The virulence factor genes on GI-MAP are found exclusively on the genome of H. pylori.

These genes code for proteins that will predispose one to more serious H. pylori infections. 

Helicobacter pylori (H. pylori):

Recent studies have shown that nearly 50% of the world’s population may harbor H. pylori. And, although many carriers are asymptomatic, H. pylori is known to have a causative role in ulcers, chronic gastritis, and stomach cancer.

Additionally, in early phases of colonization, patients may experience hypochlorhydria followed by a change to hyper aciduria. Over time, additional H. pylori strains may colonize, including those with Virulence Factors and increased disease potential.

Epidemiology

- Fecal contamination, oral to oral, and family inter-infection are common modes of transmission

Clinical Implications

- Dyspepsia, abdominal pain, nausea, vomiting and chronic gastrointestinal symptoms

- Peptic ulcers

- May induce mucosal atrophy and metaplastic changes

Virulence Factors:

Of the 50% of the population believed to be infected with H. pylori, only 2% develop gastric cancer. Positive H. pylori virulence factors on the GI-MAP represent the genetic potential for an H. pylori strain to cause pathology. For example, some clinicians may choose an aggressive treatment protocol for a patient with dyspepsia and a family history of gastrointestinal cancer, who shows elevated H. pylori and positive virulence factors. 

Potential treatment options to discuss with health care professional:

- Asymptomatic patients may not require treatment

- Consider herbal formulas to eradicate or suppress H. pylori. Ingredients may include: deglycyrrhizinated licorice, mastic gum, methylmethionine sulfonium chloride, vitamin C, zinc carnosine, bismuth citrate, berberine, goldenseal, oil of oregano, grape extract, Chinese goldthread extract, yerba mansa extract

- See pancreatic elastase-1 to determine if maldigestion and/or hypochlorhydria might be present

- Consider high-dose probiotics and 5R Protocol (see this blog article)

- Rebuild healthy gastric mucosa by reducing stress and giving soothing and healing agents such as glutamine, aloe, DGL, and vitamin A

- Address dental hygiene; the mouth is a reservoir for H. pylori

- Consider sources of exposure, especially romantic partners or family members

- Address other imbalances on the GI-MAP

» For peptic ulcer disease, the firstline triple therapy (prescription) treatment includes a proton pump inhibitor, clarithromycin, and amoxicillin or metronidazole

» Fluoroquinolones and tetracycline are used in second-line regimens against H. pylori