H. pylori is a common cause of peptic ulcers, and in rare cases can lead to stomach cancer. Transmission of H. pylori bacteria isn’t completely understood. Direct contact with bodily fluids and exposure to contaminated food or water may be the cause of H. pylori infection.
H. pylori infections can cause damage in the stomach and the first part of the small intestine (duodenum). The bacteria affects the lining of the stomach and duodenum, making them more vulnerable to digestive fluids like stomach acid. This can cause chronic inflammation of the stomach walls (gastritis) and duodenum (duodenitis).
H. pylori Symptoms
For most people, H. pylori will not cause any symptoms or problems. It’s possible that some people are born with greater resistance to H. pylori’s harmful effects.
If an H. pylori infection does cause symptoms, they could include:
- Aching, burning, or pain in the abdomen
- Nausea / Vomiting
- Lack of appetite
These symptoms are common for many gastrointestinal conditions, and your doctor will help determine if your symptoms are caused by an H. pylori infection.
Causes of H. pylori
The exact cause of how H. pylori infections spread is unknown. Experts believe H. pylori is most likely spread by direct contact with bodily fluids – including saliva, vomit, or fecal matter. Ingesting contaminated food and water is also a strong possibility.
H. pylori Risk Factors
The risk factors for H. pylori include:
- Living with Many Others – People who live in homes that are crowded are more likely to have H. pylori.
- Living without clean, reliable water – Access to a reliable, clean water source can reduce the risk of H. pylori.
- Living in a Developing Country – People who live in countries where it is more common to live in unsanitary and crowded conditions are at greater risk for H. pylori.
- Living with someone with H. pylori – People who live with someone who has H. pylori have a higher risk of H. pylori infection.
H. pylori Complications
Complications of H. pylori infection include:
- Peptic Ulcers – Roughly 10 percent of those with H. pylori will develop an ulcer. H. pylori can damage the inner surface of the stomach or small intestine, allowing stomach acid to create ulcers. Ulcers can be painful but can be treated with antibiotics if the cause is H. pylori.
- Gastritis – Gastritis occurs when the lining of the stomach becomes inflamed. H. pylori can irritate the stomach and cause gastritis.
- Stomach Cancer – There are some types of stomach cancers that an H. pylori infection is associated with.
H. pylori Testing & Diagnosis
There are several tests for H. pylori. The most common tests are:
In an H. pylori breath test, patients drink a special solution containing tagged carbon molecules. These molecules release carbon when they come in contact with H. pylori in the stomach. This carbon can be detected when you exhale.
Patients exhale into a bag and the doctor uses a device that detects the presence of carbon. Some acid-suppressing medications (PPIs), antibiotics, and bismuth subsalicylate (Pepto-Bismol) can affect the results and accuracy of this test. Your doctor will ask you to stop taking these medications one to two weeks before your breath test.
Stool tests can detect the proteins associated with H. pylori. Just like the breath test, PPIs and bismuth subsalicylate can affect the accuracy of stool tests. Talk with your doctor if you’re taking these drugs prior to a stool test.
Blood tests may reveal evidence of H. pylori, but stool and breath tests are more helpful when diagnosing active infections of H. pylori.
H. pylori Treatment
Treatment for H. pylori generally includes:
- Antibiotics – To reduce the number of H. pylori bacteria, doctors will often prescribe two antibiotics. Two different antibiotics are used to help prevent drug resistance.
- An acid-suppressing drug – Suppressing acid can help allow the stomach lining to heal. Medications that can suppress acid include:
- PPIs – Proton Pump Inhibitors reduce the stomach’s ability to create acid. Name brand examples include Prilosec, Nexium, and Prevacid.
- H-2 Blockers – These drugs block histamine which is needed to produce acid. Name brand examples include Tagamet and Zantac.
- Bismuth subsalicylate – Most commonly referred to as Pepto-Bismol, this drug coats and protects the stomach ulcer while it heals.
Up to 20 percent of patients will not be cured after the first treatment for H. pylori. Patients will usually undergo a second round of medications for two weeks. At least one of the antibiotics used in the second treatment round will be different than the first.
H. pylori Treatment Follow-up
After treatment, repeat testing using stool or breath tests is used to ensure the infection has resolved.