Helicobacter pylori

It is a spiral/helical/curved Gram negative bacteria motile with a tuft of polar flagella. It is strongly urease positive as well as being oxidase and catalase positive. It has a predilection for the gastric mucus glands. Urease helps in invasion as it neutralizes the acidic pH in the stomach helping the organism to survive. It breaks down the gastric protective mucus layer predisposing to peptic ulcer disease.

All patients with peptic ulcer disease must be screened for H.pylori by urea breath test, antigen detection in stool, IgG antibody detection from blood or rarely gastric mucosal biopsy. H.pylori has also been associated with chronic gastritis and MALT lymphomas (mucosa associated lymphoid tissue) and gastrointestinal B cell lymphomas. Interestingly, both peptic ulcer disease and MALT lymphomas are cured once H. pylori is eradicated from the body.