What is helicobacter pylori?

Helicobacter pylori (H. pylori) is a bacteria which infects the stomach lining. The chemicals it produces cause inflammation of the stomach lining. Infection appears to be lifelong unless treated with mediations to eradicate the bacteria. 

How do you get H.pylori infection?

Most infections happen in childhood and can be passed on between family members.  Although it is not always certain how the infection is transmitted, oral-oral and faecal-oral routes are possible.

How common is H.pylori infection?

Worldwide, H.pylori is very common and half the world’s population is infected.  In some areas of the world, such as parts of Africa and Asia, 90% of people are infected. 

What the problems H.pylori can cause?

All people who are infected will develop gastritis (inflammation of the stomach).  About 15% will develop ulcers of the stomach or the duodenum (the outlet of the stomach) during their lifetime.  Approximately 1% will develop cancer of the stomach.  Most people who are infected do not have symptoms but the infection can cause problems of abdominal pain, vomiting, feeling full or bloated and, if ulcers develop, bleeding may occur.

How is H.pylori diagnosed?

The most accurate way is by means of culturing samples taken from the stomach by means of gastroscopy.  These samples can also be chemically tested for H.pylori by means of a ‘CLO’ test or looked at under the microscope.

To diagnose the infection without a gastroscopy requires either a blood test for antibodies to the bacteria (serology) or involves drinking a solution which is broken down by the bacteria in the stomach and can be detected in the air breathed into a bottle (breath test).  It is also possible to check for the infection by testing the faeces (antigen test).

What are the treatments?

It is not always necessary to treat the infection, but in those people who have ulcers or other problems, treatment is advised to prevent further problems.

Because resistance to antibiotics is now common, treatment always should include two antibiotics.  These are more effective if given with treatment to reduce stomach acid.  Such combined treatment is often called triple therapy and is usually given for one or two weeks.  It is very important that the full course is taken as partial treatment is not effective.  After treatment it is possible to confirm eradication of the infection by means of the breath test or antigen test if symptoms persist.