Many Kenyans are unknowingly carrying Helicobacter pylori (H. pylori), a bacterium that can live in the stomach for years without causing symptoms.
Dr Amos Mwasamwaja, a consultant gastroenterologist at Aga Khan University Hospital, explains that most people were infected during childhood or adolescence. The bacterium can remain in the body for 13 to 14 years being part of the body without causing any disease.
“If you take 10 people in Nairobi, maybe eight have it, so it’s high…but of those 8, not everybody will seek medical attention—maybe three or four,” he says.
However, Dr Mwasamwaja says that the biggest issue they currently face while treating H. pylori is that most people have become resistant to antibiotics.
“During that time, you had flu, you took antibiotics, and it (H. pylori) was there, but the duration of antibiotics was not relevant to a cure.
You then had a UTI [urinary tract infection], and you took another dosage of antibiotics, so it registers all the antibiotics. So, the day you get tested for H. pylori and want to treat it 15 to 20 years later, it will have that memory to resist.”
Additionally, Dr Mwasamwaja talks of how patients are being misled through the use of trademarked kits that contain the same medication. He says, “We treat it using this HP kit, and it has different levels: first, second, third, and fourth line.
So, if you do the first kit, and there is no response, you go for the second. But what we’ve observed is that most people just change the trademark of the kit, but the content is the same. Never repeat the medication that has been tried, because it won’t work.”
Besides H. pylori, Kenyans are increasingly facing digestive issues like irritable bowel syndrome (IBS), which affects people of all ages—young, middle-aged, and elderly alike. Acid reflux, hyperacidity, and bloating are also common. Dr Mwasamwaja attributes these issues to disorders of gut-brain interaction but notes that H. pylori is a leading cause of dyspepsia (upper abdominal discomfort).
“The content of your stomach is very acidic, so there is a valve that separates your food pipe from your stomach. Usually, it should only open when you swallow to allow food in, and it closes to make sure that whatever is in the stomach does not come out. So, in case you have a loose valve, you may be prone to acid reflux.”
What causes the loose valve? Dr Mwasamwaja says, “It can be physiological; first-trimester pregnancy. A woman with high progesterone will have the valve relax, and stomach acid can easily flow back into the oesophagus. Also, those in the end trimester, because the baby is putting pressure on the stomach and the valve is a little bit loose, may have small food content reflux back.”
Now, another important factor that causes acid reflux is the types of food we eat. Dr Mwasamwaja says that if you consume too much high-fat food, you release a hormone called cholecystokinin (CCK), which causes relaxation of the sphincter.
“But another issue is being overweight and obese. So, anything that increases belly fat or anything that causes pressure in the abdomen and pushes the stomach can result in a lot of acid reflux.”
Additionally, Dr Mwasamwaja cautions that weight and chronic reflux can cause cancer. “When the acid keeps on irritating these parts that are not used to acid, the body tries to adapt by changing the cell types, causing cancer,” he says.
