims and the healthcare professionals. If fiscal poverty is the cause to the endless loop of disease transmission, any form of humanitarian aid and money-pumping effort serves no more purpose than providing a band-aid solution.
A change in the corrupted governmental system followed by proper subsidy distribution to the healthcare system is the key to building a strong fundaments.
How can H.pylori thrive under the acidic environment of our stomach?
Unlike many microorganisms, H.pylori has a brilliant survival mechanism to help them survive under the repetitive splash of gastric acids. They are able to secrete an enzyme called urease.
In school we learned that Acid + Base -> Salt + Water.
In this case, urease converts urea secreted by the gastric cells into bicarbonate ions and ammonia. As a result, the basic nature of ammonia helps to neutralize the acid in the stomach and prevent it from killing the H.pylori microorganism.
More importantly, H.pylori can secrete a type of toxic substance called CagA. It deforms the epithelial surface of our gastric lining and induces inflammatory response in our body. This explains the sharp, striking character of pain you experience during gastritis.
The associated symptoms of gastritis
Sometimes the associated the symptoms of gastrointestinal diseases can be very vague and vary from one person to another. They often present with abdominal pain associated with food intake. They can be accompanied by nausea, vomiting, loss of appetite and heartburn.
Over time, gastritis can lead to ulceration in the stomach lining. In severe cases, internal bleeding can occur and cause someone to collapse abruptly. Some people experience the pain before meal, while others have it after meal. The difference is said to be due to different location of ulcers.
As far as h.pylori infection is concerned, most of the ulcers occur in the antrum part of the stomach, which is the narrow lumen located near the end of the stomach before transitioning into small intestine.
Test for H.pylori infection
When you go to the doctor and complain of symptoms that might raise the suspicion of h.pylori infection, he will perform a test called urea breath test.
The is a quick procedure that requires you to take a urea capsule with water.
You will sit for 15 minutes before blowing into a breath bag. The doctor will take the breath bag to the lab for analysis.
Those who are tested positive for h.pylori infected will show higher concentration of labeled carbon dioxide in their breath. This is not likely to occur without the presence of urease in our body, which is suggestive to the presence of H.pylori.
Another effective method to test for H.pylori infection is the faecal antigen test. Faecal antigen test works by detecting the antibodies specific to H.pylori in the stool. It is specific and sensitive, but can be quite costly.
Apart from H.pylori detection, faecal antigen test can also be used to check for eradication of the disease after treatment.
Main line treatment for H.pylori infection
Say for example if you are tested positive for H.pylori infection, your doctor will prescribe to you a combination of a few antibiotics to fight off the microorganisms. The duration of the treatment varies from 10-14 days.
Two antibiotics and one proton pump inhibitor (PPI) are used in the treatment for H.pylori infection. They can commonly known as Triple Regime. The triple regime comprises of 1g of Amoxicillin, 500mg of Clarithromycin and a standard dose of Omeprazole. All taken twice a day.
You are strongly advised to complete the whole course of antibiotics even if the symptoms have gotten significantly better. This is to prevent reoccurrence of the disease.
You might have guessed, this time the H.pylori will be much harder to eliminate. But the cut off point is really debatable and subjective to individual’s or even doctor’s judgement. In fact, I have written about antibiotics resistance before, you can find out here.
In the case of reoccurrence, a stronger combination of drugs will be prescribed. They are known as Quadruple Regime. This time, the drugs will be substituted with different class of antibiotics together with a stronger PPI.
The Quadruple Regime is classically made up of Bismuth Sulphate, Metronidazole, Tetracycline and Esomeprazole. But really, the combination of drugs used is really up to your doctor as there is no one treatment that fits all.
Have you been diagnosed with H.pylori infection before?
Leave a comment below and share with me your experience.
Thank you for reading this post.