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Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report
The 5th Chinese Helicobacter treatment consensus
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Why some people not getting sick

The various unpleasant manifestations of Helicobacter can be described here. Remember however that the great majority of persons with Hp have no symptoms that they are aware of and consider themselves normal.

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HelicopterPylaros
Posts: 22
Joined: Wed Jul 25, 2018 2:18 am

Why some people not getting sick

Post by HelicopterPylaros »

Hello,

I've read, that some people are not getting sick at all, even though they are carrying Helicobacter Pylori inside them. As many others on this forum, I was heavily impacted by Helicobacter Pylor, even though I was healthy and in my thirties. I'm wondering now, why some people are getting sick why others don't. Is there an explanation for this?

Helico_expert
Site Admin
Posts: 4100
Joined: Wed Mar 02, 2011 7:20 am

Re: Why some people not getting sick

Post by Helico_expert »

actually, I believe it is because different people has different immune system, which then lead to different disease outcome.

This is what happened when you are infected with H. pylori
step 1. H. pylori extract nutrient from your stomach cells
step 2. your stomach cells are not happy and release signal to recruit immune cells.
step 3. your immune cells cannot see H. pylori as H. pylori is like ninja, good in hiding away from immune cells.
step 4. your immune cells get stressed as the stomach cells keep releasing stress signal. so your immune cells started destroying everything. Hopefully by chance, H. pylori can be destroyed.

now, there are three scenarios.

Scenario A
the mucous secreting cells get destroyed. no more mucous protection. stomach acid start digesting your own stomach. this lead to stomach ulcer.

Scenario B
The acid secretion cells get destroyed. no more acid secretion. this can lead to atrophic gastritis. microbiome start growing in the stomach. some carcinogen can accumulate in the stomach.

Scenario C
the damage is so severe, the repair by cell duplication is too slow. Stem cells start gathering from other body parts. Intestinal stem cells is usually the cells gathering there first. So your mucous producing cells and acid producing cells are slowly be replaced by intestinal cells. This lead to intestinal metaplasia or atrophic gastritis.

when H. pylori is killed. the immune cells will gradually retreat. then your stomach can gradually recover.
IF there is enough acid, some of these intestinal metaplasia cells will get destroyed by acid and healthy stomach cells will slowly replace them.
IF there is not enough acid, then microbiome and carcinogen can start accumulate and some of these intestinal metaplasia cells will become cancerous, because they are constantly mutating trying to fit in the stomach.

So, which scenario you will end up is up to your immune response. If you have weak immune response against H. pylori, you are more likely to end up in Scenario A and B. If you have strong immune response against H. pylori, you are more likely to end up in Scenario B and C.

As you aged, you are more likely to progress from Scenario A to B and from B to C.
Young people, probably around 20s-30s, are more likely to be in Scenario A
Middle age people, probably around 30s-50s, are more likely to be in Scenario B
Senior people, probably above 50s, are more likely to be in Scenario C

Also, as people are getting better diet and nutrient, it is more likely to have strong acid secretion. Acid secretion is very important in preventing gastric cancer. So even if we do nothing to the infected population. Having fresh food and healthy diet is enough to decrease gastric cancer rate.

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