and Bacteria
Can Bacteria In My Well Water Cause Stomach
Ulcers?
In short yes, but only if the well water is contaminated
with a bacterium called Helicobacter pylori.
This bacterium is now known to be associated with a high
percentage of the stomach ulcers in humans.
We'll talk about stomach ulcers, and some of the things
thought to be involved in causing them (the now infamous Helicobacter pylori, a
particular bacterium, and the contribution of emotional stress).
But first, we need to get a bit of general information
about what an ulcer is, what is going on in the stomach, and then we'll talk
about how an ulcer may form.
An ulcer is an erosion of tissue (shallow to deep,
inflamed, usually somewhat circular depression in tissue).
A perforated ulcer is one which has become deep enough to
completely penetrate tissue layers and which opens to tissue underneath.
While ulcers can occur almost anywhere, the ones with
which we are most familiar are those tiny, shallow ones often caused by a virus
infection that sometimes occur inside of our mouths (underside of our bottom
lip or inside the cheek).
Sting like the dickens don't they? These kinds of ulcers
usually disappear after a short while.
However, another kind of ulcer can cause mild (chronic
gastritis) to severe (peptic ulcer disease) health problems - this kind of
ulcer is another one with which we may be familiar - the stomach and duodenal
ulcer.
The stomach ulcer and the ulcer of the duodenum (at the
very bottom of the stomach structure - the first few inches of the beginning of
the small intestine) are erosions of the tissue (mucous) which lines (forms the
inner surface of) the gastrointestinal tract.
All parts of the body exposed to the environment - except
the skin - have this protective lining. The mucosal tissue is primarily
comprised of what are called epithelial cells, attached to what is called the
basement membrane.
The epithelial mucosal cells secrete mucous - so now you
know why this tissue is called mucosal tissue ... mucous is that really sticky
stuff that no one really likes to talk about - but which is very protective -
helps prevent potentially harmful little critters from getting a
"grip" and setting up shop in areas very close to our very important
parts ...
Depending on where the mucosal tissue is, e.g., the
respiratory, gastrointestinal, urinary, or genital tracts, or the eye, the
amount of mucous and the various things secreted within this fluid, are a
little different.
In 1982, this restricted view of the cause of stomach
ulcers began to change. A physician in Australia, Barry Marshall, did not
entirely buy the stress argument.
Biopsies (little bits of tissue) were obtained from the
mucosal stomach lining of patients suffering from chronic gastritis and the
more severe condition, peptic ulcer disease.
A previously unidentified bacterium, Helicobacter pylori
was cultured (isolated and grown) from these biopsies.
Presently, it is accepted that this bacterial organism is
the cause of both stomach and duodenal ulcers. Approximately 95% of persons
with gastric ulcers, and 100% of persons with chronic gastritis have this
bacterium within the stomach.
The organism has not been found in healthy persons (no
stomach ulcers or gastritis).
This bacterium is known to bind to the O blood-group
structure (a particular series of sugars) present on gastric epithelial cells
(a person who is O-positive is about twice as likely to develop stomach ulcers
relative to O-negative persons).
You might ask, how in the world does this organism
survive the harsh stomach environment? H. pylori can convert the substance
called urea, to carbon dioxide (gas) and another substance called ammonia.
Urea is a normal chemical product of the biochemical
pathway the cells in our body use to eliminate many nitrogen-containing
compounds from our system (excreted in the urine).
Were it not for this pathway, the toxic compound called
ammonia (you're familiar with ammonia - we use it in water solutions - aqueous
solutions - for cleaning) would build-up in our system through normal breakdown
of nitrogen-containing substances (all of the protein we eat contains nitrogen
in the form of amino acids - the building blocks of proteins), and would cause
death.
H. pylori produces a very active form of the urease
enzyme.
The ammonia produced from urease action on urea,
neutralizes the acid (would be kind-of like adding baking soda to lemon juice)
in the area where the bacteria are growing, and allows the bacteria to become
established and to grow (an infection)within the epithelial tissue.
The organism produces substances which cause tissue
damage, and, the body's immune defense system through fighting the infection,
causes further local tissue damage.
After a time, the damaged (eroded) tissue no longer can
secrete mucous properly, which allows the acid and enzymes to also begin to
attack the tissue.
