Intended for healthcare professionals

Editorials

Causes of failure of eradication of Helicobacter pylori

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7354.3 (Published 06 July 2002) Cite this as: BMJ 2002;325:3

Reduction of Helicobacter pylori and Lactobacilli.

To

The editor
British Medical Journal
London, UK.

Sub: Response to your editorial “causes of failure of eradication of Helicobacter pylori” (BMJ 2002; 325: 3-4, 6 July).

Dear Sir,
I have read with interest the editorial “causes of failure of eradication of Helicobacter pylori” (BMJ 2002; 325: 3-4, 6 July) by Dr. Jenks. It is difficult to eradicate Helicobacter pylori (H.pylori) from the gastric and duodenal mucosa and effective treatment requires multiple drug regiments(1). Antibiotic resistance to H. pylori is increasing due to widespread use of antibiotics(1). H.pylori organisms have been noted under the finger nails, between gums and teeth, dental plaque and over the tongue(2,3). In Vitro studies have shown that Lactic acid and Lactobacilli inhibit the growth of H.pylori(4). H. pylori has cytoplasmic urease which converts urea into carbon dioxide and ammonia(5). Lactic acid and Lactobacilli may prevent or suppress the production of ammonia which can inhibit the colonisation of H. pylori. Fermented milk products (curd, buttermilk and yoghurt) have lactic acid, Lactobacilli and nutrients. Intake of these fermented milk products will cause slower gastric emptying, and this will give enough time for local action of lactic acid and Lactobacilli to act on H. pylori organisms in the stomach. In addition to the use of antibiotics, proper washing of hands before meal and consumption of buttermilk(200-300 ml) twice a day before meal may help in reduction of H. pylori organisms.

References:

1. Jenks P.J. Causes of failure of eradication of Helicobacter pylori. BMJ 2002; 325: 3-4.
2. Larkin M. Hands could be key to spread of Helicobacter pylori Lancet 1999: 354(9179): 654
3. Watts T. H. pylori doesn’t live only in the stomach. bmj.com, 5 Jul 2002 (electronic response)
4. Midolo P.D., Lambert J.R., Hull R., Luo F., Grayson M.L. In Vitro inhibition of Helicobacter pylori NCTC 11637 by organic acids and lactic acid bacteria.
J Appl Bacteriol 1995; 79(4): 475-9.
5. Weeks D.L., Eskandari S., Scott D.R., Sachs G. A H+gated urea channel: the
link between Helicobacter pylori urease and gastric colonization. Science 2000;287(5452): 482-5.

Dr. Mahantayya V. Math
Department of Physiology
MGM Medical College, Kamothe, Navi Mumbai-410209.

Email: mgmmc@vsnl.com

Competing interests: No competing interests

14 July 2002
Mahantayya V. Math
Assistant Lecturer in Physiology
MGM Medical College, Kamothe, Navi Mumbai-410209.