Helicobacter pylori (H. pylori) infection
Which are the symptoms?
No specific symptomatology determined by the infection has been identified. The symptoms may therefore be those of chronic gastritis and functional dyspepsia or those of ulcerative disease. In many cases the infection is found in completely asymptomatic subjects.
How is it diagnosed?
To diagnose Helicobacter pylori infection, invasive and non-invasive methods can be used. The former involve the performance of esophagogastroduodenoscopy with gastric biopsies: the bacterium can be identified by the histologist on the histological preparation, or it can be identified already during the examination by means of a rapid test (urease test); in cases of documented resistance of the bacterium to traditional antibiotic treatments, the biopsy can be used for the culture of Helicobacter pylori, that is, for a very precise diagnostic test, although technically complex, which, combined with the antibiogram, allows to document to which antibiotics the bacterium is resistant or sensitive. This then allows for targeted eradication therapy.
Non-invasive tests allow the diagnosis of the infection through blood sampling (antibody test), breath analysis (urea breath test) or even stool analysis, a method used in few centers, but often performed in children.
How is it treated?
The eradication of the infection is achieved using different therapeutic regimens that include a potent inhibitor of gastric acid secretion (proton pump inhibitors) and a combination of antibacterials, variously combined with each other. The indication for the eradication of the infection is certain in subjects with ulcerative disease, precancerous lesions of the stomach, MALT lymphoma and in those who must undergo chronic therapy with non-steroidal anti-inflammatory drugs (NSAIDs); it is instead to be defined in all other cases.