Symptoms, treatment, test, and more

Helicobacter pylori, (H. pylori), is a type of bacteria that infects the stomach and small bowel. H. pylori is often symptomless, but it can increase the risk of ulcer, gastritis, or cancer, all of which can cause pain and other symptoms.

H. pylori was discovered in 1982 by two Australian researchers who also found that it causes peptic ulcer disease.

Peptic ulcers are open sores in the lining of the stomach or the upper part of the small intestine. Peptic ulcers are often simply called “ulcers” or “stomach ulcers.” H. pylori also increase the risk of developing stomach cancer and gastritis.

This article explains what H. pylori are, how it makes people sick, and how it causes stomach ulcers.

Many people with H. pylori do not have any signs or symptoms. However, if people get an illness caused by H. pylori, they may have various symptoms.

Symptoms of a stomach ulcer might include a dull or burning pain in the upper belly area. The pain is sometimes worse at night or when the stomach is empty. There may be temporary relief from taking an antacid. However, the pain does come back.

Symptoms of gastritis often include upper belly pain, nausea, and vomiting.

Possible symptoms of stomach cancer include:

• belly pain or swelling
• loss of appetite
• nausea or indigestion
• feeling full without eating very much
• vomiting

People with any of these symptoms should talk with their doctor. Other conditions can cause these symptoms, so proper medical care is needed to diagnose the issue.

Possible complications of stomach ulcers

An ulcer can lead to serious complications if left untreated, including:

• internal bleeding that can become life-threatening
• a hole in the stomach that can lead to infection
• scar tissue that can block the stomach or intestine, preventing it from emptying food

These complications require immediate medical attention. Possible warning signs include:

• severe stomach pain
• black or tarry stool
• stool with bright red blood
• vomit with bright red blood
• vomit that resembles coffee grounds
• feeling weak or short of breath
• feeling dizzy or faint
• chills or fever

The stomach has a layer of mucus designed to protect it from stomach acid. H. pylori attack this mucus lining and leave part of the stomach exposed to acid. Together, the bacteria and the acid can irritate the stomach, causing ulcers, gastritis, and in rare cases, stomach cancer.

Many people who have H. pylori in their stomachs do not develop ulcers or any other related problems. In fact, two-thirds of the world’s population have H. pylori, according to the Centers for Disease Control and Prevention (CDC).

In the United States, there is a 5% prevalence of the bacteria in children less than 10 years old. Hispanic and African American populations have a higher prevalence compared with white Americans. About 60% of Hispanics and 54% of African Americans have H. pylori compared to 20–29% of white Americans.

However, for reasons not yet understood, some people get ulcers, gastritis, or stomach cancer from an H. pylori infection.

Research has shown that in the first 10 years since scientists discovered H. pylori, Data from the developed world has shown that in the first decade of the discovery of H. pylori, 95% of duodenal ulcers and 85% of gastric ulcers were associated with this bacterial infection.

Furthermore, the lifetime risk of developing peptic ulcer disease (PUD) maybe 3–10 times higher in people who test positive for H. pylori than those who do not.

Ulcers are not the only problems associated with H. pylori. Researchers discovered that H. pylori may also cause gastritis, a condition that involves inflammation of the stomach’s lining.

H. pylori infection is also linked to stomach cancer. However, the American Cancer Society states that most people with H. pylori in their stomach never develop stomach cancer.

It is worth noting that peptic ulcers may also occur due to the long-term use of certain medications, including pain medications such as ibuprofen, aspirin, and naproxen. These medications are called non-steroidal anti-inflammatory drugs (NSAIDs).

Doctors can conduct a blood test to see if H. pylori antibodies are present in a person’s blood. However, since antibodies can remain in the body after the bacteria is gone, this may not be the best way to test for an active infection.

Other ways to test for the bacteria include:

• An urea breath test (UBT), in whuch a person swallows a capsule containing urea and then gives a breath sample after 10–20 minutes. This allows the doctor to see if the bacteria is present in the stomach.
• An endoscopy can help a doctor find the infection, as well as any related ulcers or inflammation.
• A stool sample can also show if a person has antigens for the bacteria on their stoll. This tells the doctor if the person has an active infection.

