H. Pylori infection on the rise

Rawalpindi
The incidence of Helicobacter Pylori Bacterium infection, a cause of acid peptic disease, is very high among population here in Pakistan and the number of cases are continuously on the rise mainly because of unavailability of ideal diagnostic and treatment facilities at public sector healthcare facilities.
According to health experts, the H. Pylori infection if not treated completely as is being happened in Pakistan, it may become chronic keeping the chances of gastric carcinoma, stomach cancer on the rise. Experts believe that H. Pylori infection must be treated properly and the bacterium must be eradicated from the body in order to reduce chances of stomach cancer.
Like other public sector hospitals of the country, the Helicobacter pylori serological device tests whose sensitivity is more than 85% is not in common practice here at the allied hospitals in town, said a senior health expert serving at the allied hospitals on condition of anonymity.
He said that most of the patients have to undergo a painful and expensive procedure through endoscopy for diagnostic purpose that might not be needed at initial stage. It is important that on average, the cost of endocopy is Rs8,000 to Rs10,000 while of serological test, it is Rs400 to Rs500.
Like many regions of the world, acidity or heart-burns due to peptic ulcer is a commonly experienced disorder in our country as well. It has been notified that over 90 per cent of duodenal ulcers and 70 per cent of epigastric ulcers are the result of Helicobacter pylori infection. According to the latest statistics of Pakistan, the prevalence of acid peptic disease is 32 per cent while the most commonly affected age groups are the adult and elderly population, said Assistant Professor of Microbiology Dr. Humaira Zafar while talking to ‘The News’.
She added that acid peptic disease is actually an imbalance between the digestive activity of gastric or stomach acid, pepsin and the protective mechanisms

to resist mucosal digestive processes. It is a combined term applied on number of peptic ulcer symptoms like heart-burns, epigastric pain, pain on empty or full stomach, distaste of mouth, reflux of food after eating, nausea, loss of appetite and frequent episodes of generalised abdominal pain in relation to food, said Dr. Humaira.
She said that Helicobacter Pylori bacterial stomach or gastric infection imparts more than 80 per cent of the cases of acid peptic disease. She adds that the infection is usually acquired from fecal oral route or the contamination of food from sewerage supply.
Dr. Humaira explained that a unique feature of this bacterium is that it produces an enzyme urease that breakdowns stomach urea into ammonia and carbon dioxide and the ammonia produces a zone around Helicobacter Pylori in highly acidic pH (less than 04) of stomach, thus rendering its survival in such environment. “It prolongs the infection and inflammation in the stomach and due to this property, the Helicobacter Pylori infection is very difficult to treat and eradicated from body.”
She added that the resistant nature predisposes in the development of stomach cancers and it is necessary to adopt strategies to completely eradicate this treatable and curable bacterial infection to reduce chances of stomach cancer.
She suggested that endoscopy is a painful procedure, so prior moving towards such invasive investigation, an alternative approach with Helicobacter Pylori serological device tests must be considered. “The cost of this serological test is about Rs400 to Rs500 per test. The endoscopy must be considered after two weeks management in case of persistent symptoms to assess stomach cancer,” said Dr. Humaira.
She said that based upon accurate diagnosis, two weeks treatment with drugs following ideal protocol must be taken to eradicate the infection from body. “The rough cost of effective drug treatment is about Rs1,500 to Rs2,000 for two weeks.”
To a query, she said that the negligence of timely treating the infection can lead to chronic condition and hence with passage of time, the chances of stomach cancer keep on rising. “Stomach cancers are extremely difficult to treat and also impose a high financial burden in under developed countries like ours.”
Dr. Humaira is of the view that the health regulating bodies in the country should consider and make sure the availability of Helicobacter Pylori diagnosis and treatment facilities in all tertiary care hospitals of Pakistan.