Helicobacter pylori infection

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at June 24, 2016
StartDiseasesHelicobacter pylori infection

H. pylori is a common bacteria that can affect digestion and lead to gastritis, ulcers, or stomach cancer. While most people who have the H. pylori bacteria do not know that they have it, others can experience worrisome symptoms that require prompt testing and treatment by a qualified medical professional. Because other health problems can cause similar symptoms to those of a Helicobacter pylori infection (H. pylori infection), it is important to seek advice from a doctor rather than attempt to self-diagnose. 


Definition & Facts 

Helicobacter pylori, or H. pylori, is a type of bacteria that lives in the stomachs of approximately two-thirds of all people. H. pylori bacteria infection is more common in developing countries but also affects people in the United States and Canada.

H. pylori infection does not cause symptoms in everyone, but in some people, it leads to problems in the digestive tract. H. pylori can cause gastritis, which is inflammation of the stomach lining. Approximately ten percent of people with H. pylori infection develop gastric or peptic ulcers in the stomach or duodenum. H. pylori infection can also lead to stomach cancer if left untreated.

Symptoms & Complaints

People with H. pylori infection may experience excessive belching, nausea or abdominal bloating, lack of appetite, or unexplained weight loss, or abdominal pain.

People with gastritis caused by H. pylori may experience discomfort or bloating after eating a small amount of food. They may feel full quickly, which can lead to excessive weight loss.

People with H. pylori ulcers will almost always experience pain. Many people describe H. pylori ulcer pain as a gnawing pain or a sharp aching feeling that comes and goes. H. pylori ulcers can be aggravated overnight or between meals when the stomach is empty.

If the ulcer is in the stomach, the person will experience pain in the upper left side of the abdomen. If the ulcer is in the duodenum, which is the beginning part of the small intestine, the person may feel pain in the upper-middle or upper-right side of the abdomen. If the ulcer is bad enough, sometimes the person’s pain is constant.


Most people are infected by H. pylori bacteria at some time in their childhood. Bacteria is more easily spread in school and daycare settings where many children are confined to small spaces and are most likely to come into contact with contaminated surfaces and other children’s excretions. H. pylori bacteria can be transmitted from person to person and through contaminated food or water.

Many people get H. pylori infection by coming into contact with the excretions of someone who has the infection. Because most people who have the H. pylori bacteria in their systems do not experience any symptoms, they will not think to take precautions against spreading the infection while doing everyday activities like preparing meals.

H. pylori can be spread through saliva, which means that any surface that has touched someone’s mouth or been sneezed on could contain the bacteria. People who live in crowded conditions, developing countries, or with someone else who has H. pylori infection are at higher risk for becoming infected. H. pylori has become very prevalent because the bacteria has become resistant to many types of antibiotics

Diagnosis & Tests

Doctors most often diagnose H. pylori infection through a diagnostic breath test. The patient will breathe into a bag first without having ingested a solution and then breathe into the bag after having drank the solution. The sample will be tested to see if there was an increase in carbon dioxide and will help the doctor determine if the symptoms that the patient is presenting are caused by an H. pylori infection or another cause. For the test to be accurate, the physician will tell the patient to stop taking proton-pump inhibitors and certain antibiotics before the breath test.

Doctors may also run a stool sample test or blood test to test for antigens or antibodies that are present in people who have been infected with H. pylori. When patients experience ulcer symptoms, a specialist might run an endoscopy test. For the endoscopy, the doctor puts a small camera down the patient's throat and runs it through the stomach and the upper digestive tract to see if there is damage to the esophagus, stomach or duodenum. The doctor might take tissue samples (perform a biopsy), especially if any irregularities are found during other tests.

Treatment & Therapy

Doctors can treat H. pylori infections with medication. After lab tests confirm H. pylori has caused an ulcer, doctors prescribe a combination of proton-pump inhibitors and antibiotics. Proton pump inhibitors like omeprazole and histamine blockers like cimetidine help to suppress stomach acid while healing the ulcer.

Doctors use more than one antibiotic at a time to treat H. pylori because the bacteria can easily become resistant to a single antibiotic. Doctors encourage people with ulcers to stop smoking, drinking alcohol, or eating spicy foods because these habits can reduce the chances of the ulcer’s healing properly.

After treatment, the doctor will typically run the tests again to make sure the H. pylori infection is gone. If the infection is not gone or returns, the patient will sometimes need stronger antibiotics or a different type of proton pump inhibitor. Doctors will often tell people with a history of H. pylori ulcers to avoid aspirin or ibuprofen as these medications can contribute to the development of ulcers. Someone with an ulcer caused by H. pylori might report that taking antacids temporarily alleviates the pain.

Prevention & Prophylaxis

It is impossible to completely avoid exposure to H. pylori infection. Since most people acquire the bacteria as children, parents can reduce their child's chances of infection by teaching kids to practice good hygiene. If a clean water supply is unavailable, people can boil their water to reduce chances of infection.

People can reduce the spread of H. pylori infection by washing their hands, practicing good food safety hygiene, and not eating or drinking from the same utensils or dishware as other people. If someone else in the household is known to be infected with H. pylori, avoid contact with that person’s saliva and other bodily functions as much as possible.