H.pylori infection and related diseases with invasive diagnostic methods

The article was written by Specialist Doctor II Bui Thu Huong - Head of Emergency, Day Treatment Unit - Vinmec Times City International General Hospital.

Helicobacter pylori is a bacterium that secretes an enzyme called urease that helps it neutralize the acidity in the stomach, so it can live and grow in the human stomach. This article will help you better understand H.pylori infection and related diseases with invasive diagnostic method.

1. H.Pylori infection and related diseases

About Helicobacter Pylori :
Gram-negative spirochetes that live in the sensitive layer of the stomach lining Major cause of inflammation, ulceration and cancer of the stomach and duodenum Increased prevalence of H. pylori infections (early infection in children) increasing diversity of H. pylori strains In 1997, the H. pylori genome was identified

H. pylori test:
Gastroduodenal X-ray has little diagnostic value Quantitating gastric acid content Endoscopy, gastric mucosa biopsy for microscopy for diagnosis and classification: Urease test Microscopic staining for bacteria H. pylori culture Other diagnostic tests for H. pylori infection Diagnostic tests for gastrointestinal bleeding and anemia

H.Pylori sống ở lớp nhạy niêm mạc dạ dày

2. Intrusive diagnostic method

2.1 Endoscopy Endoscopy with gastric biopsies allows the identification of bacteria and gastric lesions It is a reliable diagnostic method because: Diagnosis of ulcers. Allows to determine the cause of diseases: GERD, esophagitis, eosinophilia . Take biopsies for antibiotic analysis and molecular biology methods to determine the genome of bacteria. Usually performed in children with gastrointestinal symptoms. Not suitable for epidemiological studies.

Nội soi dạ dày tại Vinmec — Nội soi dạ dày

2.2 UREASE Rapid Test (RUT) RUT allows to determine the presence of bacteria based on the activity of the enzyme urease. RUT is a simple method, high diagnostic value, easy to implement to determine the status of H.pylori infection. Sensitivity: 75% to 100% . Specificity: 84% to 100%. Specificity is highest when reading results in 1 hour. The sensitivity of the RUT is affected by: The amount of bacteria in the biopsy piece. Use of urease inhibitors: antibiotics, proton-pump-inhibitors and bismuth.

2.3 Histopathology Considered the gold standard for detecting H.pylori infection Methods: Giemsa stain Hematoxylin eosine stain Genta stain, toluidine blue Romanouski and immunohistochemical methods Sensitivity: 66% to 100% Specificity: 94% to 100% Advantages: Assess inflammation and extent of injury Cons: Accuracy depends on the number of bacteria in the biopsy piece, the biopsy site, and the experience of the operator. histopathology 2.4 Bacterial culture method Is the most specific method for the diagnosis of H. pylori infection Sensitivity ranges from 50% to 90% Gram-negative bacteria, producing urease, oxidase and catalase, Accuracy of secondary test Depending on transport and culture conditions, it is a complex, time-consuming and unnecessary method for routine diagnostics. Allows determination of antibiotic sensitivity and genome of H. pylori strains.

Nuôi cấy vi khuẩn giúp chẩn đoán nhiễm H. pylori

2.5 Molecular biology method (PCR) PCR is used to detect bacteria in gastric biopsy fragments, gastric juice, dental plaque, saliva, and feces. PCR is applied when: Infection with other bacteria => difficult to isolate Transform bacteria due to inappropriate culture conditions Sensitivity 85% - 100% Specificity: 100% Advantages: Detects bacteria in saliva, gastric juice, feces Identifies genome of bacteria Cons: Modern and expensive technology and equipment

RT-PCR được dùng để chẩn đoán virus gây bệnh quai bị — Phương pháp sinh học phân tử (PCR)

3. Prevention

When babies have symptoms of abdominal pain, vomiting, abdominal distension... they must go to the hospital to be diagnosed with the disease, not self-treat.
Patients with digestive diseases or with suspected symptoms can go to Vinmec International General Hospital for examination and treatment. Vinmec gathers a team of well-trained, highly qualified and experienced gastroenterologists specialized in the treatment of diseases related to the digestive system - hepatobiliary system. In addition, Vinmec invests in a system of modern and advanced medical equipment with professional service quality, bringing high efficiency in diagnosis and treatment.

Khám sàng lọc tim mạch, khám bệnh — Bệnh nhân có triệu chứng nghi ngờ có thể đến Bệnh viện Vinmec để được thăm khám

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