Volkan KARAKUŞ, Özcan DERE, Yelda DERE, Erdal KURTOĞLU

Helicobacter Pylori: Patofizyoloji, Sıklık, Risk Faktörleri, Tanı ve Tedavi

Helicobacter pylori (H pylori) populasyonun %50'sinden fazla görülen ve gastrik mukozaya yerleşen spiral şekilli, flajelli, mikroaerofilik, gram (-) bir basildir. Dünya genelinde en yükseği gelişmekte olan ülkelerde bildirilen değişken bir görülme sıklığına sahiptir. Risk faktörleri ile ilgili çalışmalar özellikle sosyoekonomik faktörler üzerinde durmaktadır. İnsanlarda gastrit ve ülser ile ilişkisi net olarak kanıtlanmıştır. Enfeksiyon çocukluk çağında sıklıkla oral yolla bulaşmaktadır. Üre nefes testi, dışkı antijen testi, antikor tayini, endoskopi, histolojik inceleme, üreaz testi ve kültür tanıda kullanılan yöntemlerdendir. Antibiyoterapi ve antiasitler tek başına yeterli olmadığından birlikte kullanımları tercih edilmektedir. N-asetilsistein gibi mukolitik bir ajan ile H pylori tabakasının ortadan kaldırılması da tedavi öncesinde etkili olabilmektedir. Lactobacillus, Saccharomyces, Bifidobacterium ve Bifidobacterium clausii gibi probiyotik suşların eklenmesi de diğer bir tedavi yaklaşımıdır. İlk tercih tedaviler yetersiz kaldığında farklı antibiyotikleri içeren ikinci adım tedavilere gerek duyulabilmektedir

Anahtar Kelimeler:

Helicobacter pylori, gastrit, antibiyotik, tanı, tedavi

Helicobacter Pylori: Pathophysiology, Prevalence, Risk Factors, Diagnosis and Treatment

Helicobacter pylori (H pylori) is a spiralshaped, flagellated, micro- aerophilic gram-negative bacillus that colonizes the gastric mucosa of more than 50% of the human population. There are different findings for the prevalence of H pylori across the world with the highest prevalence in developing countries. Most of the reports on risk factors focused on socioeconomic indicators. Its relationship with gastritis and peptic ulcer in humans was proven. The infection is transmitted within the family in childhood, likely by oral transmission. Urea breath test, stool antigen test, antibody detection, endoscopy, histology, urease test, and culture are used for the diagnosis. Antibiotics and antiacidics are not sufficient alone, therefore combination treatment is preferred. Pretreatment with N-acetylcysteine as a mucolytic agent to destroy the biofilm of H pylori is effective. The addition of probiotics such as Lactobacillus spp., Saccharomyces spp., Bifidobacterium spp., and Bifidobacterium clausii as an adjunctive agent is another approach. If the first-line therapy fails, the second-line options should include different antibiotics.

Keywords:

Helicobacter pylori, gastritis, antibiotics, diagnosis, treatment,

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