Doctors diagnose ulcers, gastritis, and stomach cancer with a combination of the following tests:

• Medical history: Past medical problems and symptoms are discussed.
• Physical exam: The doctor will examine and listen to the belly.
• Special X-rays: These can show the inside of the stomach.
• Endoscopy: Doctors view the inside of the stomach with a special instrument while the patient is sedated or put to sleep.

H. pylori is contagious, though the way it transmits is not clear. The two most likely ways the bacteria transmit are:

• direct person-to-person transmission
• environmental contamination

When it comes to environmental contamination, the likely source is contaminated food or water. It has been found in human saliva, so experts think it can spread from person to person.

There is no known way to prevent H. pylori infection. However, experts recommend:

• Washing hands before eating and after using the restroom.
• Eating food that has been handled and prepared safely.
• Drinking only clean, safe drinking water.

H. pylori infections are more common in developing countries where people may not have access to clean, safe food and water.

People who have symptoms of an ulcer, gastritis, or another stomach issue may receive testing for H. pylori or other problems. If doctors find an ulcer, they may treat patients with a variety of medications, including some or all of the following:

• antibiotics to kill H. pylori
• medications that reduce stomach acid called proton pump inhibitors (PPIs) or histamine receptor blockers
• medications that coat the ulcer and help it heal

Sometimes, a peptic ulcer can come back after treatment. To help avoid this, experts recommend that a person:

• Stop NSAIDs or take a much smaller dose.
• Only take NSAIDs with special medications that protect the stomach.
• Avoid alcohol.
• Consider quitting smoking.

Experts also recommend that children and adolescents with H. pylori are first treated simultaneously with 1-2 mg/kg/day of a proton pump inhibitor (PPI), and two different antibiotics: amoxicillin (50 mg/kg/day) and clarithromycin (20 mg/kg/day).

This treatment should last 14 days. If this is not successful, the doctor may attempt to increase the dosages or substitute the antibiotics.

Doctors can treat most H. pylori infections successfully treated with antibiotics.

However, research suggests that some H. pylori infections are becoming resistant to certain antibiotics. This means H. pylori is able to survive antibiotic treatment, and the patient may need another drug to kill the bacteria.

A 2015 review found some patients in the United States had H. pylori infections that were resistant to two different antibiotics. A 2014 review found a high number of resistant H. pylori bacteria in Latin American countries.

Antibiotic resistance is a growing problem across the globe. The CDC says that more than 35,000 people die each year as a result of an antibiotic-resistant infection.

Many people may have heard of methicillin-resistant (Staphylococcus aureus (MRSA). However, there are many other types of bacteria that have become resistant to antibiotics.

Everyone can do their part to help fight the problem of antibiotic resistance. The CDC says that people should:

• Use antibiotics only when prescribed by a doctor.
• Never use antibiotics for colds or the flu — these are viruses and antibiotics will not work against these illnesses.
• Take the entire course of antibiotics if they have been prescribed.
• Never share antibiotics with others.
• Never use old or leftover antibiotics.

Fortunately, H. pylori are still treatable with several different antibiotics. Quick treatment will help prevent damage to the stomach and the possible problems of ulcers, gastritis, and stomach cancer.

Helicobacter pylori Infections (for Parents)

What Are Helicobacter pylori?

Helicobacter pylori (H. pylori) are a type of bacteria. These germs are a common cause of digestive illnesses, including:

• gastritis: the irritation and inflammation of the stomach lining
• peptic ulcers (often called stomach ulcers): sores in the lining of the stomach, small intestine, or esophagus
• later in life, stomach cancer

Kids can get stomachaches for many reasons, like indigestion, viruses, stress and worry, and appendicitis. Most stomachaches are not caused by Helicobacter pylori (HEL-ih-ko-bak-tur pie-LOR-eye) bacteria.

What Are the Signs & Symptoms of

H. pylori Infections?

Many people who get an H. pylori infection don’t realize it. Often, these infections don’t cause symptoms.

When the bacteria do cause symptoms, they’re usually either symptoms of gastritis or peptic ulcer disease.

