H. Pylori

Helicobacter Pylori (H. pylori) is a bacteria that can cause infection of the stomach. It can contribute to the development of diseases including:

• Dyspepsia - heartburn, bloating and nausea
• Gastritis  - inflammation of the stomach
• Ulcers – sores in the stomach and duodenum

What Is H. Pylori?

H. pylori is a fragile bacteria that live in the protective mucous layer of the stomach. These bacteria have long threads protruding from them that attach to the underlying stomach cells. The mucous layer that protects the stomach cells from acid also protects H. pylori. These bacteria do not actually invade the stomach cells as certain other bacteria can. The infection, however, is very real and does cause the body to react. Infection-fighting white blood cells move into the area, and the body even develops H. pylori antibodies in the blood.

How Does Infection Occur?

H. pylori infection likely occurs when an individual swallows the bacteria in food, fluid, or perhaps from contaminated utensils. The infection:

• Is common worldwide
• Is found more often in older people
• Occurs frequently in young people in situations where sanitation is poor

How is H. pylori Infection Diagnosed?

The following tests may be used:

• Bacteria Test – During endoscopy, the physician removes small bits of tissue, and tests them for the bacteria.
• Breath Test – A substance called urea is given by mouth. A strong enzyme in the bacteria breaks down the urea into carbon dioxide, which is then exhaled and can be measured.
• Blood Test – Measures the protein antibodies against these bacteria that are present in the blood.
• Stool Test – Determines an active infection.

Symptoms

In many cases, H. pylori does not produce symptoms. The infection remains localized to the gastric area and probably persists unless specific treatment is given. In other cases, the symptoms suggest gastritis, dyspepsia and ulcers.

• Discomfort
• Bloating
• Nausea and perhaps vomiting.
• Burning or pain in the upper abdomen, usually about an hour or so after meals or even during the night

These symptoms are often relieved temporarily by antacids, milk, or medications that reduce stomach acidity. Yet, the physician does not find an ulcer when testing the patient with X-ray or endoscopy. When H. pylori is found in the stomach, it is tempting to believe that it is the cause of the symptoms, although this connection is not yet clear-cut. The physician will usually prescribe antibiotic therapy to see if clearing the infection relieves symptoms.

Connection to Ulcers

• Stomach Ulcers - H. pylori infection is found in 50-75 percent of stomach ulcers. Some people may also be at higher risk depending on medications and their genetics. Regardless, the infection allows acid to seep in and injure the underlying stomach cells.
• Duodenal ulcers - Physicians now accept the fact that the infection is directly related to the development of duodenal ulcers. It is now rather easy to treat duodenal ulcers with strong acid-reducing medicines. But, the ulcers will usually recur unless the H. pylori infection is also cleared from the stomach.

Link to Stomach Cancer and Lymphoma

Stomach cancer and lymphoma are related to H. pylori bacteria. This does not mean that all people with H. pylori infection will develop cancer; in fact, very few do. However, it is likely that if the infection is present for a long time, perhaps from childhood, these cancers may then develop. This is another reason why it is important to treat H. pylori infection.

Treatment

Since the infection is so common, providers sometimes recommend no treatment when there are no symptoms. This approach may change with more research. When a person has an acute ulcer, the treatment consists of acid-reducing medicines and antibiotics. H. pylori is buried deep in the stomach mucous, so it is difficult to get rid of this infection. Several antibiotics are always used together to prevent the bacteria from developing resistance to any one of them.