Helicobacter pylori (H. pylori) infection occurs when H. pylori bacteria infect your stomach. This usually happens during childhood. A common cause of stomach ulcers (peptic ulcers), H. pylori infection may be present in more than half the people in the world.
Most people don't realize they have H. pylori infection because they never get sick from it. If you develop signs and symptoms of a peptic ulcer, your health care provider will probably test you for H. pylori infection. A peptic ulcer is a sore on the lining of the stomach (gastric ulcer) or the first part of the small intestine (duodenal ulcer).
H. pylori infection is treated with antibiotics.
Most people with H. pylori infection will never have any signs or symptoms. It's not clear why many people don't have symptoms. But some people may be born with more resistance to the harmful effects of H. pylori.
When signs or symptoms do occur with H. pylori infection, they are typically related to gastritis or a peptic ulcer and may include:
Make an appointment with your health care provider if you notice any signs and symptoms that may be gastritis or a peptic ulcer. Seek immediate medical help if you have:
H. pylori infection occurs when H. pylori bacteria infect your stomach. H. pylori bacteria are usually passed from person to person through direct contact with saliva, vomit or stool. H. pylori may also be spread through contaminated food or water. The exact way H. pylori bacteria causes gastritis or a peptic ulcer in some people is still unknown.
People often get H. pylori infection during childhood. Risk factors for H. pylori infection are related to living conditions in childhood, such as:
Complications associated with H. pylori infection include:
In areas of the world where H. pylori infection and its complications are common, health care providers sometimes test healthy people for H. pylori. Whether there is a benefit to testing for H. pylori infection when you have no signs or symptoms of infection is controversial among experts.
If you're concerned about H. pylori infection or you think you may have a high risk of stomach cancer, talk to your health care provider. Together you can decide whether you may benefit from H. pylori testing.
Several tests and procedures are used to determine whether you have H. pylori infection. Testing is important for detection of Helicobacter pylori (H. pylori). Repeat testing after treatment is important to be sure H. pylori is gone. Tests may be done using a stool sample, through a breath test and by an upper endoscopy exam.
During a breath test — called a urea breath test — you swallow a pill, liquid or pudding that contains tagged carbon molecules. If you have H. pylori infection, carbon is released when the solution comes in contact with H. pylori in your stomach.
Because your body absorbs the carbon, it is released when you breathe out. To measure the release of carbon, you blow into a bag. A special device detects the carbon molecules. This test can be used for adults and for children over 6 years old who are able to cooperate with the test.
A health care provider may conduct a scope test, known as an upper endoscopy exam. Your provider may perform this test to investigate symptoms that may be caused by conditions such as a peptic ulcer or gastritis that may be due to H. pylori.
For this exam, you'll be given medication to help you relax. During the exam, your health care provider threads a long, flexible tube with a tiny camera (endoscope) attached down your throat and esophagus and into your stomach and the first part of the intestine (duodenum). This instrument allows your provider to view any problems in your upper digestive tract. Your provider may also take tissue samples (biopsy). These samples are examined for H. pylori infection.
Because this test is more invasive than a breath or stool test, it's typically done to diagnose other digestive problems along with H. pylori infection. Health care providers may use this test for additional testing and to look for other digestive conditions. They may also use this test to determine exactly which antibiotic may be best to treat H. pylori infection, especially if the first antibiotics tried didn't get rid of the infection.
This test may be repeated after treatment, depending on what is found at the first endoscopy or if symptoms continue after H. pylori infection treatment.
Antibiotics can interfere with the accuracy of testing. In general, retesting is done only after antibiotics have been stopped for four weeks, if possible.
Acid-suppressing drugs known as proton pump inhibitors (PPIs) and bismuth subsalicylate (Pepto-Bismol) can also interfere with the accuracy of these tests. It's possible acid-suppressing drugs known as histamine (H-2) blockers may also interfere with the accuracy of these tests. Depending on what medications you're taking, you'll need to stop taking them, if possible, for up to two weeks before the test. Your health care provider will give you specific instructions about your medications.
The same tests used for diagnosis can be used to tell if H. pylori infection is gone. If you were previously diagnosed with H. pylori infection, you'll generally wait at least four weeks after you complete your antibiotic treatment to repeat these tests.
H. pylori infections are usually treated with at least two different antibiotics at once. This helps prevent the bacteria from developing a resistance to one particular antibiotic.
Treatment may also include medications to help your stomach heal, including:
Repeat testing for H. pylori at least four weeks after your treatment is recommended. If the tests show the treatment didn't get rid of the infection, you may need more treatment with a different combination of antibiotics.
See your health care provider if you have signs or symptoms that indicate a complication of H. pylori infection. Your provider may test and treat you for H. pylori infection, or refer you to a specialist who treats diseases of the digestive system (gastroenterologist).
Here's some information to help you get ready for your appointment, and what to expect.
At the time you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.
Also, preparing a list of questions to ask may help you make the most of your time with your health care provider. Questions to ask may include:
Ask any additional questions that occur to you during your appointment.
Your health care provider is likely to ask you a number of questions, such as:
Being ready to provide information and answer questions may allow more time to cover other points you want to discuss.
