This document provides information about Helicobacter pylori (H. pylori): 1) H. pylori is a spiral-shaped, gram-negative bacterium that lives in the mucus layer of the stomach and was identified in 1982. 2) It can cause diseases like peptic ulcers, gastric cancer, and MALT lymphoma through production of toxins and inflammation. 3) Symptoms of H. pylori infection include abdominal pain, nausea, vomiting, poor appetite, weight loss, and heartburn. 4) Diagnosis involves invasive tests like endoscopy and biopsy or non-invasive tests like a urea breath test or stool antigen test. 5) Treatment

1. Qussay Abbas
‫السورية‬ ‫العربية‬ ‫الجمهورية‬
‫للمتميزين‬ ‫الوطني‬ ‫المركز‬ ‫خريجي‬
‫ّة‬‫ي‬‫الحيو‬ ‫الطبية‬ ‫العلوم‬ ‫برنامج‬

3. The content
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Pathogenesis
of H. pylori
Diagnosis
of H. pylori
infection
Transmission
of H. pylori
Symptoms
of H. pylori
infection
Treatment and
prevention
Morphology
and structure
of H. pylori

4. 01 It was identified in 1982 by Barry Marshall and
Robin Warren
Previously Campylobacter pylori
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Spiral-shaped, Gram-negative
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Motile bacterium with 4-6 flagella
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Oxidase and catalase-positive
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5. Nobel prize

6. Humans are major source of transmission reservoir.
Person-to-person transmission of H. pylori through either fecal/oral or oral/oral exposure seems most likely.
Transmission among persons sharing the same living environment.
Family members often carry same strain.
Waste-tainted water, so a hygienic environment could help decrease the risk of H. pylori infection.
This brings up the point of the importance of “hand washing”.

7. EPIDEMIOLOGY
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8. EPIDEMIOLOGY
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9. EPIDEMIOLOGY
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10. SITE OF INFECTION
 Highly adapted organism
that lives only on gastric
mucosa.
 Gastric antrum is the
most favored site.

11.  Present in the mucus that overlies the mucosa.

12. 1- H. pylori proliferates
in mucus layer over
epithelium and is not
cleared by host immune
response
2- Pathophysiology of H.
pylori infection and its
eventual clinical
outcome is a complex
interaction between the
host and the bacterium
3- H. pylori survives and
grows there because of a
variety of virulence
factors that contribute to
gastric inflammation,
alter gastric acid
production, and cause
tissue destruction
Pathogenesis of H. Pylori

14. Outcomes:
Asymptomatic
or chronic
gastritis
Chronic
atrophic
gastritis,
intestinal
metaplasia
Gastric or
duodenal
ulcer
Gastric
cancer, MALT
lymphoma
> 80 % 15 – 20 % < 1 %

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ABDOMINAL PAIN .
PAIN OFTEN MADE WORSE
WITH EMPTY STOMACH; NIGHT
TIME PAIN IS COMMON.
NAUSEA & VOMITING.
SYMPTOMS

17. SYMPTOMS
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POOR APPETITE

18. SYMPTOMS
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WEIGHT LOSS

19. SYMPTOMS
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HEART BURN

20. SYMPTOMS
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BELCHING

21. SYMPTOMS
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BLOOD IN STOOL.

22. Diseases associated with H. Pylori
Duodenal Ulcer1
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Gastric (Stomach) Ulcer2
Non-Ulcer dyspepsia3
Weird Syndromes4
Stomach Cancer or MALT
Lymphoma
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23. Duodenal Ulcer1
Diseases associated with H. Pylori
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24. Diseases associated with H. Pylori
Gastric (Stomach) Ulcer2
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25. Diseases associated with H. Pylori
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Non-Ulcer dyspepsia3
A type of indigestion or dyspepsia
not caused by peptic ulcers. The
symptoms are often similar to
dyspepsia caused by ulcers such
as bloating and upper abdominal
pain or discomfort.
• Burning sensation or discomfort in upper
abdomen
• Bloating and belching
• An early feeling of fullness with meals
• Nausea

26. Diseases associated with H. Pylori
Weird Syndromes4
• Acne rosacea
A long term skin condition
characterized by facial
redness, small and superficial
dilated blood vessels on
facial skin, papules, pustules,
and swelling.
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27. Diseases associated with H. Pylori
Weird Syndromes4
• Acne rosacea
• Chronic fatigue syndrome
Is a medical condition
characterized by long-term
fatigue and other symptoms
that limit a person's ability to
carry out ordinary daily
activities
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28. Diseases associated with H. Pylori
Stomach Cancer or MALT
Lymphoma
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• Stomach Cancer
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29. Diseases associated with H. Pylori
Stomach Cancer or MALT
Lymphoma
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• Stomach Cancer
• MALT Lymphoma
MALT lymphoma (MALToma)
is a form of lymphoma
involving the mucosa-
associated lymphoid tissue
(MALT), frequently of the
stomach. It is a cancer
originating from B cells.
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30. LABORATORY DIAGNOSIS

31. Invasive tests
Endoscopic Biopsy
Urease Test
Non-Invasive tests
Serology
Urea breath test
Fecal antigen test

32. • Endoscopic Biopsy of Gastric mucosa
• Microscopy – Biopsy
• Staining by special stains Gram
staining
• Culture
• Biopsy testing for urease detection in
urea medium.
• Antibiotic resistance testing.

34. - Black bacilli line the pits
- Easily seen
Immunohistochemical stains

37. Culturing for H.pylori needs specific
conditions
Media :
- Skirrow’s medium
- Chocolate medium

38. The test is perfrmed at the time of gastroscopy. A
biopsy of mucosa is taken from the antrum of the
stomach, and is placed into a medium containing
urea and an indicator such as .
The urease produced by H. pylori hydrolyzes urea to
ammonia, which raises the pH of the medium, and
changes the color of the specimen from yellow
(NEGATIVE) to red (POSITIVE)

39. Non Invasive tests
•Serology:
detect an immune response by
examining a blood sample for
antibodies to the organism
(ELISA).

40. Non Invasive tests
• Urea breath test :
In this test patient drinks a urea solution labelled with C14 isotope, If H.pylori is
present in the urea is converted to ammonia and CO2 in the breath measured.

41. Non Invasive tests
• Fecal antigen test : detects H. pylori antigens in faecal specimens.

42. Treatment of H. Pylori infection
 Use of antibiotics, bismuth salts
 Ingestion of Bismuth
subsalicylate
 Antibiotics Tetracycline's and
metronidazole for two weeks
 Use of Omeprazole
 Clarithromycin
 Drug resistance
is a growing
problem

43. Treatment of H. Pylori infection
Foods to be avoided in any H.
pylori diet are those:
 dairy products
 red and processed meat
 sugar which can be used by
the bacteria
 Chocolate
 Coffee
 Spirits.

44. How to prevent H. Pylori infection??
 Washing the hands thoroughly with warm soapy water after using the
restroom and before eating also may help prevent infection.
 Eating utensils and drinking glasses should never be shared, since the
bacteria can be spread through saliva.

45. GO AWAY…
… H. Pylori
Go Away H. Pylori…

46. Thank You!
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