H. Pylori Infection

What is H. pylori?

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

H. pylori infection appears to be a risk factor for 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 through contact with infected saliva or from bowel movements. For example, the bacteria may be spread when you share eating utensils or do not wash your hands after using the bathroom or before eating. The infection tends to spread among people who are living together and sharing food and bathrooms.

By middle age, 50% of adults have been infected with H. pylori.

Doctors are trying to learn why some people infected with H. pylori have gastritis and ulcers, while most who are infected with H. pylori do not have these problems. Habits that irritate the stomach, such as smoking cigarettes and drinking alcohol, may contribute to these problems.

What are the symptoms?

Most people with H. pylori don’t have symptoms, but if you do, the symptoms may be:

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

Symptoms may be worse before or after meals.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and your personal and 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 costs less than other tests and is about 90% accurate in diagnosing H. pylori.
• A stool sample test to look for H. pylori. This test is very accurate.
• The urea breath test to check for byproducts of H. pylori bacteria. This test is accurate but costly. It is not as readily available as the blood test. To do the test, you swallow a capsule containing a substance called urea. The urea will be changed by the bacteria if you have an H. pylori infection. The changed substance can be measured in your breath 10 minutes after you swallow 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 and upper intestine for signs of gastritis or ulcers. To test for H. pylori your provider may remove a tiny piece of stomach tissue (biopsy) through the tube for lab tests. This is the most accurate way to diagnose H. pylori.

Common complications of H. pylori infection are gastritis and ulcers. To check for ulcers, you may have a stomach X-ray test 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 not recommend treatment if you don’t have symptoms of H. pylori infection. If you do have symptoms, you will need to take a combination of medicines, including antibiotics, for up to 2 weeks. If you are having a lot of stomach symptoms, your provider may give you medicine to help decrease stomach acid.

How long will the effects last?

Symptoms of H. pylori infection usually get better within a few days after you start taking the medicine. The symptoms may come back 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 exactly as prescribed. Take the medicine for as long as your provider has prescribed, even if your symptoms go away before you finish the medicine. If you are having problems with side effects from your medicine, tell your provider so you can try a different treatment.

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

Contact your healthcare provider if:

• Your symptoms don’t go away.
• You are having new symptoms.
• You cannot take your medicines because of side effects.
• You need help stopping smoking or stopping drinking alcohol.

How can I help prevent H. pylori infection?

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