an autodidact meets a dilettante…

Helicobacter pylori, looking very dirty

Recently I went to a doctor [I won’t say ‘my doctor’ as I don’t have one, having been a lifelong recalcitrant in such matters] to complain, as I occasionally do – but usually not to doctors – about my seemingly lifelong cough and throat-clearing, together with acidity problems, of slightly more recent vintage. I’d also decided, at fifty-five, to have my first ever full check-up, or even partial check-up, via a blood test. After describing my chronic symptoms to the doc, he decided to throw in a test for Helicobacter pylori for good measure. I was a bit surprised at this, as I’d generally associated H pylori, from what little I knew of it, with stomach ulcers. My problems seemed to be of the upper respiratory, or possibly upper gastro-intestinal, tract. I didn’t mention to him that I also had problems with diarrhoea, which seemed a more likely indicator.

In any case, this morning I returned for the results of my tests. The test for H pylori antibodies was positive. This was the only immunology test. There were also two endocrinology tests, a biochemistry test and a general chemistry test. The endocrinology tests were for thyroid stimulating hormone and prostate specific antigen, and both returned unproblematic results. My general chemistry test measured a number of things. First, the electrolytes – sodium, potassium, chloride and bicarbonate, all of which are within normal levels. Other measures include glucose, protein, calcium, uric acid, all of them unproblematic. The biochemistry test measured my lipid levels – cholesterol and triglycerides. My total cholesterol level is 6.0, which is a mite too high, and my LDL [low density lipoprotein] cholesterol level, at 3.4 is a particular worry, though not too much of one [I have no other obvious CV risk factors – my blood pressure is particularly good]. Also my triglyceride level, at 2.4, is too high. These things, move slowly , the doc says, but a reduction in animal and saturated fats and a bit more exercise should help. Another test in a year’s time.

The significant thing, though, was H pylori. I’ve been put on some pretty solid medication to clear it up. It’s become a standard treatment, two antibiotics [amoxycillin, 4 tabs daily, and clarithromycin, 2 tabs daily] together with a proton pump inhibitor [esomeprazole, 2 tabs daily], all taken within seven days. That’s eight tabs a day for seven days, 56 little pills.

I’ve returned to this piece after Christmas, and near the end of my course of medication. I’m still clearing my throat regularly, not a good sign, but I’ll wait a few days to see how things pan out. I’ll be taking my last pills tomorrow night, the 28th.

The Helicobacter story is an intriguing one. A few decades ago it was generally believed that bacteria just couldn’t survive in the highly acid environment of the gut. Findings to the contrary were occasionally made, but they were discounted or ignored, or couldn’t be verified. But thanks to two Australian researchers, Barry Marshall and Robin Warren, who eventually won the Nobel Prize for the work they did on this in the late seventies and early eighties, this particular bacterium, found in the stomachs of some 50% of humans world-wide, is now known to be a principal cause of gastritis and gastric ulcers, with the result that this problem, so long associated wrongly with stress, can be readily treated, in most people, by a course of antibiotics. The treatment has been shown to be very effective, a permanent cure in most cases. There have been very few such ‘magic bullet’ cures since we first got our heads around bacterial infection in the days of Louis Pasteur.

Interestingly, though, some 80% of people who are H pylori positive show no symptoms. Those who do may have many symptoms – for me, heartburn and bloating are the two most obvious, but my symptoms of constant throat-clearing and sudden-onset barking cough, don’t seem to feature much in the H pylori profile, so I’m worried that these symptoms, much more disturbing to me than the occasional heartburn [and having a much longer history], will not be cured. I’ll have to wait and  see.