Why is it important to diagnose Helicobacter during a pandemic?

COVID-19 is a dangerous disease that poses a threat not only with its unpredictable course and severe consequences for the body, but also with a burden on the healthcare system. Suffice it to recall the first months of the pandemic: all scheduled appointments and examinations were postponed, medical institutions were redesigned, and doctors were preparing for a long and hard work with covid patients over the coming months.

And although all the efforts made made it possible to soften the blow, the excess mortality of people, unfortunately, still took place. The reason for this was not only the coronavirus infection itself, but also the inability to receive timely medical care for people with other diseases who needed it.

The relationship of COVID-19 with gastrointestinal problems

Currently, the situation with coronavirus in Russia has relatively stabilized, and planned medical care has become available to citizens again. Patients can apply to medical institutions to specialists of various profiles. Timely treatment and prevention of chronic diseases, as well as various exacerbations, are very important, since it is not known what epidemiological situation will arise in the near future. We only know that the coronavirus will stay with us for a long time. Maintaining all organ systems in a healthy state will ease the course of a coronavirus infection in the event of a potential infection. In particular, this is very true for the digestive system, and here’s why.

Since the first weeks of the pandemic, patients with COVID-19 have experienced not only respiratory, but also gastrointestinal symptoms: abdominal pain, vomiting, nausea, and diarrhea. Subsequently, the direct connection of these symptoms with coronavirus infection was confirmed. ^[1]. In patients with COVID-19, intestinal dysbiosis develops and its bacterial diversity decreases, even if the patient has not previously suffered from gastrointestinal problems. And an initially unhealthy gut microbiome may predispose people to severe coronavirus infection. ^[2].

The state of the gastrointestinal tract directly affects the immune system. Recall the functions of the intestinal microbiota: this includes strengthening anti-infective protection and the formation of immunity, so it is extremely important to treat all pathologies associated with it in a timely manner. ^[3]. It should be borne in mind that the organs of the gastrointestinal tract are interconnected in a subtle relationship, and this relationship is especially closely traced between the stomach and intestines. Abnormalities in the functioning of the stomach can lead to a decrease in immune defenses in the intestines and, as a result, a more severe course of COVID-19 and serious consequences from it. How can this be avoided?

Influence of Helicobacter on the course of coronavirus infection

One of the main causes of stomach pathologies is the bacterium Helicobacter pylori. Helicobacter pylori causes a number of serious diseases, in particular, gastritis, peptic ulcer of the stomach or duodenum, duodenitis, stomach cancer and iron deficiency anemia. Recent studies have pointed to another, previously unknown danger of bacteria. Its presence in the stomach can significantly aggravate gastrointestinal symptoms during the course of a coronavirus infection. Increasing abdominal pain, nausea, vomiting, and diarrhea ^[4]. Against the background of lack of appetite, the presence of such complaints forces the patient to refrain from eating, limiting the intake of nutrients necessary for recovery.

Patients who have recovered from coronavirus confirm that even with the mildest form of this disease and the absence of respiratory symptoms, there is a strong weakness and lack of strength. Add to this painful gastrointestinal symptoms: the experience is negative, unnecessary and dangerous. Moreover, Helicobacter pylori adversely affects the microbial composition of the intestine and can cause its dysbiosis, which, as mentioned above, in turn leads to a decrease in immunity and a greater vulnerability of the human body to COVID-19. ^[5]. It is because of all these dangers that it is very important to detect Helicobacter pylori infection in a timely manner, even during the COVID-19 pandemic.

Diagnostic methods for Helicobacter pylori

For the diagnosis of Helicobacter pylori, both invasive and non-invasive diagnostic methods are used. Invasive include histological examination, rapid urease test, microbiological culture, and PCR analysis. These tests are done using a biopsy, a piece of stomach tissue that a doctor removes during an endoscopy. Of the non-invasive methods, the most widely used are the urease breath test and the analysis of feces for antigen to Helicobacter. The gastroenterologist chooses the diagnostic method taking into account the clinical picture and contraindications, for example, 13C-urea breath test cannot be used in patients with gastritis and stomach ulcers ^[6].

