What Is H. pylori?
H. pylori (Helicobacter pylori) is type of bacteria commonly found in the stomach. Nearly half of all people have H. pylori in their bodies but never have symptoms or develop problems related to the bacteria.
But in some people, H. pylori can cause digestive problems, such as ulcers or chronic inflammation in the walls of the stomach (gastritis) or duodenum (duodenitis). Rarely, it can cause stomach cancer.
What Are Symptoms of H. pylori?
Most people who have H. pylori infection have no symptoms but some people can develop serious problems, including stomach or duodenal ulcers.
Symptoms of ulcers include:
- Abdominal pain or discomfort
- Feeling of fullness after eating small amounts
- Loss of appetite
- Nausea or vomiting
- Dark or tar-colored stools
- Ulcers that bleed can cause low blood count and fatigue
What Causes H. pylori?
The exact mechanism of how H. pylori is transmitted is unknown but it is thought to be spread by consuming food or water contaminated with fecal matter. The bacteria may also be present in saliva or vomit.
Is H. pylori Contagious?
How Is H. pylori Diagnosed?
H. pylori may be diagnosed with a number of different tests:
- Breath tests (urea breath tests): patients drink a specialized solution containing a substance broken down by the H. pylori bacterium and the breakdown products can be detected in a person’s breath
- Stool tests to detect H. pylori proteins in bowel movements
- Blood tests to detect specific antibodies (proteins) that the body's immune system develops in response to the H. pylori bacterium (not widely used due to concerns over its accuracy)
What Is the Treatment for H. pylori?
Treatment for H. pylori infection usually involves taking several medications for 14 days.
- Proton pump inhibitors (PPIs) to decrease the stomach acid production
- Two antibiotics are usually recommended along with a PPI to reduce the risk of treatment failure and antibiotic resistance
- Bismuth quadruple therapy: bismuth subsalicylate, metronidazole, tetracycline, and a PPI given for 14 days
- Clarithromycin triple therapy: clarithromycin, amoxicillin, and a PPI, all given twice daily for 14 days
- Concomitant therapy: a clarithromycin, amoxicillin, a nitroimidazole (tinidazole or metronidazole), and a PPI administered together for 10 to 14 days
- Hybrid therapy: amoxicillin and a PPI for seven days followed by amoxicillin, clarithromycin, a nitroimidazole, and a PPI for seven days
- Levofloxacin triple therapy: levofloxacin, amoxicillin, and a PPI for 10 to 14 days
- Levofloxacin quadruple therapy: levofloxacin, omeprazole, nitazoxanide, and doxycycline (LOAD) for 7 or 10 days (additional studies are needed to confirm the efficacy of this regimen and its cost-effectiveness)
- Levofloxacin sequential therapy: amoxicillin and a PPI for five to seven days followed by levofloxacin, amoxicillin, a nitroimidazole and a PPI for five to seven days
Many patients with H. pylori have an infection that is resistant to antibiotics, so it is important to take the entire course of all medications prescribed and to get a blood or stool test to confirm the infection has been cleared.Up to 20% of patients with H. pylori infection are not cured after completing one course of treatment and retreatment with a second course is usually recommended.
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