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The infectious acidity

Acidity is very common; however, the discovery of a microbe called H plylori has

thrown open a world of problems

I am sorry I cant eat spices I have acidity. My doctor has advised me not to

drink alcohol as I have acidity. These oft repeated statements are common

parlance today. In addition, most patients attribute their various symptoms from

headaches to as distant as urinary burning to acidity. It seems to be a common

bogeyman for a host of symptoms and diseases.

Acid is secreted in the stomach by parietal cells. The internal lining of the

stomach is subject topepsin, bile salts and number of exogenous substances

such as alcohol, bacteria and pain killers each with a propensity to damage the

stomach lining. The bodys response to the noxious substances is to secrete

bicarbonate and mucous to prevent damage to the internal lining of the stomach

called mucosa. If the mucosa is breached, the cells bordering the site of injury

can migrate to a damaged region to repair and restitute it to normal. It always

makes me imagine the wonderful reparative capacity the body has.It is capable

of regeneration.

Nitric oxide, the wonder chemical of the human body is necessary to maintain

the integrity of the stomach lining ,the mucosa.This is also secreted by the lining

of the heart arteries and is essential for maintaining heart health.

Several manipulations to increase this substance have been tried particularly by

anti-aging clinics. A major cause of damage to the stomach lining these days are

pain killers. To make pain killers less stomach damaging, the later variety knownas COX 2 inhibitors were developed. They have the propensity to decrease

tissue inflammation. Sadly, however, they increase the risk of heart disease. As

medical students, we thought that all stomach acid diseases, then termed peptic

ulcer disease, was from hurry, curry and worry. Back then if you said that peptic

ulcer was infectious, you were sure that your exam papers were terminated then

and there.

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True to paradox, in 2005 Barry Marshall and Robin Warren were awarded a

Nobel Prize for discovery of a microbe called H pylori. They had

extensiveinvestigationinthe1980swhentheinitial work of H pylori was published in

a prestigious journal. The medical world laughed at such a concept how could

acidity be an infectious disease - they asked. However, we bite our tongues now

at the impact of these organism H pylori on the human body. It has been termed

a carcinogen by the World Health Organisation and has been associated with

cancers of the stomach. In fact, the journey of these two initial researchers has

been epic.

In January 1983, they identified this organism, called it Campylobacter Pylori but

the gastroenterologists society of Australia deemed it amongst the 10% of worstpaper submitted and was rejected. It was however accepted in Brussels. In June

1984 when a leading internal medicine journal published their report, it was

heavily criticised.To

prove his point Marshall then consumed H pylori and fell ill and treated himself

with antibiotics to affect a cure. A New York Times journalist said he had never

seen the medical community more defensive or critical of a study in regard to H

pylori. H pylori play a massive role in the development of gastric cancer called

MALT lymphoma. It is prevalent around the world and thereby its existence

depends on the overall hygiene standards of living. In the developing world H

pylori affects 80% of the population by age 20. In contrast its prevalence in

industrialised countries is 20 to 50%. Transmission of this organism may occur

from person to person and is associated with developing countries, domestic

crowding, unsanitary living conditions, unclean food and water or exposure to

stomach contents of an infected individual.

There may be a genetic factor responsible for the infection as well. It can be

measured by serology in the blood or by examining the stool for the antigen.

Histology and culture and the rapid ureasetest require an endoscope be doneand a biopsy taken. Study shows that H pylori is linked to heart disease and

stroke as well. Some initial data also suggests an increase in the good

cholesterol HDL after treating H pylori with antibiotics. There is also a genetic

make up of peptic ulcer disease and first degree relations of duodenal ulcer

patients are three times as likely to develop the disease. People with blood

group O are also more likely to develop peptic ulcer disease. Smokers in

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particular are more prone not only to ulcers but also complications of ulcers.

Moreover, smoking impairs healing of ulcer. Patients with heart disease, renal

failure, chronic lung disease, kidney stones, chronic pancreatic disease and

cirrhosis are also prone to peptic ulcers. Peptic ulcers may be in the first part of

the intestine called the duodenum. They are very common and do not become

cancerous. But stomach ulcers which occur later in life can become cancerous.

Pain in duodenal ulcer occurs typically in the upper abdomen, in the middle

just below the central chest bone, the sternum. A diet full of spices, H pylori and

pain killers are the most causative features of pepticulcer disease. Endoscopy

detectsulcers in less than 30% of patients who present with dyspepsia.

It is less common to see dreaded complications of ulcers, like bleeding and

perforation after the advent of effective acid reducing drugs, which we commonlysaw through decades ago Proton pump inhibitors, H2 receptor blockers,

antacids, cytoprotective agents makes it easy for therapy to be effective.

The important message here is that if you suffer from acid peptic disease, be

sure you exclude H pylori as a diagnosis. This small bug may land up causing

you serious problems, in other systems of the body, more than what you

bargained for.