H. pylori are a type of bacteria that may infect around two-thirds of the people in the world. The H. in the name is short for Helicobacter—so called because they are spiral in shape (“helico-,” as in the word “helicopter,” means “spiral”).
Helicobacter pylori normally infect your stomach, typically during childhood, and, while this strain of bacteria does not cause problems in most cases, it may cause diseases in some people.
In your stomach, the bacteria are able to change the environment around them by reducing the acidity so they can survive. Their shape lets them penetrate your stomach lining, where they are protected by mucus. Your body’s immune cells are not able to reach them and the bacteria are able to interfere with your immune response, ensuring that they are not destroyed.
In some cases, an H. pylori infection can lead to problems such as ulcers developing in your stomach or duodenum. The duodenum is the section of gut leading from your stomach. H. pylori infection is also associated with stomach cancer and an inflammation inside your stomach known as gastritis.
H. pylori infections are thought to spread from one person’s mouth to another. They may also be transferred from feces to the mouth—if, for example, a person does not wash his or her hands thoroughly after using the bathroom. It is also possible to contract the infection from H. pylori that is present in water or food.
Children are more likely to develop an H. pylori infection—mostly due to lack of proper hygiene.
Your risk for the infection is associated with your environment and living conditions. 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
Symptoms may include abdominal pain, which typically occurs when your stomach is empty, at night, or a few hours after meals. It is described as a gnawing pain, and it may come and go. Eating or taking antacid drugs may relieve the pain.
If you have this type of pain you should visit your doctor. Also, if you have a strong pain that does not go away, you should contact your doctor.
A number of other symptoms may be associated with H. pylori infection. However, these are common symptoms that can be due to other conditions, and some are even experienced by healthy people from time to time:
Although common, if any of these symptoms persist, or if they are causing you concern, it is always best to see your doctor. If you notice blood or a black color in your feces or vomit, you should consult your doctor.
You may need to give blood samples, which will be used to look for antibodies against H. pylori.
A stool sample may be needed to check for signs of Helicobacter pylori in your feces.
If you have a breath test, you will swallow a preparation containing radioactive carbon. The H. pylori bacteria release an enzyme that breaks down this combination, releasing the carbon, which is then detected by using a special device.
A long, thin instrument called an endoscope is inserted into your mouth and fed down into your stomach and duodenum. An attached camera sends back images that are viewed on a monitor. Any abnormal areas can be inspected, and special tools used with the endoscope can take a sample of these areas, if required.
If you have an H. pylori infection that is not causing you any problems and you are not at increased risk of stomach cancer, it is thought that treatment may not offer any benefits.
Stomach cancer and duodenal and stomach ulcers are 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 treatment are lansoprazole(Prevacid), pantoprazole(Protonix), and rabeprazole(AcipHex).
You may have a test for H. pylori after you finish your treatment. In most cases, only one round of antibiotics is needed to clear the infection but, occasionally, you might need to take more, using different drugs.
For many people infected with H. pylori, their infections never cause any difficulties. If you are experiencing symptoms and receive treatment, your long-term outlook usually is positive.
Treatment may not cure the infection if a person has a stomach or duodenal ulcer or stomach cancer. For those who develop these diseases, the outlook will depend on the problem, how soon it is diagnosed, and how it is treated.