In kids, symptoms of gastritis (ga-STRYE-tis) may include:

• nausea
• vomiting
• belly pain
• bloating

In older kids and adults, the most common symptom of peptic ulcers is a lasting or burning belly pain, usually in the area below the ribs and above the navel. This pain often gets worse on an empty stomach and gets better as soon as the person eats food, drinks milk, or takes antacid medicine.

Peptic ulcers that bleed can cause:

• hematemesis (hee-muh-TEM-uh-sis): bloody vomit or vomit that looks like coffee grounds
• melena (muh-LEE-nuh): stool (poop) that’s black, bloody, or looks like tar

How Do People Get

H. pylori Infections?

People can swallow H. pylori bacteria from contaminated food, water, or eating utensils. Infections are most common in crowded areas and those without clean water or good sewage systems. People also can pass the bacteria through their saliva (spit) and other body fluids.

How Are

H. pylori Infections Diagnosed?

The problems that H. pylori infections cause can happen in many illnesses. To find out if someone has an H. pylori infection, doctors can do different types of tests.

Doctors can:

• Look at the stomach lining. The patient is sedated before this procedure. Then, the doctor inserts an endoscope — a small, flexible tube with a tiny camera on the end — down the throat and into the stomach and duodenum (first part of the small intestine). The doctor might take samples of the lining (a biopsy) to check for signs of infection and H. pylori bacteria.
• Do blood tests to look for H. pylori antibodies. Antibodies are proteins the immune system makes to get rid of a germ. Usually, they stay in our bodies in case we have to fight the same germ again. A positive test may show a past exposure to H. pylori, but not an active infection.
• Do breath tests, which can spot carbon broken down by H. pylori after the patient drinks a solution. Breath tests take time, don’t show how severe an infection is, and can be hard to do in young children.
• Do stool tests, which can find H. pylori proteins in the stool (poop). As with breath testing, stool tests can’t show how severe the infection is.

How Are

H. pylori Infections Treated?

Doctors use antibiotics to treat H. pylori infections. A single antibiotic may not kill the bacteria, so doctors often prescribe a combination of antibiotics. To ease problems from stomach acids, doctors usually also give antacids or acid-suppressing drugs.

Antibiotic treatment cures many cases of gastritis and peptic ulcer disease caused by H. pylori, especially ulcers in the duodenum.

A child who has symptoms of bleeding from the stomach or small intestine will be treated in a hospital.

How Can Parents Help?

H. pylori infection can be cured with antibiotics. So the most important thing parents can do is to give their child the antibiotic medicine as directed for as long as the doctor prescribed.

To help soothe belly pain, follow a regular meal schedule. Plan meals so that your child’s stomach isn’t empty for long periods. Eating 5 or 6 smaller meals each day may be best, and your child should take some time to rest after each meal.

Don’t give your child aspirin, aspirin-containing medicines, ibuprofen, or anti-inflammatory drugs. These may irritate the stomach or cause stomach bleeding.

Can

H. pylori Infections Be Prevented?

There’s no vaccine against H. pylori. But taking these steps can protect your family from many illnesses and help lower their risk of an H. pylori infection:

• Wash hands well and often, especially after using the bathroom and before making or eating food.
• Avoid food if you’re not sure that it was prepared safely.
• Drink water from a safe source.

When Should I Call the Doctor?

Call your doctor right away if your child has any of these symptoms:

• severe belly pain
• vomit that’s bloody or looks like coffee grounds
• poop that’s bloody, black, or looks like tar
• lasting gnawing or burning pain in the area below the ribs that gets better after eating, drinking milk, or taking antacids

Reviewed by: Jolanda M. Denham, MD

Date reviewed: January 2021

Helicobacter pylori, gastroenterologist consultation

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February 7, 2018

Many want to know how Helicobacter pylori is transmitted and treated – a dangerous bacterium that lives in the stomach, the culprit of chronic gastritis, erosions, ulcers and even stomach cancer.

What is this bacterium?

Helicobacter pylori, translated from Latin, is a spiral-shaped bacterium that lives in the pylorus. Indeed, a microscopic bacterium looks like a spiral surrounded by hairs. With the help of these hairs – flagella, it quickly moves through the internal organs to the place of its permanent residence – the pylorus – the lower tier of the stomach and the initial section of the intestine – the duodenal bulb. The bacterium Helicobacter disproved the myth that the hydrochloric acid of the stomach kills all microbes. On the contrary, the little carnivore feels at home in the destructive acid, thanks to the enzyme urease, which breaks down the hydrochloric acid.

