Helicobacter Pylori (H. Pylori) is a common bacteria that stays in your gut and can infect your stomach and small intestine. It affects more than 50% of the world’s population. In most people, no symptoms develop, and they may never know that they carry H. pylori in their gut. However, symptoms, when developed, include sores (ulcers) in the lining of the stomach or small intestine and inflammation of the stomach called gastritis.
The ‘H’ in its name abbreviates Helicobacter. In green, ‘Helico’ means spiral. The term Helicobacter indicates that these are spiral-shaped bacteria.
H. pylori is the most common cause of ulcers in the stomach and small intestine. In some people, infection ends up causing stomach cancer.
Causes of H. pylori Infection
It is not known how H. pylori spreads from person to person. However, scientists think that it may spread from an infected person’s mouth to other persons or through infected feces to another person’s mouth. It usually happens when a person does not wash their hands after going to the bathroom.
The bacteria can also spread through contaminated water or food. It is a more common way H. pylori infection can spread. However, with more of the worlds population having access to clean water and better sanitary facilities, its spread has significantly decreased, and fewer people get infected with this bacteria.
How H. pylori Makes You Sick
Cells in your stomach wall secrete acid, which helps digest food. Naturally, your stomach wall is covered by a mucus lining, which protects it from any damage caused by acid.
Most bacteria and other germs are unable to survive in this harsh acidic environment of the stomach.
However, H. pylori has certain enzymes that help it make the stomach environment suitable for living by reducing the acidity of the stomach.
Once it survives, its spiral shape allows it to enter the lining of your stomach and damage the mucus covering. In the stomach lining, it is also protected from the immune cells as these are unable to reach and kill the bacteria.
The damaged mucus covering fails to protect your stomach from acid. This leads to sores (called peptic ulcers) in your stomach and small intestine.
For long, scientists thought that stress, spicy foods, and smoking are the leading causes of peptic ulcer diseases. In 1982, the discovery of H. pylori revealed the fact that it is the most common cause of peptic ulcers worldwide. Of those infected with H. pylori, almost 10% develop a peptic ulcer.
Risk Factors for H. pylori Infection
The risk factors for infection are related to your living conditions and environment, such as;
Contaminated Water or Food: H. pylori mostly spreads through contaminated water and food.
Overcrowded House: Living in a crowded house, with a poor hygienic environment, also increases your risk of H. pylori infection.
Sharing Home with H. pylori Infected Individuals: If you share homes with an individual who is infected with H. pylori, your risk for infection is very high.
Developing Country: Living in a developing country, with no clean water, poor sanitation, and overcrowded environment, also increases your risk of H. pylori infection.
Symptoms of H. pylori Infection
Most individuals do not develop any symptoms. However, when developed, an ulcer is the primary symptom of H. pylori infection. The ulcer may be in the stomach or duodenum (very first part of your small intestine).
An ulcer in your stomach will make you suffer from pain and heartburn every time you eat some food. This is because the presence of food in your stomach stimulates acid secretion. The pain is relieved when your stomach is empty.
An ulcer in your duodenum will make you suffer from pain in your abdomen, especially at night or between meals, when your gut is empty. The pain is relieved by eating food or an antacid.
Many other symptoms are associated with H. pylori infection:
● Indigestion
● Excessive bloating
● Burping or belching
● Nausea and Vomiting
● Fever
● Headache
● Heartburn
● Not feeling hungry
● Weight loss for unclear reasons
If left untreated, an ulcer may bleed in your stomach or small intestine, causing a significant blood loss. This may lead to anemia and other issues related to reduced blood volume. You should immediately consult your doctor if you notice any of the following symptoms as:
● Blood in your stools (fresh, dark red or black colored stool indicate blood in stools)
● Blood in your vomit (coffee-colored vomit)
● Pale yellow skin
● Difficulty breathing
● Dizziness and fainting
● Feeling lethargic and lazy all day long
If you notice any of the above-described symptoms, always consult with your medical practitioner.
