Helicobacter pylori (H. pylori) is a bacteria that lives in the digestive tract. Experts claim up to two-thirds of the world’s population has H. pylori. Many people are not adversely affected by its presence, but some people develop stomach and duodenal inflammation and ulcers. In a very small percentage of the population, infection from H. pylori bacteria leads to stomach cancer.
What Causes H. pylori Infection?
One person can acquire h. pylori bacteria from another, either by a fecal-oral or oral-oral route. It can also be acquired through contaminated water or food. Once the bacteria enters the gastrointestinal (GI) tract, it attaches itself to the lining of the stomach and produces certain toxins like Vac-A that causes inflammation of the stomach lining, which further damages the stomach lining. When acid gets through the lining of a stomach damaged by bacteria, it causes painful ulcers. These ulcers can further complicate with bleeding or perforation. Perforated ulcers are characterized by a hole in the wall of the stomach or small intestinal. Both bleeding and perforated ulcers require surgery. Most people infected with H. pylori do not react this way, however, and experts do not know why others do.
Symptoms of H. pylori Infection
A person infected with h. pylori will only know about the infection if they develop gastritis (inflammation of the stomach) or ulcers. Signs of stomach ulcers include:
- A dull or burning pain in the stomach that gets worse when the stomach is empty
- Loss of appetite
- Frequent burping
- Unintentional weight loss
The following symptoms require immediate medical attention. They may indicate complications of the ulcer such as bleeding or perforation.
- Persistent abdominal pain
- Dark or bloody stool
- Difficulty breathing
- Pale skin
- Vomit that looks like coffee grounds or contains blood
- Dizziness or fainting
- Feeling full after eating a small amount
- Belly pain or swelling
- Constant decreased appetite
Risk Factors for H. pylori
Children are the demographic most likely to contract h. pylori. People who live in crowded areas, or in places that lack clean, running water, are at greater risk of contracting the bacteria, as are those living in developing countries where general living conditions are unsanitary.
Diagnosing H. pylori
More than 90% of duodenal ulcer and 70% of stomach ulcer patients are infected with H. pylori. Simple tests can confirm the presence of the bacteria.
- Blood tests. The blood of an infected person will contain antibodies that indicate that he has had the infection recently. Since antibodies can show up for years after eradication of the infection, a blood test is a good way to diagnose past or current H. pylori infection.
- Urea breath test. The patient drinks a liquid or swallows a capsule of urea. He or she then breathes into a bag, and this breath sample is sent to the lab. Higher-than-normal levels of carbon dioxide confirm the presence of H. pylori.
- Stool test. The doctor may wish to have a stool sample sent to the lab to test for foreign proteins.
- Upper gastrointestinal endoscopy. An endoscopy allows the doctor to look at ulcers and test tissue samples for H. pylori. During the exam, a tube with a small camera is inserted into the mouth, through the esophagus, and into the stomach and duodenum. The doctor will evaluate the ulcers and take a tissue sample or biopsy.
- X-ray. The doctor may wish to view the upper GI tract. The patient drinks barium to color the GI tract so that it shows up clearly in the x-ray.
Treating H. pylori
Treatment for H. pylori infection with ulcers usually consists of one to two weeks of medication. The infected individual will take antibiotics — often two kinds — to get rid of the bacteria, as well as an acid-blocker medication to heal the stomach lining, keep the ulcers from returning, and reduce pain and inflammation. The newest treatment for H pylori – sequential therapy consists of an antibiotic plus an acid blocker for five days, followed by two other antibiotics plus an acid blocker for the next five days.
Preventing H. pylori
With the majority of the population carrying this bacteria, it may not be possible to avoid an H. pylori infection altogether. However, the following hygiene measures can lower the chance of contracting H. pylori:
- Follow good hygiene techniques after using the bathroom and being outside, and before eating
- Avoid food served by people who do not use good hygiene techniques
- Avoid contaminated water. While traveling in developing countries, drink only bottled water
- Cook meats and other animal products thoroughly before eating
For people who already carry the H. pylori bacteria, the following changes can help prevent stomach ulcers:
- Stop smoking
- Reduce alcohol intake
- Substitute acetaminophen for other pain-relieving drugs (these drugs can also cause gastritis and ulcers)
- Avoid caffeine
- Avoid spicy foods
- Reduce stress levels
Prognosis for H. pylori Infection
People with mild symptoms have an excellent prognosis. Approximately 20 percent of patients with serious symptoms will have a recurrence of the infection, although ulcers usually heal well with little to no scarring. Severe infections left untreated can lead to damage to the stomach and upper GI tract, such as bleeding and perforation, which can be fatal. One more reason to treat this infection: H. pylori infection raises the risk of certain types of stomach cancer. About two percent of people with H. pylori infection develop gastric cancer.