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Eradicate! Eradicate !

A review of Helicobacter pylori and what it may do to you

Andrew J C Carmichael BDS

Abstract

A review of the available literature on Helicobacter pylori shows a wide range of conditions in which it is a factor as demonstrated either by improvement in the condition following eradication or by finding DNA of, or antigen to the bacterium.

The variety of conditions, many of which develop over decades, leads to serious consideration of the benefits of eradication of this infection as a matter of routine. Its importance could be equated with that of the eradication of TB, HPV or poliomyelitis and development of an appropriate vaccine would be valuable. In particular the involvement of Helicobacter pylori in long-term conditions affecting quality of life in old age will result in an ever increasing cost to health services in years to come.

Helicobacter pylori is a known carcinogen, recognised as such in 1994, and yet it is still tolerated.

There should be great concern about the gap in time between research findings and the practical medical use of them in the routine treatment of patients (1). Many of these treatment regimes have had quite a number of years to infiltrate the profession and yet apparently little is done to deal with an easily eradicated well-known pathogen.

Eradication of Helicobacter pylori, a common stomach bacterium, can greatly reduce your chances of suffering one or more of these diseases or in some cases, reduce the symptoms already noticed:

  • gastritis/ dyspepsia (2)(5)
  • gastric / duodenal ulcer (3)(4)(5)
  • gastric cancer (4)(5)(6)(7)(8)
  • high blood pressure (9)(10)(11)(12)
  • resolution of Syndrome X (heart and chest pain) (13)
  • altered lipid metabolism leads to obesity, heart attack and stroke (14)(15)(16)
  • iron deficiency anaemia (17)(18)
  • abnormal blood counts (neutrophils and monocytes) (19)(20)
  • neurological damage such as Parkinson’s, Alzheimer’s, MS, ME, optic nerve damage leading to blindness due to Vitamin B12 deficiency (21)(22)(23)(24)
  • chronic sub-clinical vitamin deficiency of A, B6, B12, C, E (25)(26)(27)(28)(29)(30)
  • skin conditions such as itchy, flaky, hard skin (31)(32)
  • rheumatoid arthritis (33)
  • chronic cholecystitis (34)
  • glaucoma (35)(36)
  • insulin resistance (37)
  • macular degeneration leading to blindness (38)
  • periodontal disease, tooth loss, reservoir of Hp infection in mouth (39)(40)(41)
  • some sexually acquired infections of nipples, vulva (42)

Many patients present with more than one of these conditions.

These are the subjects of a large number of peer-reviewed articles in respected journals over many years. ( reference list in numerical order )

Now it is time to do something about it.

Proposition

That ALL PD, AD, MS, medical and gastroenterology surgical patients should be tested for Helicobacter sp (43) and appropriate eradication commenced as a matter of routine using antibiotics with preceding probiotics (Bifidus and lactobacillus) to maintain a normal balance of beneficial gut bacteria (50)(51). This should be in addition to continuing dietary supplementation with omega-3 oils and / or fish oils and vitamin supplements as appropriate.

Reason for study

This study was initiated because of an interest in the results of work showing an improvement in the condition of some patients with Parkinson’s Disease (PD) following total eradication of Helicobacter pylori. In some cases this improvement amounted to regression of the condition (22)(23). It soon became apparent that the range was far wider than at first realised and the significance of the infection for health care costs throughout ever lengthening lives became obvious.

Equally it became apparent that hospital trusts can make considerable cost savings in gastroenterology by using probiotics prior to surgical treatment and by early eradication of Helicobacter thus reducing the development of conditions expensive to treat (50)(51)

Eradicating Helicobacter pylori will reduce the amount of antigen to it which circulates in blood and which has been suggested as the cause of death of sensitive long-axon nerve cells possibly because it stimulates platelet activity. This is a putative cause of neuropathies (49).

A possible solution

There is a food additive widely used in the processed food industry and therefore already of proven safety for human consumption.

6-O-palmitoyl-l-ascorbate, (E 304), (PA) is a lipid-soluble variant of Vitamin C (ascorbic acid). It is already in use in anti-wrinkle creams, infant formula milk, beefburgers (as an antioxidant preventing ‘greying’ of the meat) and is used by bodybuilders to add collagen to their intestinal and over-developed muscles. It also has the effect of reducing the formation of new blood vessels which may be relevant in macular degeneration and tumour restraint.

