Helicobacter pylori It is a spiral-shaped bacteria that grows in the mucous membrane from the stomach and is capable of neutralize the acidity of the stomach environment, so it can survive in this area of the body. It is estimated that this pathogen lives in one of every two people in Argentina. Most of them will not realize that they live with the bacteriumbecause he never develops a disease.
But in those who do develop symptoms, the infection it can cause ulcers frequent stomach and gastroduodenal (peptic) gastritis chronicle And till stomach cancer, so the World Health Organization (WHO) classifies it as carcinogen type I and classifies it as a high priority microorganism that threatens human health.
All over the world, this bacteria is combated by treatment with antibiotics. However, growing antibacterial resistance has made this health challenge extremely difficult. In Europe, a general population registry has been established on the bacteria to develop better therapies. In the United States, a similar measure is sought to be implemented, since currently it only has small-scale private studies.
In Argentina, the doctor Oscar Laudannohead of the Department of Gastroenterology of the Alfredo Lanari Medical Research Institute of the University of Buenos Aires (UBA) He has been leading the Argentine Registry of the Management of Infection Helicobacter pylori (Hp-Arg-Reg), which already has initial data of almost 1,000 patients from six provinces.
“This bacteria is not new. The discovery of him was awarded the Nobel Prize in Medicine 2005 and awarded to doctors Barry James Marshall and John Robin Warren, who demonstrated that the bacteria is present in practically all patients with gastric inflammation, duodenal ulcer or gastric ulcer. Furthermore, they highlighted that Helicobacter pylori is the main cause of gastric cancer worldwide,” Dr. Laudanno explained to Infobae.
And I add: “In Argentina, it is estimated that 50% of the population is infected with this bacteria, according to two local epidemiological studies. This pathogen is more prevalent in populations with poor hygiene conditions and access to drinking water. Therefore, the importance of reducing the presence of this bacteria is highlighted, since it reduces the incidence of ulcers and stomach cancer.”
Laudanno remarked that the optimal treatment of the bacteria H. pylori remains unclear: “Most treatments are prescribed empirically, without knowing exactly the profile of bacterial antibiotic resistance.”
“The traditional treatment of Helicobacter pylori it’s with antibiotics and has faced difficulties due to the resistance that the bacteria has developed due to the widespread misuse of these medications. We reach a point where we see that it is difficult to treat. The ulcer brings pain and bleeding,” said the doctor, highlighting that bacterial resistance is a global problem recognized by the WHO.
The former president of the Argentine Society of Gastroenterology (SAGE) pointed out that in Europe began several years ago record of this bacteria to determine the best treatment schemes, which has contributed to improving eradication strategies. And Argentina is on its way to that with this registry underway.
Laudanno stated that the local records for the treatment of H. pylori could help control the spread of antibiotic resistanceespecially in countries with data limited susceptibility and scarce resources.
“To combat this resistance, they have implemented two quadruple therapy schemes in Argentina, which consist of four medications plus a probiotic, including a proton pump inhibitortwo antibiotics like clarithromycin and levofloxacin and bismuth. This treatment, which is carried out for 14 days, achieves more than 90% of bacteria eradication in real world clinical practicel, with a favorable safety profile in second-line therapies,” Laudanno told Infobae.
He Argentine Registry of management of H. pylori (ArgReg-Hp) was launched in May 2021 with the objective of obtaining a large and representative sample of the usual clinical practice of Argentine gastroenterologists. “It seeks to identify therapies that are highly effective and can be used empirically. Cure test data are a substitute method for susceptibility and resistance testing,” he said.
This meta-analysis, led by the specialist, demonstrated that “susceptibility-guided treatment is not better than empirical treatment in first- and second-line therapy if the most effective local regimens are prescribed.”
“Updated information on local data is needed to design the best treatment strategy to achieve high rates of eradication of the bacteria and introduce the principles of antimicrobial administration to reduce the inappropriate use of antibiotics,” said Laudanno, who dreams that this program will extend to all Argentine provinces. through simple clinical monitoring of patients.
ArgReg-Hp is promoted by Alfredo Lanari Medical Research Institute (IDIM), University of Buenos Aires and the Argentine Stomach and Duodenum Club (CADED). It was approved by the Ethics Committee of the IDIM, University of Buenos Aires as a reference CEI. “The ArgReg-Hp registry provides valuable insight into the effectiveness of treatments against H. pylori in Argentina, which allows doctors to make more informed decisions and improve outcomes for patients,” said Laudanno, who presented these findings in the last Argentine Congress of Gastroenterology, highlighting the collaborative work of approximately 14 centers in several provinces of Argentina.
The study reveals a significant predominance of women, representing 66% of the participants, compared to 34% of men. The majority of participants presented dyspepsia as the main indication for eradication, constituting 77.9% of the sample. This is followed by peptic ulcer (12.4%), atrophic gastritis and intestinal metaplasia (4.1%), family history of gastric cancer (3.5%) and iron deficiency anemia (2.3%).
The geographical distribution reveals a greater participation of the province of Buenos Aires (46.9%), followed by the Autonomous City of Buenos Aires (24.8%). Regarding the provinces, the percentage of participants in Jujuy is (9.9%), Córdoba (6.3%), Santa Fe (6.1%) and Mendoza (5.7%). This detailed analysis highlights the diverse demographic composition of participants in the Argentine H. pylori Management Registry, providing a comprehensive view of the sample.
The expert added that 50% of Argentines live with overweight and/or obesity, according to the latest National Risk Factor Survey of 2019, which could influence the prevalence of Helicobacter pylori.
According to Centers for Disease Control and Prevention (CDC)Approximately two-thirds of the world’s population is infected with H. pylori. In USAHispanics are among the most affected groups, along with adults of Asian and African American origin, who have a greater susceptibility and face a two to four times higher risk of developing gastric cancer.
Meanwhile, according to experts from Mayo Clinic, Helicobacter pylori infection occurs when this bacteria infects the stomach Helicobacter pylori. This usually occurs in the childhood and over time it is a common cause of stomach ulcers (peptic ulcers) that can occur in more than half of the world’s population.
The transmission of H. pylori It can occur in a variety of ways, including direct person-to-person contact through saliva, vomit, or feces. It can also be transmitted through contaminated water or food. The prevalence of this bacteria is high in areas with poor sanitation and overcrowding, which facilitates its spread.
Although many people with H. pylori do not present symptoms, those who develop them may experience:
- Pain or discomfort in the upper abdomen.
- Swelling.
- Nausea.
- Loss of appetite.
- Frequent belching.
- In severe cases, it can lead to peptic ulcers and increase the risk of gastric cancer.
The diagnosis of H. pylori It can be done through various tests, such as:
- Urea breath test.
- Stool analysis.
- Endoscopy with gastric biopsy.
- Serological tests to detect antibodies.
The standard treatment for H. pylori It involves a combination of antibiotics and medications that reduce gastric acid production, known as proton pump inhibitors (PPIs).
In Argentina, as indicated in the study by Dr. Oscar Laudanno, the Empirical treatments using quadruple therapies with or without bismuth and zinc-based therapies have shown a bacterial eradication rate of 90% or more.