A bacteria called H. pylori is the pathogen responsible for the highest number of global cancer and chronic ulcer cases.
H. pylori accounted for over 800,000 cancer cases in 2018 alone and about 30% to 40% of all Americans have got an H. pylori infection at some point.
The stomach infection with H. pylori is not the cause of the illness itself; over half of the global population is infected, but most are asymptomatic.
So why is H. Pylori so virulent, though subtle?
Transmission
H. pylori bacteria usually spread from person to person and also likely through:
- Dirty food, water, or utensils
- Mouth to mouth (kissing)
- Contaminated poop or vomit
- Contact with the body fluids of someone who is already infected.
Once H. pylori enter your body, it multiplies in the lining of your stomach weakening it. This makes it more likely that your stomach acids will cause an ulcer.
Persistent colonization with more virulent strains can induce several gastric and extragastric disorders including:
Risk Factors
Most people get H. pylori during childhood, but adults can get it, too. Infections are often related to your living conditions.
Risk factors include:
- Crowded living conditions
- Lack of clean water and sewer service
- Living in close quarters with someone who is infected
- Living in a developing country
H. Pylori Symptoms
Having the bacteria doesn’t necessarily cause symptoms. But you’ll probably notice them if you get stomach inflammation (gastritis) or a peptic ulcer due to H pylori.
The most common issue is a dull or burning pain in your belly. The feeling may come and go and may worsen when your stomach is empty. You may feel better after you eat, drink milk, or take an antacid.
Other symptoms include:
- Bloating
- Burping
- Loss of appetite
- Nausea & Vomiting
- Weight loss for no clear reason
- infection may also be asymptomatic
H. Pylori Diagnosis
Your doctor will likely ask you about your medical history and any medication you are on. Then they’ll proceed with a physical exam which may include checking your belly for any swelling, tenderness, or pain.
H. Pylori Tests
There are several tests your doctor can use to find out if you’re infected:
Stool tests (Antigen & PCR)
Stool antigen tests detect H. pylori in your poop. They’re the most common tests used to find the bacteria.
Stool PCR tests (polymerase chain reaction tests) also look for H. pylori in your poop. They also look for mutations that can make the bacteria antibiotic-resistant. PCR tests are more expensive than antigen tests and may not be as easy to get.
Urea breath test
Here, you exhale into a bag so your doctor can measure how much carbon dioxide (CO2) is in your breath. Then you swallow a liquid or pudding that contains a substance called urea.
Several minutes later, you’ll exhale into a different bag to measure your CO2 again.
If you have H. pylori in your gut, it will break down the urea in the liquid you swallowed, and CO2 will be released in your breath. If there’s more CO2 in the second sample than the first, your test is positive for H. pylori.
Upper GI Endoscopy
The doctor uses a tube with a small camera (endoscope), to look down your throat and into your stomach and the upper part of your small intestine.
The procedure may also be used to collect a sample that will be checked for H. pylori. You may be asleep or awake during the procedure, but you’ll get medicine to make you more comfortable.
Upper GI Tests
Your doctor will have you take a chalky white liquid (barium), and will then conduct an X-ray on you. The barium coats your throat and stomach and makes them stand out clearly on the image for better examination of your gut.
Computed Tomography (CT Scan)
This powerful X-ray can be used to detect stomach conditions like peptic ulcers.
H. Pylori Treatment
Ulcers caused by H. pylori are usually treated with a combination of antibiotics and a proton pump inhibitor (PPI).
Triple therapy: Therapies that combine PPIs with two antibiotics remain the first-line option for treating H. pylori.
Antibiotics: Broad-spectrum antibiotics prescribed by the doctor, keep the bacteria from building up a resistance to a particular one. Amoxicillin, clarithromycin (Biaxin), metronidazole (Flagyl), tetracycline (Sumycin), or tinidazole (Tindamax) are likely options.
Proton pump inhibitors (PPIs): These drugs reduce the acid in your stomach by blocking the tiny “pumps,” or glands, that produce it. They include esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole.
Some studies suggest that H. pylori plays an important role in the natural stomach ecology by influencing the type of bacteria that colonize the gastrointestinal tract.
Other studies suggest that non-pathogenic strains of H. pylori may beneficially normalize stomach acid secretion, and regulate appetite.
Most ulcers caused by H. pylori will heal after a few weeks. Don’t take nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naproxen for pain, since they can damage your stomach lining. If you need pain medicine, talk to your doctor.
