H. pylori Infection: Symptoms, Causes, Diagnosis, Treatment & Prevention

 

The bacteria H. pylori is the cause of both gastritis and peptic ulcer disease. It mostly affects children. Of those infected, just 20% experience symptoms. Bloody vomit, unexpected weight loss, and dull or scorching stomach ache are other symptoms.

H. pylori infection is a prevalent cause of stomach ulcers, often known as peptic ulcers, and it may affect over half of the people worldwide.

Because they never become ill, the majority of people are unaware that they have an H. pylori infection. Your doctor will likely do an H. pylori infection test if you start exhibiting symptoms of a peptic ulcer. An ulcer on the stomach lining (gastric ulcer) or the upper portion of the small intestine (duodenal ulcer) is referred to as a peptic ulcer.

Proton pump inhibitors and antibiotics are frequently used in combination to treat ulcers caused by H. pylori.

Also Read: Hepatitis A: Symptoms, Causes, Risk factors, Diagnosis, Treatment & Prevention

What is H. pylori?

Your stomach is infected with a type of bacteria called Helicobacter pylori (H. pylori). It may result in sores and inflammation in the duodenum, the upper portion of your small intestine, or the lining of your stomach. Stomach cancer can arise from an infection in some people.

H. pylori infection is common. It is present in the body of almost two-thirds of people in this world. Most people never have any symptoms from it. However, it's the most typical reason for peptic ulcers, painful open sores in your digestive system. Rarely, stomach cancer may even result from it.

Symptoms:

The majority of persons infected with H. pylori never experience any symptoms. Why so many people do not exhibit symptoms is unknown. However, some individuals might have a higher born resistance to the harmful effects of H. pylori.

When H. pylori infection symptoms do manifest, they are usually associated with gastritis or a peptic ulcer and can include:

• A pain or burning sensation in your abdomen

• A stomach pain that could worsen if you don't have food in your stomach

• Nausea

• Appetite loss

• Frequently burping

• Bloating

• Unintentional loss of weight

• Dark stools, possibly due to blood in them

Causes:

When the H. pylori bacteria infect your stomach, an H. pylori infection occurs. The most common way that H. pylori bacteria spread from person to person is by direct contact with saliva, vomit, or feces. Contaminated food or water can potentially transmit H. pylori. It is still unclear how the H. pylori bacteria specifically produces peptic ulcers or gastritis in some people.

Risk factors:

H. pylori infections frequently occur in childhood. Living conditions during childhood are associated with risk factors for H. pylori infection, including:

• You are living in close quarters. Your chance of contracting H. pylori infection may rise if you live in a house with lots of other people.

• Living without a reliable supply of clean water. A steady source of uncontaminated, flowing water lowers the likelihood of H. pylori infection.

• Living in a nation under development. The chance of contracting H. pylori infection is higher in those who reside in underdeveloped nations. This could happen as a result of the prevalence of filthy and cramped living arrangements in developing nations.

Living with an H. pylori-infected person. If you live with someone who has H. pylori infection, your chances of getting it are higher.

How is an infection with H. pylori diagnosed?

Your doctor may request one or more of the following tests if they believe the H. pylori bacterium is the source of your stomach ulcer:

• The breath test involves exhaling into a bag both before and after drinking a solution. The test measures how much carbon dioxide you release both before and after drinking the solution. After consuming the solution, a greater level indicates the presence of H. pylori.

• Stool test: This test examines a stool sample for signs of H. pylori.

• Upper endoscopy: The stomach is reached through the throat using a flexible tube. To check for the presence of H. pylori, a little tissue sample from the lining of the stomach or intestine is obtained.

Complication:

The following are complications linked to H. pylori infection:

• Ulcers. The stomach and small intestine's protective lining may sustain harm from H. pylori. This can lead to the formation of an ulcer (open sore) from stomach acid. An ulcer affects 10% of those who have H. pylori.

• Inflammation of the lining of the stomach. An H. pylori infection may irritate and inflame the stomach (gastritis).

• Stomach cancer. An H. pylori infection significantly increases the risk of developing some forms of stomach cancer.

In what way is H. pylori treated?

You don't require treatment if you don't exhibit any symptoms. Avoid clear of nonsteroidal anti-inflammatory drugs if you have been diagnosed with H. pylori. These medications may make ulcers more likely to occur.
Ulcers caused by Helicobacter pylori are treated with a combination of proton pump inhibitors that reduce acidity and antibiotics.

• Antibiotics: Two antibiotic prescriptions are often prescribed. Amoxicillin, clarithromycin (Biaxin®), metronidazole (Flagyl®), and tetracycline are among the frequently used options.