It is known to eradicate Helicobacter in vitro more efficiently than antibiotics even in low concentrations. In vivo its lipid solubility would make it able to penetrate the lipid based biofilm with which Helicobacter surrounds itself in the gastric mucosa. PA is a powerful anti-oxidant and can provide a source of ascorbate to replace the Vitamin C lost to the Helicobacter infestation which uses ascorbic acid as a nutrient thus denying it to the host (26)(27)(28). Ascorbate is essential for tissue repair and this lack of repair in subclinical chronic Vitamin C deficiency accounts for many of the disease effects listed above. It also provides a source of lipid useful in the repair process.

Concentrations of this Vitamin C ester are found up to 8 times that of ‘ordinary’ Vitamin C in the brain, very relevant in neuropathies. The suggested daily intake of this powder is 5 x 200 mg (44)(45)(46). It should be investigated as a means of gentle eradication of Helicobacter pylori in vivo because of its lack of side effects and proven safety as a widely used additive to a large range of foods.

Conclusion

Eradication of Helicobacter pylori has profound lifelong health benefits and is cost effective compared to the long term costs of resultant ill-health if it is allowed to persist. It should be a matter of routine in medical practice to test for it and initiate eradication.

References regarding Helicobacter pylori eradication and food additives

1 The Translation of Helicobacter pylori Basic Research to Patient Care
Peter B. Ernst, David A Peura and Sheila E. Crowe
Gastroenterology Volume 130, Issue 1, January 2006, Pages 188 – 206
2 The bidirectional communication between neurons and mast cells within the gastrointestinal tract
Luc Van Nassauw, Dirk Adriaensen and Jean-Pierre Timmermans
Autonomic Neuroscience doi: 10.1016/j.autneu.2006.10.003
3 Critical role of an endogenous gastric peroxidase in controlling oxidative damage in H. pylori-mediated and non-mediated gastric ulcer
Mrinalini Bhattacharjee, Samir Bhattacharjee, Arnab Gupta and Ranajit K. Banerjee
Free Radical Biology and Medicine Volume 32, Issue 8, 15 April 2002, Pages 731 – 743
4 Helicobacter pylori infection, not gastroesophageal reflux, is the major cause of inflammation and intestinal metaplasia of gastric cardiac mucosa
John R. Goldblum M.D., Joel E. Richter M.D., Michael Vaezi M.D., Gary W. Falk M.D., Thomas W. Rice M.D. and Richard M. Peek M.D.
The American Journal of Gastroenterology Volume 97, Issue 2, February 2002, Pages 302 – 311
5 Serum and plasma concentration of oxidant and antioxidants in patients of Helicobacter pylori gastritis and its correlation with gastric cancer
Shruti S. Khanzode, Suchet D. Khanzode and Ganesh N. Dakhale
Cancer Letters Volume 195, Issue 1, 30 May 2003, Pages 27 – 31
6 Carcinogenic role of tumor necrosis factor-alpha inducing protein of Helicobacter pylori in human stomach
Suganuma, Masami; Kuzuhara, Takashi; Yamaguchi, Kensai; Fujiki, Hirota
Journal of Biochemistry and Molecular Biology Volume 39, Issue 1, January 31, 2006, Pages 1 – 8
7 Will eradication of Helicobacter pylori infection influence the risk of gastric cancer?
Richard H. Hunt FRCP, FRCP(C), FACG
American Journal of Medicine Supplement Volume 117, Issue 5, Supplement 1, 6 September 2004, Pages 86 – 91
8 Can gastric cancer be prevented by Helicobacter pylori eradication?
Peter Malfertheiner, Professor, Lucia C Fry, Consultant and Klaus Munkenuller, Consultant
Best Practice and Research Clinical Gastroenterology Volume 20, Issue 4, 2006, Pages 709 – 719
9 Eradication of Helicobacter pylori infection improves blood pressure values in patients affected by hypertension
Migneco, Alessio; Ojetti, Veronica; Specchia, Lucia; Franceschi, Francesco; Candelli, Marcello; Mettimano, Marco; Montebelli, Rita; Savi, Luigi; Gasbarrini, Giovanni
Helicobacter Volume 8, Issue 6, December 2003, Pages 585 – 589
