How the super bacteria that causes gastritis works and what is the most effective treatment

Australian scientists Barry Marshall and Robin Warren they received the Nobel Prize in Medicine in 2005 for a discovery made more than 20 years earlier. Then, around the year 1984, they had typified for the first time a bacterium in the stomach, it was the Helicobacter pylori. But they had advanced even further. They saw that this pathogen caused ulcer and chronic gastritis and that it could be cured with an antibiotic, which was bismuth.

But, as said, it was the middle of the 1980s, and They were times in which medicine was inclined towards the use of acid secretion inhibitors to alleviate gastritis and ulcers, so the discovery was dismissed without much thought. It would take those two decades, until the early 2000s, for the discovery to be claimed and progress was made in the use of antibiotics to cure many gastric diseases.

“This bacterium normally lives in the human stomach. But how can it live there with the permanent acid secretion that the stomach has? Because it releases an enzyme called urease, which creates a layer around it that allows it to cancel out the acid and get between the mucus of the stomach and the epithelial cells to live in a place where it is not affected by acid secretion.”explained to Infobae the doctor Rudolph Corti, gastroenterologist, head of the Esophagus and Stomach Unit of the Udaondo Hospital of the City of Buenos Aires Y director of the specialty of Gastroenterology at the Faculty of Medicine of the UBA.

The bacteria “It generates active gastritis, a gastric ulcer and fundamentally, gastric cancer has been detected in recent years. It seems that in countries with a higher prevalence of gastric cancer, such as the countries of the Pacific coast, the Asian countries, etc., there is a high prevalence of Helicobacter pylori and gastric cancer”, he assured.

Dr. Corti assured that serious statistics show that “More than 80% of gastric cancers in the most distal part of the stomach would be related to this bacterium.” Instead, “why not all patients, despite being infected, develop gastric cancer, is not yet known”, he said, although he warned that it is a disease with a large component of “environmental factors”such as the consumption of “foods with a high fat content, red meats or eating few carotenoids, few leafy vegetables, little vitamin C. It is multifactorial, but they are all environmental factors, that is why removing the helicobacter removes one of the factors that can generate gastric cancer”.

Chronic gastritis or chronic duodenitis, caused by infection by the bacterium helicobacter pylori, is the most frequent of the diseases. Chronic gastritis can cause changes in the lining or inner layer of the stomach, such as atrophic gastritis (or “wasting/thinning” of the gastric mucosa, which is the innermost layer of the stomach) or in other cases, stomach cancer.

Neither does the bacterium explain all gastritis and gastric ulcers, although it is a preponderant factor. According to Dr. Corti, these pathologies “They may be primarily due to this bacterium and the other very important cause is taking non-steroidal anti-inflammatory drugs, such as aspirin, ibuprofen, diclofenac, etc.” These are the most prevalent causes in Argentina and “the two can occur together, the bacteria and the taking of anti-inflammatories,” he said. For this reason, “when a patient takes anti-inflammatories for more than 4 weeks and the bacteria is present, it must be eradicated to avoid the potentiation of the effects”.

In Argentina, Helicobacter pylori is considered to have a “prevalence in the asymptomatic population of almost 50%. In other words, 1 in 2 people is infected. And, among those who have “some symptom of the upper or epigastic digestive tract, heartburn, etc., up to 70% are infected.”

As for the routes of transmission, science has detected several. “The first of these is the fecal-oral route. It is known that it can enter through the mouth because there is a rest of bacteria in the dental plaque and there are antigens of the bacteria in the fecal matter”explained the specialist to this medium. “The other form of transmission, which occurs in countries with a lower socio-economic level, is the gastro-oral route.” The main example is that of “boys under 1 year of age who vomit or regurgitate and they re-ingest their vomit and become infected again. The third possibility is by vectors like trypanosoma cruzi” that generates Chagas disease and transmitted by vinchuca. Also “The house fly, in some countries like Sweden. This is the least studied of all. Y Remains of bacteria have been observed in contaminated water in areas of our country. So the water could be a contaminant if it’s infected.” he added.

Since Marshall and Warren first approached each other, the available cures have been refined. In any case, Dr. Corti clarified that “To date, the ideal treatment for the eradication of the bacteria has not been achieved. With the best results we have, we reach 90% eradication and it is achieved with two treatments. We both have them in Argentina”.

At the moment, he stressed, “the only therapeutic gesture we have to prevent this gastric reaction is the eradication of this bacterium. therefore, “it must be sought. These gastritis can be cured when the bacteria disappear.

“One of the therapies is called quadruple, is bismuth-free, includes an acid secretion inhibitor—which may be the omeprazole, pantoprazole— amoxicillin, netromycin and metronidazole. At 14 days of treatment, he explained.

The other treatment, he added, “it is the novelty in Argentina”, although “it has already been used in the world since 2015″. It is a “3-in-1 capsule. Three medications have been compacted into one capsule: bismuth, which is the main chemotherapy and antibiotic for helicobacter, which has never had resistance until now; tetracycline oxide and metronidazole. Those three go in a capsule. Which is actually two capsules in one,” he explained.

Treatment consists of “3 tablets per day after breakfast, lunch and dinner of the same capsule for 10 days. With that the eradication It exceeds 90% worldwide, according to very serious statistics.” It is a treatment whose total cost in Argentina, said the specialist, is around $6,000, while the same therapy costs $1,000 in the United States.

The drug was developed by Craveri Laboratories, with 100% Argentine capital, and is made entirely in the country. The drug was launched last May and has a monocapsule triple therapy format with bismuth. It has the approval of the main regulatory authorities in the world (FDA, from the US, and EMA, from Europe), but until now, it was not available in Argentina, reported the manufacturing company.

Corti explained that “it is a treatment of choice. It is called in Argentina Trylori and in the world Pylera, but it is exactly the same. The Trylori is designed and patented by the Craveri laboratory, which is the first Argentine laboratory that was able to achieve a molecular structure of this type in our country because it is a very difficult design to carry outyou have to have special machines, among other things”

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