ตรวจหาเชื้อแบคทีเรีย H.pylori สาเหตุหลัก...โรคแผลในกระเพาะอาหาร (Peptic Ulcer)

Gastric disease is a common condition that causes discomfort and suffering from intermittent abdominal pain. In some cases, complications such as gastric bleeding or perforation may occur, and it may be one of the causes of stomach cancer. The affected areas may develop gastric ulcers or duodenal ulcers. Due to the similar causes, these conditions are often collectively referred to as “Peptic Ulcer Disease”.
<h2 style=" color: #008080;">Causes of Peptic Ulcer Disease</h2>
<ol>
<li style="">Infection with Helicobacter pylori (H. pylori) bacteria is the most important cause of peptic ulcers, accounting for 60% of all cases.</li>
<li style="">Increased stomach acid can easily lead to peptic ulcer disease.</li>
<li style="">Damage to the stomach lining, such as from aspirin, painkillers for bone pain, or alcohol consumption.</li>
</ol>
<h2 style="text-align: center; color: #008080;"><img decoding="async" style="width: 50%;" src="https://pyt-storage.sgp1.cdn.digitaloceanspaces.com/photo_from_old_pyt/forms/04288e0d81fa95d915adb92c947352ef.jpg" /></h2>
<h2 style=" color: #008080;">Symptoms of Peptic Ulcer Disease</h2>
<ol>
<li style="">Pain in the upper abdomen or epigastric region.</li>
<li style="">Feeling of fullness, bloating, tightness, burning, or heat. Symptoms are related to eating or the type of food. Some patients may experience abdominal pain at night.</li>
<li style="">Some patients may have complications such as vomiting blood.</li>
</ol>
<h2 style=" color: #008080;">What is the harmful stomach bacteria Helicobacter pylori?</h2>
<ol>
<li style="">This type of bacteria is highly acid-resistant, allowing it to live in the mucous layer inside the stomach.</li>
<li style="">It can produce toxins that damage the stomach lining cells, causing inflammation of the stomach lining, which is the most important cause of peptic ulcers.</li>
<li style="">Research from medical associations and the World Health Organization has found that this bacteria is a carcinogen (Carcinogen group 1), increasing the risk of stomach cancer in patients with peptic ulcers by 3-6 times compared to normal people.</li>
</ol>
<h2 style=" color: #008080;">Methods to detect Helicobacter pylori infection include:</h2>
<ol>
<li style="">Endoscopy with biopsy.</li>
<li style="">Testing for H. pylori through breath analysis.</li>
<li style="">Blood test to detect antibodies from infection.</li>
</ol>
<h2 style=" color: #008080;">According to research by the Food and Drug Administration, the effectiveness of each test method varies as follows:</h2>
<table id="customers">
<tbody>
<tr>
<th>Test Method</th>
<th>Endoscopy – Biopsy</th>
<th>Antibody Detection</th>
<th>Breath Test</th>
</tr>
<tr>
<td style="text-align: center;">Sensitivity</td>
<td style="text-align: center;">95.4%</td>
<td style="text-align: center;">95.7%</td>
<td style="text-align: center;">98.8%</td>
</tr>
<tr>
<td style="text-align: center;">Specificity</td>
<td style="text-align: center;">100%</td>
<td style="text-align: center;">100%</td>
<td style="text-align: center;">100%</td>
</tr>
<tr>
<td style="text-align: center;">Accuracy</td>
<td style="text-align: center;">96.6%</td>
<td style="text-align: center;">91.8%</td>
<td style="text-align: center;">99.1%</td>
</tr>
</tbody>
</table>
<h2 style=" color: #008080;">Treatment to eradicate Helicobacter pylori infection</h2>
<ol>
<li style="">Take acid secretion inhibitors for 6-8 weeks combined with antibiotics for 1-2 weeks.</li>
<li style="">After stopping medication for 4 weeks, patients should return for a follow-up Helicobacter pylori test.</li>
</ol>
<h2 style=" color: #008080;">Overall steps for diagnosis and treatment</h2>
<ul>
<li style="">Identify the cause of peptic ulcer disease.</li>
<li style="">Biopsy → Breath test → Antibody detection.</li>
<li style="">If infection is detected, treat with acid reducers and antibiotics.</li>
<li style="">Return for follow-up testing to confirm treatment success.</li>
</ul>
<h2 style=" color: #008080;">Key principles of H. pylori detection in the stomach using the breath test</h2>
Helicobacter pylori bacteria can produce the enzyme Urease. Therefore, diagnosis involves the patient taking a 13C-coated Urea pill. If the patient is infected with H. pylori, the pill is broken down, producing ammonia (NH3) excreted in urine and carbon dioxide gas (13CO2) exhaled in the breath. The hospital collects breath samples from the patient for analysis.
<h2 style=" color: #008080;">Detection of Helicobacter pylori infection in the stomach by 13C-Urea Breath Test</h2>
<h4 style=" color: #008080;">Patient preparation</h4>
<ol>
<li style="">Fast from food and drink for at least 4 hours before the test to ensure an empty stomach.</li>
<li style="">Avoid foods containing urea such as alcohol, sugarcane juice, and pineapple juice.</li>
<li style="">Avoid smoking.</li>
<li style="">Stop antibiotics and acid secretion inhibitors such as PPIs (e.g., omeprazole, esomeprazole, dexlansoprazole) and P-CABs (e.g., vonoprazan) at least 2 weeks before the test or as directed by a physician.</li>
</ol>
<h2 style=" color: #008080;">Procedure for the 13C-Urea Breath Test</h2>
<img decoding="async" style="width: 100%;" src="https://pyt-storage.sgp1.cdn.digitaloceanspaces.com/photo_from_old_pyt/forms/6ed7f836d7332b48aa5b02d2b3698d19.jpg" />
<ol>
<li style="">Exhale into sample bag (Bag no.1) until full before taking the UBiT pill.</li>
<li style="">Swallow the UBiT pill (within 5 seconds) with one glass of water (100 milliliters). Do not chew or hold the pill in the mouth.</li>
<li style="">Lie on the left side for 5 minutes.</li>
<li style="">Sit upright for 15 minutes.</li>
<li style="">After 20 minutes from taking the UBiT pill, exhale into the second sample bag (Bag no.2) until full.</li>
<li style="">Submit both sample bags to the staff for analysis.</li>
</ol>
<h2 style=" color: #008080;">Advantages of the 13C-Urea Breath Test</h2>
<ul>
<li style="">Non-invasive and painless for patients.</li>
<li style="">98% accuracy.</li>
<li style="">Specifically detects H. pylori.</li>
<li style="">The 13C-coated Urea pill is non-radioactive.</li>
<li style="">Safe for both patients and staff.</li>
<li style="">No residual substances remain in the body.</li>
<li style="">Reduces infection risk as sample bags are disposable.</li>
<li style="">Easy and quick analysis with results available in 30 minutes.</li>
</ul>
&nbsp;
Gastroenterology and Liver Center&nbsp; Phyathai 2 Hospital, 4th Floor, Building A Tel. 02-617-2444 ext. 7401, 7406

Many people may understand that peptic ulcer disease is caused by increased stomach acid, but in fact, Helicobacter pylori (H. pylori) bacterial infection is the main cause found in up to 60% of cases.

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Testing for H.pylori bacteria, the main cause... of peptic ulcer disease (Peptic Ulcer)

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