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

Year 2018, , 105 - 123, 01.01.2018

Volkan Karakuş Özcan Dere Yelda Dere Erdal Kurtoğlu

https://doi.org/10.5505/kjms.2016.37431

Abstract

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

Keywords

Helicobacter pylori, gastrit, antibiyotik, tanı, tedavi

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

Abstract

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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