10 Prevalence of Helicobacter pylori infection in coronary artery disease and effect of its eradication on coronary lumen reduction after percutaneous coronary angioplasty
Kowalski M.; Konturek P.C.; Pieniazek P.; Karczewska E.; Kluczka A.; Grove R.; Kranig W.; Nasseri R.; Thale J.; Hahn E.G.; Konturek S.J.
Digestive and Liver Disease Volume 33, Issue 3, 2001, Pages 222 – 229
11 A link between Helicobacter pylori and/or Chlamydia spp. infections and atherosclerosis
Magdalena Chmiela, Magdalena Kowalewicz-Kulbat, Anita Miszczak, Monika Wisniewska, Tomas Rechcinski, Katarzyna Kolodziej, Jaroslaw Kasprzak, Torkel Wadstrom and Wieslawa Rudnicka
FEMS Immunology and Medical Microbiology Volume 36, Issue 3, 25 May 2003, Pages 187 – 192
12 Helicobacter pylori (H. pylori) infection in coronary artery disease: influence of H. pylori eradication on coronary artery lumen after percutaneous transluminal coronary angioplasty. The detection of H. pylori specific DNA in human coronary atherosclerotic plaque
Kowalski, M
Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society Volume 52, Issue 1, Supplement 1, August 2001, Pages 3 – 31
13 Resolution of Syndrome X after eradication of virulent CagA-positive Helicobacter pylori
Nocente, R; Gentiloni, N; Cremonini, F; Giorgi, A; Serricchio, M; Santoliquido, A; Gasbarrini, G; Gasbarrini, A
Southern Medical Journal Volume 93, Issue 10, October 2000, Pages 1022 – 1023
14 Helicobacter pylori is associated with modified lipid profile: impact on lipoprotein(a)
G. Chimienti, F. Russo, B. L. Lamanuzzi, M. Nardulli, C. Messa, A. Di Leo, M. Correale, V. Gianuzzi and G. Pepe
Clinical Biochemistry Volume 36, Issue 5, July 2003, Pages 359 – 365
15 Does eradication of Helicobacter pylori infection help normalise serum lipid and CRP levels?
Kanbay M.; Gur G.; Yucel M.; Yilmaz U.; Boyacioglu S.
Digestive Diseases and Sciences Volume 50, Issue 7, 2005, Pages 1228 – 1231
16 Association between chronic Helicobacter pylori infection and acute ischemic stroke: Fukuoka Harasanshin Atherosclerosis Trial (FHAT)
Yasunori Sawayama, Iwao Ariyama, Maki Hamada, Shigeru Otaguro, Takao Machi, Yuji Taira and Jun Hayashi
Atherosclerosis Volume 178, Issue 2, February 2005, Pages 303 – 309
17 A hematologist’s view of unexplained iron deficiency anemia in males: Impact of Helicobacter pylori eradication
Chaim Hershko, Mara Ianculovich and Moshe Souroujou
Blood Cells, Molecules and Diseases doi 10.1016/j.bcmd.2006.09.006
18 The clinical importance of hypochlorhydria (a consequence of chronic Helicobacter infection): Its possible etiological role in mineral and amino acid malabsorption, depression, and other syndromes
R. E. Cater 11
Medical Hypotheses Volume 39, Issue 4, December 1992, Pages 375 – 383
19 Helicobacter pylori eradication decreases blood neutrophil and monocyte counts
Kondo Y.; Joh T.; Sasaki M.; Oshima T.; Itoh K.; Tanida S.; Kataoka H.; Ohara H.; Nomura T.; Itoh M.
Alimentary Pharmacology and Therapeutics, Supplement Volume 20, Issue1, 2004, Pages 74 – 79
20 Effect of Helicobacter pylori eradication in patients with chronic idiopathic thrombocytopenic purpura – A randomised controlled trial
Suzuki T.; Matsushima M.; Masui A.; Watanabe K.-L; Takagi A.; Ogawa Y.; Shirai T.; Mine T.
American Journal of Gastroenterology Volume 100, Issue 6, 2005, Pages 1265 – 1270
21 Alzheimer’s disease and Helicobacter pylori infection: Defective immune regulation and apoptosis as proposed common links
Jannis Kountouras, Emmanuel Gavalas, Christos Zavos, Christos Stergiopoulos, Dimitrios Chatzopolous, Nikolaos Kapetanakis and Dimitrios Gisakis
Medical Hypotheses Volume 68, Issue 2, 2007, Pages 378 – 388
22 Role of inflammation in gastrointestinal tract in aetiology and pathogenesis of idiopathic parkinsonism
Clive Weller, Norman Oxlade, Sylvia M. Dobbs, R. John Dobbs, Andre Charlett and Ingvar T. Bjarnason
FEMS Immunology and Medical Microbiology Volume 44, Issue 2, 1 May 2005, Pages 129 – 135
