Helicobacter Pylori

What is Helicobacter pylori?

Helicobacter pylori (H. pylori) is a bacteria that can cause stomach irritation (gastritis), heartburn, nausea and bloating (dyspepsia), and ulcers in the stomach and intestine.

H. pylori appears to be a factor in the development of stomach cancer. However, most people with H. pylori do not get stomach cancer.

How does it occur?

H. pylori is a common infection. Most often the bacteria are spread from mouth to mouth or from bowel movements (for example, when you do not wash your hands after using the bathroom). By middle age 50% of adults have been infected with H. pylori. It tends to spread among people who are living together, sharing food and bathrooms.

Doctors are trying to learn why some people infected with H. pylori have gastritis and ulcers, while many others also infected with H. pylori do not have these medical problems. Stomach-irritating habits such as smoking and drinking alcohol may contribute to these problems.

What are the symptoms?

The symptoms may be:

• stomach pain
• nausea or vomiting
• heartburn
• diarrhea.

Symptoms may be worse before or after meals. One third of the people who are infected never have any symptoms.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and your family history of stomach problems. He or she will also ask how much alcohol and nicotine you are using. Your provider will examine you.

If your healthcare provider tests you for H. pylori, there are 4 ways to do it:

• A blood test to look for antibodies to H. pylori. It is the least costly test and is about 90% accurate in diagnosing H. pylori.
• A stool sample test to look for H. pylori. This test is the newest test. It is very accurate.
• The urea breath test to check for byproducts of H. pylori bacteria. This test is costly and not as available as the blood test, but it is accurate. To do the test, you swallow a substance (urea), which is changed by the bacteria if you have an H. pylori infection. The changed material can be measured in your breath 10 minutes after you swallowed the urea.
• A procedure called upper endoscopy to see the stomach and intestinal lining and take samples of tissue. This is the most accurate way to diagnose H. pylori. Your provider puts a thin tube with a tiny camera on the end (the endoscope) through your mouth and down into your upper digestive tract. He or she can then look at the stomach or upper intestine for signs of gastritis or ulcers. The doctor may remove a tiny piece of stomach tissue (biopsy) through the tube for lab tests.

Common complications of H. pylori infection are gastritis and ulcers. To check for ulcers, you may have a special stomach X-ray called an upper GI or upper endoscopy. (The upper GI is not helpful in finding H. pylori, but it does find most ulcers.)

How is it treated?

Your healthcare provider may recommend treatment only if you have symptoms of H. pylori infection. If you do have symptoms, you will probably take a combination of medicines, including antibiotics, for up to 2 weeks.

How long will the effects last?

Symptoms of H. pylori infection usually improve within a few days after you start taking the medicine. The symptoms may come back later if you become infected with the bacteria again.

How can I take care of myself?

If you are being treated for H. pylori infection, be sure to take your medicine just as your healthcare provider has prescribed it. Take the medicine for as long as your provider has prescribed it, even if the symptoms go away before you finish the medicine.

When H. pylori is present, you should try to avoid irritating your stomach. Examples of irritants are caffeine, alcohol, and anti-inflammatory medicines such aspirin, ibuprofen, and naproxen. If you find that any other particular food or drink causes stomach upset or pain, avoid that food or drink.

You should let your provider know if you are having new symptoms or if your symptoms continue or return.

How can I help prevent H. pylori infection?

Doctors don't yet know how to prevent H. pylori infection.