According to Olga Falkowski, MD, board-certified pathologist and Medical Director of Acupath Laboratories, Inc., a national medical laboratory that specializes in gastrointestinal pathology, "the biopsy remains the gold standard for testing for H. pylori, but we are very excited about new technologies coming down the road with the hopes that better determining the causes of ulcers or gastritis can also help prevent Parkinson's and some cancers such as lymphoma."
Many H. pylori infections go undiagnosed because the infection causes no symptoms, says Dr. Falkowski. When symptoms are present, such as pain and bloating, prompt and effective testing for H. pylori is critical. People with H. pylori infections are at increased risk for developing ulcers in the stomach and/or small intestine (gastric or duodenal ulcers), inflammation of the stomach lining (gastritis), lymphoma and stomach cancer. H. pylori is the only type of bacteria known to cause cancer. One study from France, published in the May 2012 issue of The Lancet Oncology, reveals that one in six cancers worldwide is caused by infection, and that one of the four most prevalent infections is H. pylori.
There are several tests used to detect an H. pylori infection. Patients should discuss the options with their doctors to decide which is best for their individual situation. With that, Dr. Falkowski details the most common options:
Testing for H. pylori
- A biopsy - long regarded as the gold standard of testing - is when a doctor removes tissue from the stomach or intestine. A biopsy is an invasive procedure, but also the most effective, as there are several ways to test the samples in the lab including immunohistochemical studies which identify the presence of H. Pylori.
* For the breath test, patients swallow a capsule containing urea. If the patient has an active H. pylori infection, the urea breaks down to carbon dioxide and is detectable in a patient's exhalation. Looking beyond H. pylori, breath testing is on the cusp of breakthroughs for other diseases, including lung cancer and asthma.
*A blood test is effective - but getting results takes longer than with a breath test - because the H. pylori bacteria creates serum antibodies. The presence of antibodies - in this case IgG, IgM, or IgA - means the patient hasH. pylori now, or was infected with it in the past.
*A stool test pinpoints antigens (molecules) present in the H. pylori bacteria, and is typically used to support a diagnosis or determine if a course of treatment was, in fact, successful.
Patient awareness as critical as effective testing
With the link between H. pylori and a growing number of diseases, Dr. Falkowski is stressing the need for continued study in these areas, as well as increased patient awareness and activism.
"While it may be tempting to write off abdominal discomfort or bloating as stress related, this is one time a patient should follow their instincts and see a doctor," Dr. Falkowski adds. It is better to diagnose the H. pylori infection and eradicate it with simple antibiotics, than to allow it to fester unchecked and possibly lead to life-threatening disease." Dr. Falkowski suggests that patients concerned about abdominal discomfort discuss testing options with their physicians.
Olga Falkowski, M.D. is board-certified in anatomic and clinical pathology by the American Board of Pathology, and serves as the Medical Director and Director of Molecular Genetics at Acupath Laboratories, Inc.
Acupath Laboratories, Inc. is a Plainview, New York, specialty medical lab engaged in cutting-edge diagnostics. www.acupath.com
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