Diagnosis
The symptoms described above can also be caused by the overuse of NSAIDs (most commonly used pain-killers). Your doctor may need to perform some tests to differentiate the cause of your symptoms and initiate the right treatment.
Your doctor will ask about your previous medical and family history. Your doctor will specifically ask about the use of NSAIDs, such as ibuprofen, for any reason. If you are using, make sure to inform your doctor about this.
Your doctor may need to perform some other procedures and tests, including:
Physical Exam
Your doctor will examine your abdomen for any signs of swelling, pain, or bloating in your belly. He may also listen to the sounds in your abdomen using his stethoscope.
Blood Test
Your doctor will draw a small sample of your blood and get it tested for antibodies against H. pylori.
However, the blood test is not an ideal method to diagnose H. pylori. It can not tell whether you have an active infection or a previous infection. It may show positive even after your previous infection was cured. Moreover, It can not be used to confirm if the disease is cured or not after the treatment.
Urea Breath Test
During a breath test, you will swallow a pill containing urea with labeled carbon atoms.
If H. pylori is present in your stomach, it will degrade the urea releasing the labeled carbon atoms which are absorbed in your blood and later exhaled with your breath. You will exhale into a device that can detect those labeled carbon atoms.
If the device detects labeled carbon atoms in your breath, this indicates that you have H. pylori infection.
Stool Antigen Test
You may need to collect a sample of your stool in a small container and give it in the laboratory to get tested for information.
This will test the presence of H. pylori antigens (proteins associated with H. pylori infection) in your stool.
A positive stool antigen test indicates that you have an active H. pylori infection.
Caution: Medicines you are using to alleviate your symptoms (antacids, proton pump inhibitors, and antibiotics) may interfere both with breath and stool tests. This need to be stopped before your test. Refer to the pre-procedure instruction sheet of the test for further information.
Endoscopy
If the above tests are not conclusive, you may need to follow endoscopy, an invasive procedure, to figure out the cause of your symptoms.
Your doctor will pass a flexible tube (with a tiny camera) through your mouth and esophagus to enter into your stomach and duodenum. Your doctor will look for any abnormalities in your stomach and duodenum, and will also take a small section of your gut for a biopsy.
The biopsy will pinpoint the cause of your symptom. But it is the last choice when all other tests are not conclusive.
Treatment
If you do not develop any symptoms, you do not need treatment. However, if you have any of these symptoms, consult your doctor about the treatment options. The treatment initiated early cures the ulcer and also reduces the risk of cancer due to H. pylori ulcers.
The treatment for an H.pylori infection is based on triple therapy. Triple therapy includes two different antibiotics and an antacid drug to reduce the acidity of your stomach. Antibiotics work better in a less acidic environment.
Some of the drugs included in Triple therapy are:
● clarithromycin
● metronidazole
● amoxicillin, and
● proton pump inhibitors (omeprazole, lansoprazole, and pantoprazole)
Make sure to inform your doctor if you have any allergies to these drugs. If you have, your doctor may need to change your medications.
Typically, H. pylori infection is completely cured with a single course of antibiotics and proton pump inhibitors.
Long-Term Outlook
In many individuals, H. pylori infection does not cause any symptoms or difficulties. However, if you developed symptoms and have started your medicines, your long-term outlook is very positive and optimistic.
After you have completed your treatment, your doctor will again call for the urea breath test and stool antigen test to confirm that you have eradicated the infection.
If the infection is not eradicated, your ulcer may come again after you stop the medicine. You may need to take the 2nd course of treatment.
If the infection is still not eradicated, or if you have a family history of stomach cancer, there is a risk of developing stomach cancer. However, stomach cancer from H. pylori is rare.
The Bottom Line
H. pylori is a common bacteria that can cause ulcers in your stomach. It has infected more than half the world’s population. Most individuals do not develop symptoms. However, symptoms, if developed, are easily treated using Triple therapy medicines. Moreover, the long-term outlook of the infection is also very positive.
