Twenty years ago, stomach ulcers were treated with cream that is so loaded with fat and cholesterol that it often caused heart attacks. Today, almost everyone with belching and burning in the stomach should be treated with antibiotics. In 1983 they laughed at Dr. Barry Marshall when he reported that stomach ulcers were caused by infection with helicobacter pylori and could be cured with antibiotics. Fellow physicians were so mean to him that he responded by swallowing a vial of helicobacter and almost died.
Now almost everyone agrees that all people who have belching and burning in the stomach and a positive blood test for helicobacter pylori can be cured with antibiotics, but many gastroenterologists stubbornly refuse to treat patients with ulcer symptoms and a negative blood test or biopsy for that germ. They are clearly wrong because recent literature shows that at least 19 germs cause an irritation in the stomach (9), including H. helmannii, H. felis, H. rappini, H. cinaedi, H. fennelliae and H. pullorum, H. hepaticus, H. Billis, H. canis, cytomegalovirus and mycoplasma (1,2,3,4,5,6,7,). Helicobacter species have been isolated from the stomachs of dogs, cats, ferrets, pigs, monkeys and cheetahs, birds, mice, chickens. The standard treatment of one week of clarithromycin 500 mg twice a day, metronidazole 500 mg twice a day and omeperazole 20 mg once a day is safe and effective. As I have mentioned many times, these germs also grow in saliva, so they are transmitted by kissing. So some doctors prescribe antibiotics to all people with belching and stomach burning and check their spouses for infections.
When a person has belching and stomach burning and no obvious infection, a doctor may diagnose GERD or reflex which means that the person will never get better and must take ulcer medicines for the rest of his life. It is cruel to tell a person with belching and burning that he has reflux unless he has first been given the standard treatment regimen of two antibiotics and one ulcer medication for at least one week. If that regimen doesn't stop his symptoms, the person should take ampicillin and an ulcer medication for six weeks. If that doesn't work, the person is stuck with a diagnosis of reflux, which has no cure.
1) JG Kusters, EJ Kuipers. Non-pylori Helicobacter infections in humans. European Journal of Gastroenterology & Hepatology. 10: 3 (MAR 1998):239-241.
2) JC Debongnie, M Donnay, J Mairesse, V Lamy, X Dekoninck, B Ramdani. Gastric ulcers and Helicobacter heilmannii. European Journal of Gastroenterology & Hepatology. 10: 3 (MAR 1998):251-254.
3) MA Stone, DB Barnett, JF Mayberry. Lack of correlation between self-reported symptoms of dyspepsia and infection with Helicobacter pylori, in a general population sample. European Journal of Gastroenterology & Hepatology. 10: 4 (1998):301-304.
4) M Stolte,G Kroher,A Meining,A Morgner,E Bayerdorffer,B Bethke. A compari- son of Helicobacter pylori and H-heilmannii gastritis-A matched control study involving 404 patients. Scandinavian Journal of Gastroenterology 32:1(JAN 1997):28-33.
5) MJ Blaser. Hetero- geneity of Helicobacter pylori. European Journal of Gastroenterology & Hepatology. 9:Suppl.1 (APR 1997)S3-S6.
6) C Seidl,V Grouls,HJ Schalk.Bulboduodenitis associated with Helicobacter heilmannii (formerly Gastrospirillum hominis) infection. A rare cause of duodenal ulcer. Leber Magen Darm 27: 3 (MAY 1997):156-159.
7) H Yoshida,K Hirota,Y Shiratori,T Nihei,S Amano, A Yoshida,O Kawamata,M Omata. Use of a gastric juice-based PCR assay to detect Helicobacter pylori infection in culture-negative patients. Microbiology 36:1(JAN1998):317-320.
8) J Fox. Helicobacters: the next generation. Baillieres Clinical Infectious Diseases 4: 3(NOV 1997):449-471.
9) A Meining, G Kroher, M Stolte. Animal reservoirs in the transmission of Helicobacter heilmannii - Results of a questionnaire-based study. Scandinavian Journal of Gastroenterology. 33: 8(AUG 1998):795-798. H. heilmannii infection was strongly associated with contact with dogs, cats, cattle, or pigs.
10) M Stolte, E Meier, A Meining. Cure of autoimmune gastritis by Helicobacter pylori eradication in a 21-year-old male. Zeitschrift Fur Gastroenterologie 36: 8 (AUG 1998):641-643.
11) A Meining, G Kroher, M Stolte. Animal reservoirs in the transmission of Helicobacter heilmannii - Results of a questionnaire-based study. Scandinavian Journal of Gastroenterology 33: 8(AUG 1998):795-798. dogs, chickens cats, cattle, or pigs reservoirs in the transmission of H. heilmannii. J Fox. Helicobacters: the next generation. Baillieres Clinical Infectious Diseases 4: 3(NOV 1997):449-471. dogs, cats, ferrets, pigs, monkeys and cheetahs, other mammals, and birds. mice H. canis, H. rappini and H. pullorum isol To date, there are at least 19 formally named species of the new genus, Helicobacter.
13) Sxcand J Gastroenterology 1997;32:535-40.
15) Gut 1999;45:186-90.
18) Letter to the Editor NEJM 2000;342:589-90.
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