H. pylori (Helicobacter pylori)
What is H. pylori?
H. pylori - or Helicobacter pylori - is one of the most common germs that live inside our bodies - usually in the stomach. Most people pick it up during childhood. If you are infected with H. pylori you may get an ulcer or indigestion.
The spiral shape of the bacteria and the way they move allow them to penetrate the stomach's protective mucous lining, weakening it and making the stomach more vulnerable to gastric acids. It can also stimulate excess stomach acid, inflaming the stomach and causing gastritis.
Infection with the bacteria is associated with a very slightly increased risk of stomach cancer over time. However, the risk of getting stomach cancer is small and no-one knows if treating H. pylori actually reduces that risk.
It’s not known how H. pylori infection is spread, but scientists believe it may be contracted through food and water. According to the British Medical Journal, eight out of 10 people over 60 have it, with higher rates in developing countries.
Symptoms of H. pylori
Most people with H. pylori don’t have any symptoms. Having H. pylori infection doesn't necessarily mean you'll have ulcers or develop stomach cancer. It's not clear why some infected people develop ulcers and others don't.
When H. pylori does cause symptoms, they are usually symptoms of gastritis or peptic ulcer disease. The most common symptom of peptic ulcer disease is gnawing or burning abdominal pain, usually in the area just beneath the ribs. This pain typically gets worse when your stomach is empty and gets better when you eat, drink milk or take an antacid.
Other symptoms may include:
- Weight loss
- Loss of appetite
- Vomiting (vomit may be bloody or look like coffee grounds)
- Black, tarry stools
If you are having black stool or vomiting blood, you should seek urgent medical advice or attend A&E. The National Institute for Health and Clinical Excellence (NICE) advises you should see a specialist or have an endoscopy within two weeks of these warning signs.
How H. pylori is diagnosed
Several types of tests are available to help diagnose H. pylori infection. These include:
Breath test. A test used to check for the presence of a gas produced by the bacteria.
Blood test. A test that looks for antibodies in the blood that indicate exposure to H. pylori.
Stool test. A test that uses a small sample of stool to look for evidence of infection.
Endoscopy. A thin, flexible tube with a camera is passed through the mouth and down into the stomach.
Treatments for H. pylori
Treatments for H. pylori work very well and get rid of the bacteria in eight out of 10 people. There are a number of treatments for H. pylori infection. They include:
- Antibiotics to kill the bacteria
- Medicine, including H2-blockers and proton pump inhibitors, to reduce the amount of stomach acid
- Surgery to treat ulcers
Doctors used to advise people with ulcers not to eat spicy, fatty, or acidic foods. However, it is now known that diet has little if any effect on ulcers for most people. Smoking, however, can interfere with the healing of ulcers and has been linked with recurrence. If you smoke and have ulcers, that is another reason to stop.
The appropriate treatment for you will depend on a number of factors, including:
- Your age, health and medical history
- The severity of infection or stomach damage
- Your ability to tolerate certain medicine or treatments
- Your treatment preference