None of these methods is the “gold” standard in clinical practice, therefore, for a more reliable result and an accurate diagnosis, doctors use the results of two or more methods, comparing them with each other.

The development of modern diagnostic methods allows more accurate diagnosis of the infection, which, in turn, contributes to the timely treatment of H.pylori-associated diseases. ^[7]. For example, in Japan, since 2013, according to the state strategy, preventive and large-scale diagnostics of infection with this bacterium has been carried out, aimed at reducing cases of stomach cancer caused by Helicobacteriosis. ^[8]. In addition to detecting the presence of the bacterium itself in the stomach, tests are sometimes performed to assess its virulence and antibiotic sensitivity factors, as well as screening for precancerous lesions and gastric cancer.

Treatment of Helicobacter infections

Typically, to treat an H. pylori infection, a doctor will prescribe therapy that includes a combination of antibiotics with proton pump inhibitors and bismuth drugs. The treatment regimen involves taking the recommended number of tablets per day for several weeks. It is really important for the patient to take whatever the doctor prescribes and follow his instructions. This is especially true for antibiotics: it is important to use them correctly in order to avoid the emergence of resistance in bacteria. The antibiotic resistance of H. pylori is currently being investigated by scientists, and there are already reports of cases of resistance of this microorganism to common drugs, such as clarithromycin and metronidazole. ^[9].

Not earlier than six to eight weeks after the completion of therapy, it is necessary to test for Helicobacter pylori again to make sure that the treatment is effective. Increasing antibiotic resistance is one of the reasons why re-testing for H. pylori after a course of treatment should be taken seriously. If the bacterium is present, at the discretion of the doctor, the course of therapy can be repeated again, while one antibiotic is replaced by another.

In addition to drug therapy, the patient should make some changes in diet and lifestyle. It is recommended to avoid bad habits and stress, diversify the diet with vegetables and fruits, and exclude starchy, sweet, fried and spicy foods. To prevent complications associated with Helicobacter pylori, it is especially important to remove foods that irritate the gastric mucosa from the diet: hot spices, spices, carbonated drinks, coffee and alcohol. It must be remembered that self-medication and the lack of timely therapy can lead to the development of oncological diseases of the gastrointestinal tract, constant pain and digestive problems, and, as mentioned above, a more severe course of coronavirus infection and its negative consequences.

How to protect yourself from disease

The COVID-19 pandemic, unfortunately, is still ongoing and it is not known when it will end. Moreover, no one knows what will happen to the healthcare system in the next few months, six months, or a year. Nevertheless, while citizens still have the opportunity to visit medical institutions, it is necessary to take all measures to protect their health and avoid a decrease in immunity and the development of cancer. H. pylori infection is one of the leading risk factors for stomach cancer, which, according to statistics, ranks second in cancer mortality worldwide. ^[10]. So, an infection that is not detected or treated in a timely manner can lead to irreversible consequences.

In hospitals, unlike many other public places, coronavirus restrictions are carefully enforced, and most of the medical staff have either already had the infection or are vaccinated. Doctors wear masks and maintain social distance, so the risk of contracting COVID-19 is significantly lower than in the same public transport. All this allows us not to shelve existing health problems, especially those that can affect the severity of COVID-19.

A healthy GI tract is the key to higher immunity from COVID-19, as well as a quick and complete recovery. Timely diagnosis of H. pylori and treatment contribute to the normal functioning of the gastrointestinal tract. A pandemic is not a reason to forget about other diseases, and since in the current conditions of hospital work it is quite possible to diagnose such a dangerous infection as Helicobacter, you need to use this for the benefit of your health, while not endangering yourself or other people.

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