How does Helicobacter affect the stomach? Destroys parietal (parietal) cells of the mucous (inner) membrane of the stomach, throwing out poisonous products – toxins. Protective blood cells – neutrophils, lymphocytes and others, pursue the pest, trying to destroy both it and the altered parietal cells – inflammation occurs. The amount of protective mucus at the site of the bacterium is noticeably reduced, hydrochloric acid rapidly acts on the altered area, aggravating the constant inflammation of the mucosa. This is manifested by pain in the stomach “under the spoon”, heartburn, belching, plaque on the tongue, bad breath, constant nausea, that is, symptoms of chronic gastritis. Chronic long-term inflammation of the gastric mucosa leads to changes in its cells, up to the development of gastric cancer.

How does Helicobacter enter the body? Since Helicobacter lives in the stomach, infection is possible when the bacterium enters the human body through the mouth. This is the habit of taking food or dishes with unwashed hands, and the desire to try food in someone else’s plate or bite off an apple or a friend’s sandwich when they are offered to try it – children are so often infected. In addition, you can become infected when using common dishes, through kisses, and therefore Helicobacter is often found in members of the same family.

So what’s the point of going to a café with your own dishes now? Luckily, Helicobacter pylori is not a resistant bacterium and dishwashing is enough to kill it. Good restaurants and cafes are of course equipped with such machines, and you can visit them without the risk of infection.

How do I know if I have a Helicobacter pylori infection?

There are many ways to detect the presence of an insidious bacterium in the body. First of all, this is a histological method, when during FGDS (fibrogastroduodenoscopy) – an examination of the stomach, which can be performed in Chelyabinsk at the All Medicine Clinic – cells of the gastric mucosa are taken for examination. Not only the bacterium Helicobacter pylori is detected, but the condition of the inner lining of the stomach is also assessed – the severity of inflammation and the degree of change in mucosal cells against the background of inflammation. The following methods are breath tests. Helicobacter produces the enzyme urease, which is able to decompose urea with the formation of ammonia and carbon dioxide. The essence of the methods in determining either the composition of carbon dioxide in the exhaled air of a patient (urea breath test) or ammonia (Helic test). The helik test is widely used, especially in pediatric practice, as a simple, non-invasive diagnostic method for the patient. Another common diagnostic method is the detection of specific antibodies of class G immunoglobulins – IgG in the patient’s blood. Helicobacter pylori infection is accompanied by the development of an immune response – the production of antibodies, of which IgG are found in 95-100% of cases. This is a reliable diagnostic method that allows you to assess the degree of contamination with Helicobacter pylori, but not the best way to control the treatment of Helicobacter pylori infection, since the level of IgG antibodies can remain high after the complete death of the microorganism for a long time – 1-1.5 years. In this case, if an analysis for antibodies is nevertheless done, a decrease in their level is assessed no earlier than 2-3 months after the end of treatment. More often, to monitor the effectiveness of the treatment of Helicobacter pylori infection, a fecal analysis is performed. It is based on the detection of Helicobacter DNA in the feces and is qualitative – it shows whether Helicobacter is detected or not, without assessing the degree of contamination. The method can also be used to diagnose the presence of infection before treatment, for example, in children, as it is simple and painless.

I have been diagnosed with Helicobacter pylori – what should I do?

If a positive test for Helicobacter pylori is detected, you should seek advice from a gastroenterologist or general practitioner. In the treatment of infection, antibiotics are used, and only a doctor prescribes them.

Is it possible to cure Helicobacter by taking de-nol, as shown in advertising, or by folk remedies? Helicobacter pylori infection can be completely eliminated only with certain antibiotics.

Do I need to poison myself with antibiotics if nothing bothers me, and the result of the test for Helicobacter pylori is positive? The infection may not bother you, in 70% of cases it happens, gastritis proceeds “silently” for years, but after a few years, due to sluggish inflammation, atrophy of the mucous membrane occurs and its transition to stomach cancer cannot be ruled out. In each case, the decision to conduct treatment is made by the attending physician.