23 Link between Helicobacter pylori infection and idiopathic parkinsonism
S.M. Dobbs, R.J. Dobbs, C. Weller and A. Charlett
Medical Hypotheses Volume 55, Issue 2, August 2000, Pages 93 – 98
24 Epidemic Optic and Peripheral Neuropathy in Cuba: A Unique Geopolitical Public Health Problem
Thomas R. Hedges 111, MD, Michio Hirano, MD, Katherine Tucker, PHD, and Benjamin Caballero, MD, PHD
Survey of Ophthalmology Volume 41, Number 4, January-February 1997
25 Plasma levels of antioxidant vitamins C and E are decreased in vascular parkinsonism
George P. Paraskevas, Elizabeth Kapaki, Olga Petropolou, Maria Anagnostouli, Vasileious Vagenas and Constantine Papageorgiou
Journal of The Neurological Sciences Volume 215, Issues 1-2, 15 November 2003, Pages 51 – 55
26 Influence of gastric juice pH on the metabolism of vitamin C in gastric mucosa and juice
Safranow K, Korzonek M, Dziedziejko V, Jacubowska K, Sulzyc-Bielicka V, Domanski L, Ciechanowski K, Chlubek D.
Pol Merkur Lekarski, 2006 Feb; 20(116); Pages 168 – 172
27 Relationship of Helicobacter pylori CagA(+) status to gastric juice vitamin C levels
Rokkas T.; Liatsos C.; Petridou E.; Karameris A.; Ladas S.D.; Raptis S.A.
European Journal of Clinical Investigation Volume 29, Issue 1, 1999, Pages 56-62
28 Omeprazole and dietary nitrate independently affect levels of Vitamin C and nitrite in gastric juice
Craig Mowat, Andrew Carswell, Angela Wirz and Kenneth E. L. McColl
Gastroenterology Volume 116, Issue 4, Pages 813 – 822
29 Investigation of Helicobacter pylori ascorbic acid oxidating activity
Lars Odum and Leif P. Andersen
FEMS Immunology and Medical Microbiology Volume 10, Issues 3-4, February 1995, Pages 289 – 294
30 Vitamin B12, demyelination, remyelination and repair in multiple sclerosis
Ariel Miller, Maya Korem, Ronit Almog and Yanina Galboiz
Journal of the Neurological Sciences Volume 233, Issues 1-2, 15 June 2005, Pages 93 – 97
31 Tumor initiating activity of Helicobacter pylori water extract on mouse skin carcinogenesis
Takeshi Ishikawa, Norimasa Yoshida, Harukuni Tokada, Eiichiro Ichiishi, Masashi Kuchide, Satoshi Kokura, Yuji Naito, Shinya Toyokuni, Hoyoko Nishino and Toshikazu Yoshikawa
Cancer Letters Volume 191, Issue 1, 28 February 2003, Pages 41 – 47
32 Therapeutic effects of the antibacterial treatment on intractable skin diseases in Helicobacter pylori-positive patients
Mikihisa Sakurane, Matsunaka Masahiro, Koji Uede, Akiko Shiotani, Shingo Nishioka
Department of Dermatology; Second Department of Internal Medicine, Wakayama Medical University, Japan (Poster Display P249)
33 Eradication of Helicobacter pylori may reduce disease severity in rheumatoid arthritis
Zentillin, P; Seriolo, B; Dulbecco, P; Caratto, E; Iiritano, E; Fasciolo, D; Bilardi, C; Mansi, C; Testa, E; Savarino, V
Alimentary Pharmacology and Therapeutics Volume 16, Issue 7, July 2002, Pages 1291 – 1299
34 Helicobacter pylori and other Helicobacter species in gallbladder and liver of patients with chronic cholecystitis detected by immunological and molecular methods
Apostolov E.; Abu Al-Soud W.; Nilsson I.; Kornilovska I.; Usenko V.; Lyzogubov V.; Gaydar Y.; Wadstrom T.; Ljungh A.
Scandinavian Journal of Gastroenterology Volume 40, Issue 1, 2005, Pages 96 – 102
35 Eradication of Helicobacter pylori may be beneficial in the management of chronic open-angle glaucoma
Kountouras J.; Mylopoulos N.; Chatzopoulos D.; Zavos C.; Boura P.; Konstas A.G.P.; Venizelos J.
Archives of Internal Medicine Volume 162, Issue 11, 10 June 2002, Pages 1237 – 1244
36 Induction of apoptosis as a proposed pathophysiological link between glaucoma and Helicobacter pylori infection
Jannis Kountouras, Christos Zavos and Dimitrios Chatzopoulos
Medical Hypotheses Volume 62, Issue 3, March 2004, Pages 378 – 381
37 The effect of Helicobacter pylori on insulin resistance
Aydemir S.; Bayraktaroglu T.; Sert M.; Sokmen C.; Atmaca H.; Mungan G.; Gun B.D.; Borazan A.; Ustundag Y.
Digestive Diseases and Sciences Volume 50, Issue 11, 2005, Pages 2090 – 2093
