Helicobacter pylori (H. pylori)

Description

Helicobacter pylori (H. pylori) infection occurs when the infection by Helicobacter pylori (H. pylori) is a bacterium that infects the stomach. This usually happens during childhood. A common cause of stomach ulcers (peptic ulcers), H. pylori infection may be present in more than half of the people in the world.

The majority of people don't realize they have H. pylori infection, because they never get sick. If they develop signs and symptoms of a peptic ulcer, your doctor will probably test for H. pylori infection. A peptic ulcer is a sore in the lining of the stomach (gastric ulcer) or the first part of the small intestine (duodenal ulcer).

The H. pylori infection is treated with antibiotics.

Symptoms

The majority of people with H. pylori infection have no signs or symptoms. It is not clear why many people do not 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, which are usually associated with gastritis or peptic ulcer disease and may include:

  • A pain or a burning sensation in the stomach (abdomen)
  • Stomach pain that may be worse when the stomach is empty
  • Nausea
  • Loss of appetite
  • Frequent belching
  • Swelling
  • Unintentional weight loss

When to see a doctor

Make an appointment with your health care provider if you notice any signs and symptoms that may be gastritis or peptic ulcer disease. Seek medical help right away if you have:

  • Severe or continuing stomach (abdominal) pain that can wake you up from your sleep
  • Black, tarry stools
  • Stools with blood or vomit black or vomit that looks like coffee grounds

Causes

H. pylori infection occurs when the H. pylori bacteria infect their stomach. The bacterium, H. pylori infection, usually transmitted from person-to-person through direct contact with saliva, vomit or feces. H. pylori may also be transmitted through contaminated food or water. The exact form of the bacterium H. pylori, which causes gastritis or a peptic ulcer in some people, it is still unknown.

Risk factors

Frequently, people infected by H. pylori in childhood. The risk factors for H. pylori infection are related to the living conditions in childhood, such as:

  • Living in overcrowded conditions. Living in a house with many other people, can increase your risk of infection by H. pylori.
  • Living without a reliable supply of clean water. Having a reliable supply of clean, running water helps to reduce the risk of H. pylori infection .
  • Living in a developing country. People living in developing countries have a higher risk of H. pylori infection. This may be because the overcrowding and insanitary conditions of life may be more common in developing countries.
  • Living with someone who has anH. pyloriinfection. You are more likely to have H. pylori infection if you live with someone who has the infection by H. pylori.

Complications

The complications associated with the infection by H. pylori are:

  • The ulcers. H. pylori can damage the protective layer of the stomach and the small intestine. This can allow stomach acid to create an open sore (ulcer). Approximately 10% of people with H. pylori will develop an ulcer.
  • The inflammation of the lining of the stomach. The infection by H. pylori can affect the stomach, causing irritation and the inflammation (gastritis).
  • Cancer of the stomach. The H. pylori infection is a risk factor for certain types of stomach cancer.

Prevention

In areas of the world where H. pylori infection and its complications are common, health care providers sometimes the test healthy people for H. pylori . If there is a benefit for the tests of H. pylori infection when there are no signs or symptoms of infection is the subject of dispute among experts.

If you are worried about the infection by H. pylori, or think you may have a high risk of stomach cancer, talk with your health care provider. Together, you can decide if you can benefit from H. pylori test.

Helicobacter pylori (H. pylori)

Diagnosis

Several tests and procedures that are used to determine if you have the infection by Helicobacter pylori (H. pylori). The test is important for the detection of Helicobacter pylori (H. pylori). Repeat the test after the treatment it is important to make sure that H. pylori infection is gone. The tests can be done using a stool sample, through a breath test and by an upper endoscopy exam.

The analysis of feces

  • Stool antigen test. This is the most common type of stool to detect H. pylori . The test looks for proteins (antigens) associated with infection by H. pylori in the stool.
  • Stool PCR test. A laboratory test called a stool polymerase chain reaction (PCR) test can detect the infection by H. pylori in stool. The test also can identify mutations that may be resistant to the antibiotics used for the treatment of H. pylori . However, this test is more expensive than a stool antigen test, and may not be available in all medical centers.

