Helicobacter pylori (H pylori) is a bacterium that is present in approximately half of the people in the world. However, not everybody infected with H pylori develops the signs and symptoms of the H pylori infection.
H pylori infection is caused most commonly by consuming food or water (or any liquid) that is contaminated with the fecal matter containing the H pylori bacteria. It can also spread by mouth-to-mouth contact. However, it is unclear why some people with H pylori develop the symptoms while others do not.
Some people with H pylori infection develop a variety of digestive symptoms, such as persistent inflammation of the stomach (chronic gastritis), inflammation of the duodenum (duodenitis), stomach ulcers, and even stomach cancer. The bacteria infect the body in the following way:
- The bacteria infect the protective tissue (mucosa) that lines the stomach
- Certain enzymes and toxins are released
- The protective mucous barrier is destroyed by the bacteria, exposing cells to toxins
- The immune system gets activated
- Together, these factors may injure the cells of the digestive tract (stomach or duodenum) that result in digestive system disorders
Who is at risk for H pylori infection?
In developing countries, you have greater chances of getting an H pylori infection during your childhood. You are at risk for H pylori infection if
- You live in crowded homes.
- You live in places where there is no reliable supply of clean water.
- You live in a developing country (since there are problems with sanitation, most people get affected before age 10).
- You live with someone who has an H pylori infection.
- Hispanics and African-Americans have a higher rate of infection than Caucasians. This may point to the genetic susceptibility of H pylori to certain people.
In the United States and other developed countries, H pylori infections are more common in adults.
Which tests are used to diagnose H pylori infection?
The most common tests used to diagnose H pylori are:
- Urea breath tests: You will be asked to drink a specialized solution and then blow through a straw into a glass tube. After that, your breath will be tested. The presence of carbon molecules in the breath makes the test positive (H pylori infection is present).
- Stool tests: Stool antigen tests are used to detect H pylori proteins in the stool.
- Blood tests: Certain blood tests can help identify if you have an active infection or have been previously infected.
What is the best treatment for H pylori infection?
The most effective treatment for H pylori often involves taking several medications for 2 weeks and is known as triple therapy. These medications include:
- A proton pump inhibitor: Some examples include lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (AcipHex)
- Two different antibiotics (Metronidazole and Tetracycline or Metronidazole and Amoxicillin)
- Bismuth subsalicylate (Pepto-Bismol)
The best treatment regimens may differ from patient to patient depending on the antibiotic resistance.
Successful treatment of H pylori can help in the healing of the ulcer, prevent the recurrence of ulcers, and reduce the risk of ulcer complications (like bleeding). To get maximum results from H pylori treatment, it is important to take the entire course of all medications.
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Patient education:Helicobacter pylori infection and treatment (Beyond the Basics). Available at: https://www.uptodate.com/contents/helicobacter-pylori-infection-and-treatment-beyond-the-basics