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Can bacteria in my well water cause stomach ulcers?

Bottled Water Contaminants

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, didn't 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.

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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's 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 isn't a cause of peptic ulcers, it's 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.