The breath test

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 into contact with H. pylori in the stomach.

Because your body absorbs the carbon, which is released when you exhale. To measure the release of carbon, you blow into a bag. A special device that detects the carbon molecules. This test can be used for adults and for children older than 6 years of age who are able to cooperate with the test.

Scope of application of the test

A health care provider may perform a scope of the test, known as an upper endoscopy exam. Your doctor may do this test to investigate the symptoms that can be caused by conditions such as peptic ulcer or gastritis, which may be due to H. pylori .

For this test, you will be given medication to help you relax. During the exam, your health care provider threads of a long, flexible tube with a tiny camera (endoscope) that is attached to the bottom of your throat and esophagus and into the stomach and the first part of the intestine (duodenum). This instrument allows your provider to see the 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, is usually done to diagnose other digestive problems, along with the H. pylori infection. Health care providers can use this test for the additional tests, and other digestive conditions. You can also use this test to determine exactly which antibiotic may be better for the treatment of H. pylori infection, especially if the first antibiotics tried not to get rid of the infection.

This test can be repeated after treatment, depending on what is in the first endoscopy or if symptoms persist after the infection by H. pylori treatment.

Testing considerations

Antibiotics can interfere with the accuracy of the tests. In general, the repetition of tests are performed only after the antibiotics have been stopped for four weeks, if possible.

Acid-suppression drugs known as inhibitors of the proton pump (Ppis) and bismuth subsalicylate (Pepto-Bismol) can also interfere with the accuracy of these tests. It is possible that the acid-suppression drugs known as histamine (H-2) blockers may also interfere with the accuracy of the tests. Depending on the medications you are taking, you will need to stop drinking, if possible, until two weeks before the test. Your health care provider will give you specific instructions about their medications.

The same tests used for the diagnosis can be used to determine if the H. pylori infection is gone. If you were previously diagnosed with the infection by H. pylori, by what is generally expected of at least four weeks after completion of antibiotic treatment to repeat these tests.

Treatment

H. pylori infections are usually treated with at least two different antibiotics at the same time. This helps to prevent the bacteria to develop resistance to a particular antibiotic.

Treatment may also include medicines to help your stomach heal, including:

  • Proton pump inhibitors (Ppis). These drugs stop the production of acid in the stomach. Some examples of inhibitors of the proton pump (Ppis) are omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), and pantoprazole (Protonix).
  • Bismuth subsalicylate. More commonly known by the brand name Pepto-Bismol, this medicine works by coating the ulcer and the protection of acid in the stomach.
  • The histamine (H-2) blockers. These drugs block a chemical called histamine, which triggers the production of acid. An example is the cimetidine (Tagamet HB). the histamine (H-2) blockers are only prescribed for H. pylori infection if Ppis may not be used.

The repetition of the tests for H. pylori, at least, four weeks after your treatment, it is recommended. If the tests show that the treatment does not get rid of the infection, you may need more than one treatment with a combination of antibiotics.

Preparing for your appointment

Consult your health care provider if you have signs or symptoms that indicate a complication of the infection by H. pylori. Your healthcare provider can test and treat 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 prepare for your appointment, and what to expect.

What you can do

At the time of making the appointment, ask if there is something that you need to do in advance, such as restrict your diet.

Also, the preparation of a list of questions can help you make the most of your time with your health care provider. Questions may include:

  • How H. pylori infection because of the complications that I am experiencing?
  • Can H. pylori cause other complications?
  • What kinds of tests do I need?
  • Do these tests require any special preparation?
  • What treatments are available?
  • What treatments are recommended?
  • How do I know if the treatment works?

Additional questions that occur during your appointment.

What to expect from your doctor

Your health care provider is likely to ask a series of questions, such as:

  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • When did your symptoms begin?
  • Is there something that is better or worse?
  • Your parents or siblings experienced similar problems?
  • What medications or supplements that you take regularly?
  • Do you take over-the-counter pain relievers such as aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve)?

Be prepared to provide information and respond to questions can allow more time to cover other points you want to discuss.

Symptoms and treatment of the infection by Helicobacter pylori (H. pylori)