August 28, 2010

Up close with the monster within

THE gut-gnawing, H pylori, cannot be seen by the naked eye. On top of a pinhead, millions of these monstrous-looking corkscrew pathogens can be seen under an electron microscope.

They look like helicopters – except that their "rotor blades" are located on one end instead of being on the top of their peanut-shaped bodies. That is partly the reason why they are called "helicobacter" and the term "pylori" refers to their favourite fortress, the epithelial lining – in the lowest part of the stomach or the pylorus.

H pylori thrive in the gastric pool and swim with ease with the aid of their flagella. As voracious as piranhas they make mince meat of stomach cells, causing bleeding and peptic ulcers that could eventually perforate.

In Malaysia ethnic Chinese have the largest incidence of H pylori colonisation in their bellies while the Indian population comes a close second and the lowest percentage is among the Malays.

No one should attempt to take on these Jurassic-like invisible horrors through self-diagnosis, self-doctoring or self-medication with antacids.

Symptoms of H pylori infection include an unusually full-feeling in the stomach and sharp fiery pain from the navel to the breastbone with intermittent vomiting as well as nausea. The abdominal pain can radiate to the throat, sometimes to the back, the lower abdomen and of course the solar plexus and the apex of the shoulders.

Most patients complain of unbearable chest burn and a sourish-pungent taste flourishing in the mouth. Acid reflux is common during an attack and sometimes the symptoms of H pylori infection can mimic the symptoms of a heart attack and vice versa. That is why gastric pain and symptoms of acid reflux must be promptly examined by a doctor.

H pylori infection can be diagnosed via blood tests, breath tests and oral gastro-duodenal scopy and or colonoscopy. During the scope procedure the physician will remove some stomach tissue to be tested for malignancy.

A gem of folksy "scientific conjecture" has it today, that the man who left behind his legacy of the Nobel Prize, Alfred Nobel himself may have been infected with H pylori bacterium. This is based on what Nobel’s autobiographer wrote and what Nobel himself penned.

The autobiographer wrote that Nobel complained of frequent indigestion and abdominal discomfort. Nobel himself in trying to sum up his life in one terse sentence wrote: "I am a misanthrope and yet utterly benevolent, have more than one screw loose, yet am a super-idealist who digests philosophy more efficiently than food."

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