'Helicobacter pylori' : nurses' perceptions of diagnosis and treatment in adults

Background Helicobacter pylori is a bacterium that lives in the stomach’s gastric mucosa layer. H. pylori is a carcinogen that increases the risk of stomach and duodenum ulcers, gastro-oesophageal reflux disease and stomach cancer.

Prevalence rates of H. pylori are higher in people with a learning disability than in the general population; however, despite the increased risk of H. pylori in people with a learning disability there is a lack of literature that applies specifically to this population and their families or carers.

Aim To explore issues related to the diagnosis and treatment of H. pylori in people with a learning disability by examining the attitudes, beliefs, experiences and behaviours of staff working with people with a learning disability who are undergoing assessment and/or treatment for H. pylori.

Another aim of this study was to understand the barriers to using preventive strategies, completing assessments and treating H. pylori in people with a learning disability.

Method Focus groups were conducted with 16 staff members from two learning disability services. Before the focus groups, staff members were sent an information sheet with facts about H. pylori in people with a learning disability. Transcribed focus group discussions were analysed to identify themes.

Results Staff reported issues with identifying accurate prevalence figures for H. pylori in people with a learning disability in their services due to the limited number of people who had undergone assessment. Identifying the signs and symptoms of H. pylori was also challenging for staff due to communication difficulties with people with a learning disability, or because the individual had minor symptoms or was asymptomatic. Other staff said that symptoms could be attributed to the side effects of medicines.

Staff believed that people with a learning disability should be treated for H. pylori, given the associated risks of the bacterium, but that the lack of guidance on re-testing after treatment meant it was challenging to incorporate re-testing into care planning.

Conclusion Little consideration has been given to the presence of H. pylori in people with a learning disability over the past decade, despite the fact it is an important health concern that can be identified and treated. Staff, carers and people with a learning disability should discuss with their GP having a blood, stool or breath test to check for H. pylori.

Adding assessment for H. pylori to annual health checks will ensure screening becomes routine and may reduce complications or signs and symptoms, such as reflux and bloating.