H. Pylori Infection

What is H. pylori?

H. pylori, or Helicobacter pylori, are bacteria that can cause stomach irritation (gastritis), heartburn, nausea, and bloating. 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.

What is the cause?

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 before eating or after using the bathroom. 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 do not have these problems. Habits that irritate the stomach, such as smoking cigarettes or drinking alcohol, may contribute to these problems.

What are the symptoms?

Most people with H. pylori don’t have symptoms. If you do have symptom, they may include:

• stomach pain
• nausea or vomiting
• heartburn (a burning pain in the lower chest when acids in your stomach flow back into your food pipe)
• 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 use. Your provider will examine you.

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

• A blood test to look for antibodies to H. pylori.
• A stool sample test to look for H. pylori.
• The urea breath test to check for byproducts of H. pylori bacteria. To do the test, you swallow a capsule containing a substance called urea. If you have an H. pylori infection, the urea will be changed by the bacteria. 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. Your provider puts a long, flexible tube and tiny camera into your mouth, down your throat, and into your stomach and intestine to look 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. This test 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.

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?

• 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.
• 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.