• Proton pump inhibitor: Lansoprazole (Prevacid®), omeprazole (Prilosec®), pantoprazole (Protonix®), rabeprazole (Aciphex®), and esomeprazole (Nexium®) are examples of proton pump inhibitors that are often used.

• Bismuth subsalicylate: This medication, such as Pepto-Bismol®, is occasionally added to the above-stated mixtures of antibiotics and proton pump inhibitors. This drug protects the lining of the stomach.

Typically, a combination treatment is administered for 14 days.

A more recent medication called Talicia® is a single capsule that contains a proton pump inhibitor (omeprazole) along with two antibiotics (rifabutin and amoxicillin).

Prevention:

Healthcare professionals occasionally do H. pylori tests on healthy individuals in areas of the world where the virus and its consequences are prevalent. Experts disagree on the usefulness of testing for H. pylori infection in cases when there are no symptoms or signs of illness.

Talk with your healthcare professional if you have concerns about an H. pylori infection or believe you may be at high risk for stomach cancer. You and your partner can determine if an H. pylori test would be beneficial for you.

Your chance of contracting H. pylori infection can be decreased if:

• Drinking clean water. (This is especially important if you are in an area of the world where the water supply is known to be contaminated.)

• Before eating and after using the bathroom, give your hands a thorough 20-second wash with soap and water.

References:

• Guevara B, Cogdill AG. Helicobacter pylori: A Review of Current Diagnostic and Management Strategies (https://pubmed.ncbi.nlm.nih.gov/32170476/). Dig Dis Sci. 2020 Jul;65(7):1917-1931. Accessed 8/31/2021.

• Bittencourt de Brito B, et al. Pathogenesis and clinical management of Helicobacter pylori gastric infection. World Journal of Gastroenterology. 2019; doi:10.3748/wjg.v25.i37.5578.

• Zeng M, Mao XH, Li JX, et al. Efficacy, safety, and immunogenicity of an oral recombinant Helicobacter pylori vaccine in children in China: a randomized, double-blind, placebo-controlled, phase 3 trial (https://pubmed.ncbi.nlm.nih.gov/26142048/). Lancet. 2015 Oct 10;386(10002):1457-1464. Accessed 8/31/2021.

• Peptic ulcer disease. American College of Gastroenterology. https://gi.org/topics/peptic-ulcer-disease/. Accessed Jan. 31, 2022.

• Jones LN. Koletzko S, Goodman K. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016) (https://espghan.info/files/Joint_ESPGHAN_NASPGHAN_Guidelines_for_the.HP.pdf). JPGN. 2017;64(6):991-1003. Accessed 8/31/2021.

• H. pylori. American College of Gastroenterology. https://gi.org/topics/h-pylori/. Accessed Jan. 31, 2022.

• National Institute of Health. National Cancer Institute. Helicobacter pylori and Cancer (https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/h-pylori-fact-sheet). Accessed 8/31/2021.

• North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). Helicobacter Pylori (H. Pylori) (https://gikids.org/digestive-topics/helicobacter-pylori/). Accessed 3/4/2021.

• Cleveland Clinic: "H. Pylori Infection," "H. Pylori (Helicobacter Pylori) Breath Test / Urea Breath Test"

• American Academy of Pediatrics. Helicobacter Pylori Infections (https://www.healthychildren.org/English/health-issues/conditions/abdominal/pages/Helicobacter-Pylori-Infections.aspx). Accessed 8/31/2021.

• Peptic ulcers (stomach ulcers). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/all-content. Accessed Jan. 31. 2022.

• Mayo Clinic: "Omeprazole, Amoxicillin, And Rifabutin (Oral Route)," "Helicobacter pylori (H. pylori) infection," "Peptic Ulcers."

• Helicobacter pylori infection. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastritis-and-peptic-ulcer-disease/helicobacter-pylori-infection. Accessed Jan. 31, 2022.

• Piscione M, et al. Eradication of Helicobacter pylori and gastric cancer: A controversial relationship. Frontiers in Microbiology. 2021; doi:10.3389/fmicb.2021.630852.

• Wing EJ, et al., eds. Diseases of the stomach and duodenum. In: Cecil Essentials of Medicine. 10th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Jan. 31, 2022.

• Jameson JL, et al., eds. Helicobacter pylori infections. In: Harrison's Principles of Internal Medicine. 20th ed. McGraw Hill; 2018. https://accessmedicine.mhmedical.com. Accessed Jan. 31, 2022.

• Parikh N. Helicobacter pylori (https://www.statpearls.com/articlelibrary/viewarticle/22683/). StatPearls. Accessed 8/31/2021.