Helicobacter pylori infection is very common among the population, is there any point in treatment if it can be re-infected later? Yes, re-infection is possible, but it does not happen often – about 6 people out of 100 treated get the infection again if the rules of prevention are not followed. They are very simple – wash your hands before eating, do not try other people’s food, do not eat in dubious eateries where there is no confidence in the correct processing of dishes, do not kiss people who are not very close. It is also important, when detecting Helicobacter pylori infection, to test all family members for it, starting from adolescence, and ideally, to treat all infected people at the same time. Children, if nothing bothers them, are treated from adolescence – from 12-13 years old. If a child complains of abdominal pain or nausea, then examination and treatment are carried out according to indications at an earlier age.

People very often complain about exacerbation of gastritis. But in many cases, it can be cured by getting rid of the bacteria that caused inflammation of the stomach. If the infection is left unattended, over time, gastritis will turn into atrophic. Then the patient will need to take a biopsy at least once a year in 5-7 places of the stomach, so as not to miss the cancer.

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Fedorenko

Svetlana Vladimirovna

Gastroenterologist, Ph.D.

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Symptoms of the presence of Helicobacter pylori in the human body, where to take tests and test for the presence of a microorganism

Helicobacter pylori

Helicobacter pylori are pathogenic microorganisms. The mucous membranes of the digestive tract are the place where Helicobacter pylori lives. It has been scientifically proven that this type of bacteria can cause inflammation and damage to the duodenum, ulcers and stomach cancer, and chronic gastritis. The bacterium is able to release toxic substances that lead to the formation of inflammatory processes, ulcers and erosions.

How does the bacterium enter the body?

Helicobacter pylori penetrates together with food, kissing, when using shared dishes. Also, unwashed hands, the use of common personal hygiene items can become a gateway where Helicobacter pylori becomes infected. Children often become infected through nipples, bottles, toys. According to recent scientific studies, the bacterium is also transmitted by the oral-genital route. Through the esophagus, it enters the stomach and adheres to its mucous membranes. As a result, inflammatory processes occur.

The most common infection occurs in childhood, when the child’s immune system cannot cope with the bacterium on its own. If you do not start treatment, harmful microorganisms will remain in the intestines.

Symptoms of infection with Helicobacter pylori

If the body has the bacterium Helicobacter pylori, its symptoms will be as follows:

• pain or discomfort in the gastrointestinal tract;
• heaviness in the stomach after eating;
• decreased appetite;
• vomiting, nausea;
• dark stool;
• there is an admixture of blood in the vomit.

These signs of Helicobacter pylori in children and adults indicate infection with a bacterium, being a reason to immediately consult a doctor.

When is it important to detect the presence of bacteria?

In such conditions and diseases, it is important to timely detect the presence of a pathogenic microorganism:

• erosive superficial or atrophic gastritis;
• if you have had an ulcer in the past;
• in exacerbation of duodenal or stomach ulcers;
• with long-term use of drugs that affect the reduction of acidity;
• with chronic use of non-steroidal drugs or painkillers;

If relatives have been diagnosed with gastrointestinal cancer, they should also be tested for Helicobacter pylori.

Diagnostic methods

The following methods are used to diagnose the presence of bacteria:

• screening test to detect specific antibodies to this bacterium in the blood;
• breath tests with 97% accuracy;
• donation of feces, saliva for the detection of bacterial DNA;
• microscopic examination of the mucous membrane – gastroscopy.

The doctor chooses the optimal diagnostic method.

Methods of treatment

Only the attending physician can prescribe medication. As a rule, treatment is carried out according to a scheme that includes taking 3-5 drugs, which include antibiotics. The duration of treatment is up to two weeks.

With Helicobacter pylori symptoms and treatment with De Nol will also be carried out in complex therapy. When selecting medications, the specialist will take into account which medications were prescribed earlier, whether there is an allergy to medications.

Why is it important to start treatment on time?

Thanks to the timely appeal to specialists, you can:

• get rid of chronic gastritis;
• reduce the risk of gastrointestinal cancer;
• stop the atrophy of the mucous membranes of the digestive tract;
• stop the worsening of the ulcer;

You can also reduce the risk of damage to the mucous membranes, which may be due to the use of drugs with anti-inflammatory or analgesic effects.