how long can H.Pylori last if not cured?

Question

Is it possible for H.Pylori to last for 10 years if not cured properly?

Answer 1

Yes, of course.

Helycobacter Pylorii is a gram- bacteria which live is acid envronment, like stomach or duodenum.

Common thoughts are that since stomach is acid, HP should die during time. This is not true, because this bacteria has different "weapons" to survive:

-urease: this enzyme uses urea in the stomach to produce ammonia and HCO3-(bicarbonate), that neutralize the acid of the stomach;

-motility: this bacteria can move: this prevent acid to attack it;

-specific proteins (adhesins): which allows the bacteria to attach to the side of the mucous membrane.

Then, making other enzymes, like "vacA" and "cagA", can damage your stomach/duodenum wall and enter, causing the well known ulcers.

This bacteria is also important in the genesis of gastric cancer, if it is not treat.

Diagnosis is really simple:

-invasive methods: with an endoscopy, doctor take a "bite" of the mucous wall and make both histological research, culture or test with urea (if needed, I can explain better later)

-not invasive: urea breath test, feces test, serology IgG anti HP

Therapy is simple as well:

-proton pump inhibitors(PPI) + clarithromycin + metronidazole or amoxicillin for 2weeks

-if clarithromycin resistance: PPI + tetracycline + bismuth + metronidazole

This is called "sequential therapy"; there is also the triple therapy, but researches prove that sequential is effective.

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Ref.

• Chapter 151 of the Harrison's principles of Internal Medicine

• Treatment of H. pylori infection: the reality.