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Do I really have stomach ulcers?

Tuesday, 27 January 2009
Answered by: Dr Anil Handoo
onsultant, Dept. of Haematology,
B L Kapoor Memorial Hospital
New Delhi
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Q. Does Nexium 20 mg help treat ulcers? Does it have any side effects? I did a H. pylori test of my blood and the result is negative? Kindly advise.

A.  Esmoprazole magnesium trihydrate (Nexium) is a proton-pump inhibitor. It works by inhibiting the so-called gastric acid pump that is required for the stomachs cells to secrete acid. It is a very effective suppresser of acid production. As far as the H. pylori bacterium is concerned this drug is used as a part of the triple-drug regimen. This drug does not eradicate the bacteria, but reduces the acidity in the intestinal tract, thereby increasing the effectiveness of the bacteria-fighting drugs being used in the regimen. This drug directly may not be effective in prevention of gastric (stomach) cancer but as a part of H. pylori regime may contribute by H. pylori eradication, which in some studies has been found to be associated with increased incidence of stomach cancer. The drug is mainly used in: -Treatment of Gastroesophageal Reflux Disease (GERD) -Healing of Erosive Esophagitis & maintenance of healing of Erosive Esophagitis -Peptic ulcer Side effects are uncommon but may include an allergic reaction, headache, stomach pain, and diarrhoea. The Helicobacter pylori (H. pylori) test is done to determine whether an infection with H. pylori bacteria may be causing an ulcer or irritation of the stomach lining (gastritis). And also to determine whether treatment for an H. pylori infection has been successful Since the test you have undergone for Helicobacter pylori is a blood test it possibly must have been a blood antibody test. A blood test checks to see whether your body has made antibodies to H. pylori bacteria. If you have antibodies to H. pylori in your blood, it means you either are currently infected or have been infected in the past. In your case probably this is the test, which is negative and therefore suggests that you are not infected by H pylori. However, this test is not absolute. The predictive value is around 70-85%. The most reliable method for detecting H. pylori infection is a biopsy check during endoscopy with a rapid urease test, histological examination, and microbial culture. None of the test methods is completely failsafe. Some other tests of value are Urea breath test & Stool antigen test. Again to know if there is no ulcer, an upper gastrointestinal endoscopy would be essential. Also it would be worthwhile to know that Helicobacter pylori is a bacterium that inhabits various areas of the stomach and duodenum. It causes a chronic low-level inflammation of the stomach lining and is strongly linked to the development of duodenal and gastric ulcers and at times stomach cancer. More than 50% of the world’s population harbours H. pylori in their upper gastrointestinal tract. Infection is more prevalent in developing countries. The route of transmission is unknown, although individuals become infected in childhood. Over 80% of individuals infected with the organism are asymptomatic. H. pylori is a major cause of diseases of the upper gastrointestinal tract. Eradication of the infection in individuals will improve symptoms including dyspepsia, gastritis and peptic ulcers, and may prevent gastric cancer.

A.  Esmoprazole magnesium trihydrate (Nexium) is a proton-pump inhibitor. It works by inhibiting the so-called gastric acid pump that is required for the stomachs cells to secrete acid. It is a very effective suppresser of acid production. As far as the H. pylori bacterium is concerned this drug is used as a part of the triple-drug regimen. This drug does not eradicate the bacteria, but reduces the acidity in the intestinal tract, thereby increasing the effectiveness of the bacteria-fighting drugs being used in the regimen. This drug directly may not be effective in prevention of gastric (stomach) cancer but as a part of H. pylori regime may contribute by H. pylori eradication, which in some studies has been found to be associated with increased incidence of stomach cancer. The drug is mainly used in: -Treatment of Gastroesophageal Reflux Disease (GERD) -Healing of Erosive Esophagitis & maintenance of healing of Erosive Esophagitis -Peptic ulcer Side effects are uncommon but may include an allergic reaction, headache, stomach pain, and diarrhoea. The Helicobacter pylori (H. pylori) test is done to determine whether an infection with H. pylori bacteria may be causing an ulcer or irritation of the stomach lining (gastritis). And also to determine whether treatment for an H. pylori infection has been successful Since the test you have undergone for Helicobacter pylori is a blood test it possibly must have been a blood antibody test. A blood test checks to see whether your body has made antibodies to H. pylori bacteria. If you have antibodies to H. pylori in your blood, it means you either are currently infected or have been infected in the past. In your case probably this is the test, which is negative and therefore suggests that you are not infected by H pylori. However, this test is not absolute. The predictive value is around 70-85%. The most reliable method for detecting H. pylori infection is a biopsy check during endoscopy with a rapid urease test, histological examination, and microbial culture. None of the test methods is completely failsafe. Some other tests of value are Urea breath test & Stool antigen test. Again to know if there is no ulcer, an upper gastrointestinal endoscopy would be essential. Also it would be worthwhile to know that Helicobacter pylori is a bacterium that inhabits various areas of the stomach and duodenum. It causes a chronic low-level inflammation of the stomach lining and is strongly linked to the development of duodenal and gastric ulcers and at times stomach cancer. More than 50% of the world’s population harbours H. pylori in their upper gastrointestinal tract. Infection is more prevalent in developing countries. The route of transmission is unknown, although individuals become infected in childhood. Over 80% of individuals infected with the organism are asymptomatic. H. pylori is a major cause of diseases of the upper gastrointestinal tract. Eradication of the infection in individuals will improve symptoms including dyspepsia, gastritis and peptic ulcers, and may prevent gastric cancer.

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