Eventually, the mucosal layer will erode, and access of
these harsh substances and actions to underlying tissue layers is established
and maintained. This local damage and the resultant erosion of tissue is an
ulcer.
If you have suffered from recurring ulcers that seem to
go away every time you take antibiotics for another problem, you may have this
bacterium in your water supply.
A simple method to test for this organism in water is not
yet available. Any of the standard methods of disinfection will kill this
organism if it is present in your water.
Stress is still associated with ulcers, but some people
have seen their ulcers disappear when they switched to a municipal water system
or other sanitary drinking water supply.
This bacterium is now known to be associated with a high
percentage of the stomach ulcers in humans. So what exactly does this have to
do with your drinking water?
A recent study from the university of Penn State (1999)
has tied Helicobacter pylori in well water and clinical infection in persons
drinking from that supply.
Helicobacter pylori is an organism linked to the cause of
at least 75 percent of all stomach ulcers and two types of stomach cancers.
The Penn State Harrisburg researchers made the association
between water containing H. pylori and the infection through tests of private
wells supplying drinking water to individual households.
Interviews with residents who consumed the water found a
statistically significant correlation between presence of the bacterium and
cases of stomach ulcers.
Baker said drinking water is generally considered safe
when coliform bacterium is not present. But the ulcer-causing bacterium was
found in coliform-free water samples, she added.
"What this really
means is that our current methods for testing drinking water may be saying that
water is fine while H. pylori may actually be present," she said.
The research findings, released at a meeting
of the American Society for Microbiology in Chicago, was described by the team
as the first to "demonstrate a
direct link between contaminated drinking water and stomach ulcers."
Baker said the study involved private, untreated water
supplies and not municipal water sources, which are less likely to contain the
organism.
Working with Jon Hegarty, a graduate student in the Penn
State Harrisburg Environmental Pollution Control program, Baker previously
identified the presence of H. pylori in well and surface waters in the region
more than one year ago.
In that study, the bacterium was found in more than 75
percent of the tested surface water samples.
That research represented the first report of live H.
pylori in surface water in the United States, demonstrating a major reservoir
for the organism outside the human body.
In the United States, an estimated 2.5 million new H.
pylori infections occur each year.
Peptic ulcer disease affects nearly 5 million people with
treatment costs exceeding $5 billion, not including indirect costs due to work
and productivity loss.
Approximately 16,000 deaths are attributed annually to
complications of peptic ulcer disease.
If you suspect your well water has infected you or a
loved one with the H. pylori bacteria, it is best to seek medical attention as
well as investigate ways to safely treat your well water source.
It's also important to note that H. pylori is the most
common, but not the only, cause of peptic ulcers.
Besides H. pylori, other causes of peptic
ulcers, or factors that may aggravate them, include: Regular use of pain
relievers.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can
irritate or inflame the lining of your stomach and small intestine.
The medications are available both by prescription and
over-the-counter.
Nonprescription NSAIDs include aspirin, ibuprofen (Advil,
Motrin, others), naproxen (Aleve) and ketoprofen (Orudis KT).
To help avoid digestive upset, take NSAIDs with meals.
NSAIDs inhibit production of an enzyme (cyclooxygenase) that produces
prostaglandins.
These hormone-like substances help protect your stomach
lining from chemical and physical injury. Without this protection, stomach acid
can erode the lining, causing bleeding and ulcers.
Smoking.
Nicotine in tobacco increases the volume and
concentration of stomach acid, increasing your risk of an ulcer. Smoking may
also slow healing during ulcer treatment.
Excessive alcohol consumption.
Alcohol can irritate and erode the mucous
lining of your stomach and increases the amount of stomach acid that's
produced.
It is uncertain, however, whether this alone can progress
into an ulcer or whether other contributing factors must be present, such as H.
pylori bacteria or ulcer-causing medications, such as NSAIDs.
Finally ... Stress.
Although stress per se is not a cause of peptic ulcers, it
is a contributing factor.
Stress may
aggravate symptoms of peptic ulcers and, in some cases, delay healing.
You may
undergo stress for a number of reasons - an emotionally disturbing circumstance
or event, surgery, or a physical trauma, such as a burn or other severe injury.
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