Travelers to Thailand at Risk for Bacteria Infection

Travelers to Thailand should be aware of a common bacteria that infects people and has the potential to cause ulcers, gastritis, and even stomach cancers in rare cases. Although many travelers may get shots and take extra precautions in regards to the regular infectious diseases in Thailand, many are probably unaware of this particular bacteria because it's not considered to be as dangerous as others and there is no vaccine for it. The bacteria itself is called Helicobacter pylori ( H. pylori), and it's been identified as the primary cause in majority of ulcer cases. It's prevalence is quite amazing, with over 50% of the world's population being infected, but only certain people display symptoms, and they usually occur while a person is in their late 20's or older for some reason. The bacteria itself is not life threatening in most cases, and can be treated successfully and easily with a simple course of antibiotics. But if a person is not aware of it, it may take some time before they are diagnosed with it, which can end up costing a person thousands of dollars in doctor visits and frustration while it remains undiagnosed. So if you're suffering from an ulcer, or if you're not already aware of this bug, you may want to learn more about it so you can be informed. This way, you can maybe try to avoid it, or at least know what to expect in case it ever affects you, especially if you are traveling in undeveloped countries like Thailand.

Background
Up until the 90's, many people believed that ulcers were caused by stress or eating spicy or rich foods. While these can definitely aggravate an ulcer and make it worse by slowing down healing time, they were proven to not be the initial cause of ulcers. In 2005, a team of researchers from Australia were awarded a Nobel Prize for discovering the true cause of ulcers. It took them over 12 years to finally prove that a bacteria, H. pylori, was responsible for causing 90% of ulcers in both humans and animals. Today, not many people are aware of this discovery until they actually develop an ulcer and begin to search for causes or remedies on the internet.

According to the World Health Organization, H. pylori affects 50% of people in developed countries, and 80% of people in developing countries such as Thailand. In a study performed in Thailand in 1990, 17.5% of children between the ages of 5 and 9 were infected with this bacteria, while 55% of people in their 20's and 75% of people between 30 and 50 years of age were infected. Very few people will show symptoms of infection, though for those who do, the symptoms can be mild or severe, depending on how long it's left untreated and other factors. Ulcers are probably the most common symptom, though infection can also lead to gastritis and other stomach problems in some people, including certain cancers of the stomach if the problem is left untreated for too long. Some other common stomach disorders that have been linked to H. pylori include GERD, Acid Reflux, and Irritable Bowel Syndrome (though it's rare for it to be causing IBS). There has even been some researchers who have suggested that it may play a role in other illnesses and diseases, such as Rosacea and various forms of acne, but these claims have not been fully proven. But it is worth noting that in one particular study, many volunteers who had Rosacea were tested for H. pylori infection, and 84% tested positive. So there is definitely some evidence that this infection could play a role in various skin disorders or other problems.

How Infections Occur
Although it's already been proven how H. pylori can lead to stomach problems, nobody has been able to prove exactly how the bacteria ends up in the human stomach. The same study that was done in Thailand in 1990, suggested that it may be spread from person to person. Although children in Thailand between 5 and 9 years of age have a 17.5% prevalence rate, the researchers tested many children at a orphanage in Bangkok, and found that 74% of them were infected. This helped add evidence to the theory that it may be spread between persons. The person to person theory is probably the most common theory that most researchers agree on as a method of transmission. While many animals do have the bacteria as well, for some reason, it appears that it grows more easily in the human stomach and populations of H. pylori are much more abudant in humans. There are also many other theories that are all backed by evidence, so there may be more than one mode of transmission. Scientists have discovered that house flies, for example, can easily carry the bacteria. So one theory is that they can spread it to food or cooking utensils and silverware, when flies land on them, which is then consumed by humans. Another theory is that it's spread by drinking from water contaminated with fecal matter or other human or animal contaminants.

How H. pylori is Treated
H. pylori is usually treated with a combination of antibiotics and acid suppressants. This combination is called triple therapy, and has shown to be 90% effective in people who follow through with it for 15 days. The 3 most common medications used in this combination are two antibiotics, such as Clarithromycin and Amoxicillin, and a proton pump inhibitor, such as Prilosec or Prevacid. Once a person is treated with these medications, H. pylori will rarely return in most cases. Not all doctors are aware of H. pylori, specifically the ones who do not specialize in gastroenterology. So if you visit one doctor, and they try to tell you that it's caused by spicy foods or stress, try to see a different doctor. Every source on the internet, including the World Health Organization and the Center for Disease Control contradicts that old school type of sentiment.

Seeing a doctor can be difficult sometimes and expensive, so if you are unable to see a doctor, you may want to try natural alternatives, but only as a last resort. It's best to see a doctor and get on a triple therapy regimen, because even if your stomach symptoms are relieved, the bacteria may still be in your stomach and may begin to populate again. But if you have ran out of options, you should definitely give natural treatments a try. There are many studies that indicate that eating certain foods for a month to 2 months can help inhibit H. pylori growth. Some of these foods include bananas (particulary plantains), turmeric, ginger, finger-root, cranberries, cabbage and broccoli sprouts. These may all be worth a try, by including them in your diet on a daily basis. I've also found that taking an acid reducer while doing this may be helpful, such as Pecid AC. Avoiding foods that can cause cause inflammation in the stomach or acid production is probably also helpful.

How to Avoid Infection
Since nobody knows a definitive cause of H. pylori infection, it's best to just use good judgment when it comes to person to person contact, though it may be unnecessary since the infection is easy to treat and very difficult to avoid. Being aware of the warning signs and getting tested for H. pylori once you have an ulcer or associated stomach problems is more important than trying to avoid it, but for some people, some extra precautions may help. You should avoid kissing strangers or sharing food or drinks with people who you don't know, or who you suspect of having an ulcer or stomach problems. If you're eating in a public place or a restaurant (especially the food carts and stalls that are common in Thailand), you may want to make sure it's a sanitary environment. Don't drink any water from public reservoirs, lakes, ponds, or rivers, and avoid ingesting rain water whenever possible. The Songkran Festival in Thailand is a perfect example of a situation where somebody can accidentally ingest a little rain water or water from a public reservoir. If you do partake in the festivities and people are spraying water on you, try to not open your mouth too many times and make sure you wash your hands and mouth well afterwards before handling or eating any food.





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