38 Association of Helicobacter pylori with central serous chorioretinopathy: hypotheses regarding pathogenesis
Christiano Giusti
Medical Hypotheses Volume 63, Issue 3, 2004, Pages 524 – 527
39 Are dental plaque, poor oral hygiene, and periodontal disease associated with Helicobacter pylori infection?
Anand P.S.; Nandakumar K.; Shenoy K.T.
Journal of Periodontology Volume 77, Issue 4, 2006, Pages 692 – 698
40 Expression cloning of a periodontitis-associated apoptotic effector, cagE homologue, in Actinobacillus actinomycetemcomitans
Yen-Tung A. Teng, and Wenqui Hu
Biochemical and Biophysical Research Communications Volume 303, Issue 4, 18 April 2003, Pages 1086 – 1094
41 Persistence of Helicobacter pylori in the oral cavity after systemic eradication therapy
Gebara E.C.E.; Faria C.M.; Pannuti C.; Chehter L.; Mayer M.P.A.; Lima L.A.;
Journal of Clinical Periodontology Volume 33, Issue 5, May 2006, Pages 329 – 333
42 Some fibrocystic breast change may be caused by sexually transmitted H. pylori during oral nipple contact: Supporting literature and case report of resolution after gut H. pylori eradication treatment
R.E.Kast
Medical Hypotheses doi:10.1016/j.mehy.2006.09.050 (article in press)
43 Helicobacter pylori “Test and Treat” or Endoscopy for Managing Dyspepsia: An Individual Patient Data Meta-analysis
Alexander C. Ford, Michelle Qume, Paul Moayyedi, Nicolas L.A. Arents, Annmarie T. Lassen, Richard F.A. Logan, Kenneth E.I. McColl, Paul Myres and Brendan C. Delaney
Gastroenterology Volume 128, Issue 7, June 2005, Pages 1838 – 1844
44 Palmitoyl ascorbate: Selective augmentation of procollagen mRNA expression compared with L-ascorbate in human intestinal smooth muscle cells
Rosenblat G.; Willey A.; Zhu Y.-N.; Jonas A.; Diegelmann R.F.; Neeman I.; Graham M.F.
Journal of Cellular Biochemistry Volume 73, Issue 3, 15 May 1999, Pages 312 – 320
45 Diverse effects of ascorbic acid and palmitoyl ascorbate on Helicobacter pylori survival and growth
M.Tabak, R.Armon, G. Rosenblat, E. Stermer and I. Neeman
FEMS Microbiology Letters Volume 224, Issue 2, 29 July 2003, Pages 247 – 253
46 Ascorbyl Palmitate as a Carrier of Ascorbate into Neural Tissues
Mieczyslaw Pokorski, Magdalena Marczak, Aneta Dymecka, Piotr Suchocki
Journal of Biomedical Science Volume 10, Issue 2, 2003
47 Multiple Effects of Trehalose on Protein Folding In Vitro and In Vivo
Mike A. Singer and Susan Lindquist
Molecular Cell Volume 1, Issue 5, April 1998, Pages 639 – 648
48 Aggregation mechanism of polyglutamine diseases revealed using quantum chemical calculations, fragment molecular orbital calculations, molecular dynamics simulations, and binding free energy calculations
Koki Tsukamoto, Hideaki Shimizu, Takashi Ishida, Yutaka Akiyama and Noboyuki Nukina
Journal of Molecular Structure: THEOCHEM Volume 778, Issues 1-3, 11 December 2006, Pages 85 – 95
49 Cholesterol synthesis inhibitors protect against platelet-activating factor-induced neuronal damage
Clive Bate, Louis Rumbold and Alun Williams
Journal of Neuroinflammation Volume 4, Issue 5, 18 January 2007
50 Probiotics and Helicobacter pylori
C.Felley MD, Associate physician, instructor and P. Michetti MD, Professor and chief
Best Practice and Research Clinical Gastroenterology Volume 17, Issue 5, October 2003, Pages 785 – 791
51 Effect of probiotics on intestinal regrowth and bacterial translocation after massive small bowel resection in a rat
Jorge G. Mogilner, Isaac Srugo, Michael Lurie, Ron Shaoul, Arnold G. Coran, Eitan Shiloni, and Igor Sukhotnik
Journal of Pediatric Surgery Volume 42, Issue 8, August 2007, Pages 1365 – 1371

Andrew J C Carmichael is a retired Dental Surgeon with a particular interest in microbiology, nutrition and neuropathies – primarily Parkinson’s Disease

Relevant interests:

  • Former Governor of Lancashire Teaching Hospitals NHS Foundation Trust
  • Former Chair Preston Branch of the Parkinson’s Disease Society