What is an H. pylori infection?
H. pylori are
spiral-shaped bacteria that grow in the digestive tract and have a tendency to
attack the stomach lining. H. pylori
infections are usually harmless, but they’re responsible for the majority of
ulcers in the stomach and small intestine.
H. pylori is a common type of bacteria that usually infects the
stomach. They may be present in more than half of all people in the world,
according to the Mayo
Clinic. The “H” in the name is short for Helicobacter. “Helico”
means spiral. The bacteria are spiral shaped.
H. pylori normally infect your stomach during
childhood. While infections with this strain of bacteria typically don’t cause symptoms,
they can lead to diseases in some people, including peptic ulcers, and an
inflammatory condition inside your stomach known as gastritis.
H. pylori are
adapted to live in the harsh, acidic environment of the stomach. These bacteria
can change the environment around them and reduce its acidity so they can
survive. The shape of H. pylori
allows them to penetrate your stomach lining, where they’re protected by mucus
and your body’s immune cells are not able to reach them. The bacteria can
interfere with your immune response and ensure that they’re not destroyed. This
can lead to stomach problems.
What causes H. pylori infections?
It’s still not known exactly how H. pylori infections spread. The bacteria have coexisted with
humans for many thousands of years. The infections are thought to spread from
one person’s mouth to another. They may also be transferred from feces to the
mouth. This can happen when a person does not wash their hands thoroughly after
using the bathroom. H. pylori can
also spread through contact with contaminated water or food.
The bacteria are believed to cause stomach problems when they
penetrate the stomach’s mucous lining and generate substances that neutralize stomach
acids. This makes the stomach cells more vulnerable to the harsh acids. Stomach
acid and H. pylori together irritate
the stomach lining and may cause sores or peptic ulcers in your stomach or
duodenum, which is the first part of your small intestine.
Who is at risk for H. pylori infection?
Children are more likely to develop an H. pylori infection.
Their risk is higher mostly due to lack of proper hygiene.
Your risk for the infection partly depends on your
environment and living conditions. Your risk is higher if you:
- live in a developing country
- share housing with others who are infected
with H. pylori
- live in overcrowded housing
- have no access to hot water, which can help to
keep areas clean and free from bacteria
It’s now understood that peptic ulcers are not caused by
stress or eating foods high in acid, but they’re actually caused by this type
of bacteria. About 10 percent of people infected with H. pylori develop a peptic ulcer, according to the Mayo
Clinic. Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs)
also increases your risk of getting a peptic ulcer.
What are the symptoms of H. pylori infection?
Most people with H. pylori
don’t have any symptoms.
When the infection leads to an ulcer, symptoms may
include abdominal pain, especially
when your stomach is empty at night or a few hours after meals. The pain is
usually described as a gnawing pain, and it may come and go. Eating or taking
antacid drugs may relieve this pain.
If you have this type of pain or a strong pain that doesn’t
seem to go away, you should visit your doctor.
A number of other symptoms may be associated with H.
pylori infection, including:
- excessive burping
- feeling bloated
- nausea or vomiting
- lack of appetite, or anorexia
- unexplained weight loss
- foul breath
However, these are common symptoms that could be caused by
other conditions. Some of the symptoms of H.
pylori infection are also experienced by healthy people. These symptoms are
common, but if any of them persist or you’re concerned about them, it’s always
best to see your doctor. If you notice blood or a black color in your feces or
vomit, you should consult your doctor.
How are H. pylori infections diagnosed?
Your doctor will ask about your medical history and family
history of disease. Be sure to tell your doctor about any medications you’re
taking, including any vitamins or supplements. If you’re experiencing symptoms
of a peptic ulcer, your doctor will likely ask you specifically about your use
of NSAIDs, such as ibuprofen.
Your doctor may also perform many other tests and procedures
to help confirm their diagnosis:
During a physical exam, your doctor will examine your
stomach to check for signs of bloating, tenderness, or pain. They’ll also
listen for any sounds within the abdomen.
You may need to give blood samples, which will be used to
look for antibodies against H. pylori. For a blood test, a
healthcare provider will draw a small amount of blood from your arm or hand.
The blood will then be sent to a laboratory for analysis.
A stool sample may be needed to check for signs of H.
pylori in your feces. Your doctor will give you a container to take
home with you to catch and store a sample of your stool. Once you return the
container to your healthcare provider, they will send the sample to a
laboratory for analysis.
If you have a breath test, you’ll swallow a preparation
containing urea. If H. pylori bacteria are present, they will release
an enzyme that breaks down this combination and will release carbon dioxide,
which a special device then detects.
If you have an endoscopy, your doctor will insert a long,
thin instrument called an endoscope into your mouth and down into your stomach
and duodenum. An attached camera will send back images on a monitor for your
doctor to view. Any abnormal areas will be inspected, and special tools used
with the endoscope will take samples from these areas if that’s necessary.
What are the complications of H.
infections can lead to peptic ulcers, but the infection or the ulcer itself can
lead to more serious complications. These include:
- internal bleeding, which can happen when a
peptic ulcer breaks through your blood vessel
- obstruction, which can happen when an ulcer
blocks the food from leaving your stomach
- perforation, which can happen when an ulcer breaks
through your stomach wall
- peritonitis, which is an infection of the
peritoneum, or the lining of the abdominal cavity
show that infected people also have an increased risk of gastric adenocarcinoma,
which is a type of stomach cancer. While the infection is a major cause of
stomach cancer, most people infected with H.
pylori never develop stomach cancer.
How are H. pylori infections treated?
If you have an H. pylori infection that
isn’t causing you any problems and you aren’t at increased risk of stomach
cancer, treatment may not offer any benefits.
Stomach cancer, along with duodenal and stomach ulcers, is
associated with H. pylori infection. If you have close relatives with
stomach cancer or a problem such as a stomach or duodenal ulcer, your doctor
may want you to have treatment. Treatment can cure an ulcer, and it may reduce
your risk of developing stomach cancer.
You will normally need to take a combination of two
different antibiotics, together with another drug that reduces your stomach
acid. Lowering stomach acid helps the antibiotics work more effectively. This
treatment is sometimes referred to as triple therapy.
Some of the drugs that are used in a triple therapy
- proton-pump inhibitors (PPI), such as pantoprazole
(Prevacid), esomeprazole (Nexium), pantoprazole (Protonix), or rabeprazole (AcipHex)
- metronidazole (for seven to 14 days)
- amoxicillin (for seven to 14 days)
Treatment may vary depending on your past medical history
and if you have allergies to any of these medications.
After treatment, you will have a follow-up test for H.
pylori. In most cases, only one round of antibiotics is needed to clear the
infection, but you might need to take more, using different drugs.
Lifestyle and diet
There’s s no evidence that food and nutrition play a role in
preventing or causing peptic ulcer disease in people infected with H. pylori. However, spicy foods, alcohol,
and smoking may worsen a peptic ulcer and prevent it from healing properly.
What can I expect in the long term?
For many people infected with H. pylori, their
infections never cause any difficulties. If you’re experiencing symptoms and
receive treatment, your long-term outlook is usually positive.
For those who develop diseases associated with an H. Pylori infection, the outlook will
depend on the problem, how soon it’s diagnosed, and how it’s treated. You may
need to take more than one round of treatment to kill the H. pylori bacteria. If the infection is still present after one
round of treatment, a peptic ulcer could return or, more rarely, stomach cancer
could develop. Very few people infected with H. pylori will develop stomach cancer. However, if you have a
family history of stomach cancer, you should get testing and treatment for an H. pylori infection.