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From: Ron ronh8semail@netscape.net
Date: 09/08/01
Time: 08:30 PM
Hi CKP,
Thanks for your valuable input.
I do realize that medicalspeak is rife with the words "could, may, should, possibly, appears", and a long list of choice disclaimers which allow almost anything to be said with impunity.
My vocabulary tends to be a little too restricted and avoids these words because I am not trying to win any Nobel Prizes or to encourage any supporting studies. If my inaccuracies are guily of being too broad and hopeful, it is not because I am trying to sell anything, instead it is to encourage discussion and further fact finding to occur. You, instead would suppress all that could be learned from sources at odds with your findings and discourage those with hopeful connections from letting others judge for themselves.
I realizr that Dr. Marsha;; (oops! amother typo) is not even claiming that duodenal peptic ulcers ars caused directly by Helicobacter, but describes that they may cause the damage to the mucosal layer that indirectly allows duodenal peptic ulcers to gain a foothold. Why then, has his research been accepted and why have at least a million been treated with his "triple therapy" when the mere restoration of the mucosal layer might be as effective?
Here is a pasting from the Helicobacter Foundation's site that you and others may find interesting.
Ron --------------------------------------------------------------
Diseases Related to H. Pylori
Duodenal Ulcer Disease
Duodenal peptic ulcers occur in the first part of the intestine, one of two inches past the end of the stomach. Most duodenal ulcers occur in patients with H. pylori infection. If duodenal ulcers are treated with antacids or drugs such as Tagamet, Zantac, or Pepcid, they usually come back when the drugs are stopped. Acid reducing drugs are expensive and do not cure the duodenal ulcer problem.
It has now been proven that by killing Helicobacter pylori, many patients with duodenal ulcer can be cured. The treatment is most successful in patients under the age of 50, but older persons also benefit. After killing the H. pylori germ, most patients (80%) will be able to stop taking acid reducing drugs (i.e. Tagamet, Zantac, Pepcid).
Gastric (Stomach) Ulcers
These peptic ulcers have two causes. The most common cause is also H. pylori infection of the stomach. We expect stomach ulcers to behave similar to duodenal ulcers so that after killing the H. pylori, they should not recur. Stomach ulcers are more complicated than duodenal ulcers, however, but the effectiveness of antibiotic treatment for stomach ulcers appears to be similar to that seen in duodenal ulcers (cure rate 70-90% if H.pylori is eradicated). It is worth noting that antibiotics effective against H. pylori have been used as stomach ulcer treatment in China for several years with very good results.
About 30% of stomach ulcers are not caused by H. pylori but are due to the corrosive effect of aspirin type medications, such as are taken for arthritis. These stomach ulcers may benefit from antibiotic treatment if Helicobacter pylori is also present. If H. pylori is not present, then treatment with acid-reducing drugs or prostaglandins may be successful.
Cancer in the stomach
Stomach cancers (gastric adenocarcinomas) are often associated with H.pylori (70-90%). In an extensive review of gastric cancer and H.pylori the Eurogast Study Group determined that presence of H.pylori confers an approxi-mately six fold risk of gastric cancer, accounting for about half of all gastric cancers. Supposedly, chronic gastritis leads to intestinal metaplasia (atrophic gastritis) which then undergoes malignant change. In the final stage H.pylori may no longer be detected on biopsy but immunologic studies may show evidence of past infection.
Mucosa associated lymphoid tissue (MALT) may undergo malignant change causing a low-grade lymphoma of the stomach. Retrospective biopsy studies show that 90% of such MALT lymphomas are asso-ciated with H.pylori. Early reports indicate about a 50% cure for localized MALT after cure of H.pylori.
Non-ulcer dyspepsia, (and some cases of nausea and vomiting)
In patients with chronic dyspepsia who do not have ulcer disease, the role of H.pylori therapy has not been proven. Therefore, consider other diagnoses before assuming that H.pylori is the cause. If other diagnoses are not obvious, consider a trial of anti-H.pylori therapy. In some patients an immediate response is seen but in others gradual improvement occurs over several months. There are several reports indicating that patients with chronic vomiting remit after H.pylori is eradicated. Try antibiotics if a patient known to have HP has nausea. Start treatment gradually with the least toxic combination first. For example, omeprazole....then amoxicillin...then metronidazole or clarithromycin as the patient settles (this may be a week or two). If the patient has not been investigated before, but has symptoms compatible with peptic ulcer, testing for and treating H.pylori is probably safe and cost effective.
Asymptomatic patients
We do not recommend routinely treating asymptomatic patients who are found to have H.pylori. The only exceptions are patients who are relatives of persons with gastric cancer, or in whom intestinal metaplasia has been detected on gastric biopsy, or who are infected spouses of a patient reinfected with H.pylori.
WEIRD H.Pylori Syndromes
This section can contain a lot of unproven speculation and anecdotal information without scientific proof. Anyhow, it may offer some leads into some unusual and poorly understood conditions. We will add to it and connect links in the next few months.
There are several conditions which might be caused or worsened by H.pylori. Acne rosacea is a red skin rash on the face, it may respond to HP therapy. Patients with HP have increased permeability of the gastric mucosa and so are potentially exposed to unprocessed antigens from food. This might predispose to immune problems. H.pylori antibodies cross react with several tissues in the GUT so autoimmune states are possible with H.pylori. Weird skin rashes have occasionally disappeared when H.pylori was treated. Many patients experience improved well being and energy level when H.pylori is treated so consider it in Gulf Veterans Syndrome and Chronic Fatigue Syndrome. Lots of people with chronic halitosis respond to treatment for H.pylori. This may be because mouth bacteria, sinus and periodontal disease responds to the same antibiotics. It may be that H.pylori is the cause of the halitosis (bad digestion, achlorhydria etc.). In any case, treating H.pylori might be worthwhile.
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