Direct bacterioscopic observation of Helicobacter in the oral cavity, stomach and rectum

Abstract

Background Bacterial cells of Helicobacter Pylori (HP) are often found in people with chronic gastritis and peptic ulcer disease (PUD). All patients with symptoms are usually screened for HP bacterial cells by different methods of detection. Studies have shown that HP can colonize the stomach and other parts of the gastorointestinal tract such as the oral cavity and rectum.

Aims To visualize and evaluate the bacterial cells of Helicobacter Pylori in vivo in the gastric, oral and rectal mucosa using immunocytochemical detection.

Methods Studies were carried out on smears from biopsies of the oral cavity, rectum and stomach (ICD-10K29.3) from seventy patients with chronic gastritis for the detection of Helicobacter pylori (HP) using immunocytochemistry. This technique allows detection of both coccoid and spiral forms of HP.

Results Our research demonstrated that the stomach was dominated by spiral forms, with coccoid forms being much less common (on average about 5 per cent). There was a quite different distribution of spirals and cocci in the oral cavity and rectum. The oral cavity demonstrated almost exclusively coccoid forms of HP, rarely spiral and HP were detected only in coccoid forms in the rectum.

Bacterioscopic investigation of gastrointestinal mucosa carried out via direct immunocytochemical staining clearly shows that HP - mucosal colonization occurs in the stomach (typically more than 50 helical cells in a single field of view), and that HP exits the body through the oral cavity and intestinal tract (5–10 cocci forms in 300 fields of view). Results of HP detection in the oral cavity and rectum corresponded with HP detection in the stomach in 80 per cent and 83 per cent of cases, respectively.

Conclusion Immunocytochemical observation of HP in the oral cavity, stomach and rectal mucosa suggests that HP bacterial cells enter the gastrointestinal tract as coccoids, colonize stomach mucosa in vegetative spiral form and leave as coccoid forms. Thus, our data from direct bacterioscopy strongly supports the hypothesis that HP infection spreads and contaminates the gastrointestinal tract through its coccoid forms.