Gastric acid is not always harmful

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Gastric acid illustration. (Source: Sains Kompas)

Gastritis, often known as heartburn, is often associated with an increase of gastric acid. However, people do not know much that heartburn can also be caused by Helicobacter pylori infection. Helicobacter pylori is bacteria / germ associated with various stomach diseases such as dyspepsia (fullness in the stomach), gastritis, and even gastric cancer. On a microscope, H. pylori bacteria appear to be spiral-shaped and react negatively to gram staining.

H. pylori bacteria prefer the degree of acidity (pH) which is near neutral, pH 6.7 – 7.0. Normally, the stomach produces stomach acid to make a degree of acidity (pH) of the stomach ranging from 1.0-2.0. At this very acidic pH, H. pylori bacteria cannot survive. In order to be able to multiply in the stomach, H. pylori bacteria produce urease compounds that produce ammonia and increase gastric pH so that H. pylori can survive and multiply in the stomach.

Anatomically, the stomach is divided into 4 parts, the cardia, corpus, fundus and antrum. The cardia is the upstream part of the stomach that connects with the esophagus while the pylorus is the downstream part of the stomach. Antrum pylorus is the final end of the pylorus associated with the duodenum. The corpus and fundus have a lower acidity (pH) because there are many parietal cells that produce gastric acid while the cardia and pylorus have a higher acidity (pH) compared to the corpus and fundus, especially in the pylorus antrum.

H. pylori bacteria that enter the stomach will prefer a degree of acidity that is near neutral, especially in the antrum. The antrum is also favored by H. pylori bacteria because there are many mucus that can protect H. pylori from deadly gastric acid.

Research by Bernadetta et al shows that H. pylori infection in the stomach is more common in the antrum rather than in the corpus. From a biopsy examination of gastric tissue, H. pylori bacteria only appear on the antrum. And if H. pylori infection gets worse, then H. pylori is found in the corpus. It shows that gastritis sufferers need to detect for H. pylori infection.

In gastritis with H. pylori infection, treatment by giving drugs that reduce stomach acid is not enough because H. pylori germs actually like the degree of acidity (pH) that is near neutral. Gastritis treatment also cannot be done by simply increasing the secretion of mucus in the stomach because H. pylori bacteria can actually survive among the mucous material. Treatment of gastritis accompanied by H. pylori infection must involve eradicating the germ. Because the presence of H. pylori bacteria in the stomach, besides causing prolonged gastritis, also triggers gastric cancer.

Research by Bernadetta et al. clearly shows that the density of H. pylori bacteria in the part of the antrum that has a higher degree of acidity (pH) clearly have more bacteria than that of the corpus with a lower degree of acidity (pH). A low degree of acidity is needed to dispel the presence of H. pylori germs. Food with more alkaline tend to neutralize the stomach acid properties and will make H. pylori bacteria grow fast.

In any case of gastritis, it is clearly necessary to identify the presence of H. pylori infection. Examination to find out the presence of H.pylori bacteria can be done invasively (such as biopsy of the gastric mucosa) or in a non-invasive examination (such as Urease Breath Test to detect the presence of urease produced by H. pylori bacteria).

Histopathological examination of gastric biopsy material can detect the presence of H. pylori bacteria directly. In this examination, H. pylori bacteria will be seen directly under a microscope. Urease Breath test examination may detect H. pylori indirectly by detecting the presence of a compound that urease produced by H. pylori.

Bacteria H, pylori will produce urease which functions to neutralize stomach acid. When the stomach is less acidic, H. pylori bacteria will develop more easily, causing prolonged gastritis and can even increase the incidence of gastric cancer.

From the research of Bernadetta et al. it can be concluded that H. pylori bacteria prefer the part of the antrum with a degree of acidity that is closer to neutral than the portion of the corpus which has lower degree of acidity. The presence of gastric acid produced by parietal cells in the corpus of the stomach, will inhibit the growth of Helicobacter pylori. The presence of gastric acid is not always harmful.

Author: Willy Sandhika

The full article can be viewed on the following page,

http://www.ina-jghe.com/journal/index.php/jghe/article/view/703

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