Key Bacteria in Formation of Ulcers May Be Identified

Studies indicate that some chronic ulcers may be caused by a type of bacteria, suggesting for the first time a cure for the condition.

Bacteria called Helicobacter pylori, which are commonly found in the digestive tract, have been linked to ulcer formation, said Dr. Alex Sherman, a gastroenterologist at New York University Medical Center.

“While several options are available to treat ulcers, the findings about this bacteria offer a good chance at a cure,” Sherman said.

The organism, which is present worldwide, is also associated with gastritis, an inflammation of the stomach lining.

Up to 10 million Americans suffer from peptic ulcers, small inflamed craters in the lining of the stomach or duodenum, the upper part of the small intestine.

Sherman said 90% of people with duodenal ulcers and 75% of those with gastric ulcers have Helicobacter pylori present in their digestive tracts. About 20% of healthy adults have the bacteria.

The reason that some people with the bacteria develop ulcers and others do not remains to be discovered. Ulcer formation is thought to be a complex reaction involving several factors, of which Helicobacter pylori is essential, Sherman said.

In an Australian study, treatment that eradicated the organism showed a recurrence rate for peptic ulcer of zero, as opposed to the natural recurrence rate of more than 80%.

Sherman said a combination of bismuth subsalicylate, the active ingredient in Pepto-Bismol, and two antibiotics is being considered for the treatment of severe or difficult-to-manage duodenal ulcer disease.

The therapy is not without drawbacks. There are adverse side effects in some people, including abdominal pain and rashes. Also, overdoses of bismuth compounds may result in damage to the central nervous system, especially in people with kidney ailments.

The current treatment for peptic ulcers, which is usually very effective, generally involves antacids or H2 blockers, drugs that inhibit the production of stomach acid. This allows the ulcer to heal but may not prevent ulcers from recurring.

A related area of investigation is the method of diagnosing the presence of Helicobacter pylori. At present, this requires testing samples of tissue removed from the patient’s stomach or duodenum. Researchers are working on a simple breath test or blood test that will identify the organism.