Helicobacter Pylori (H.Pylori) is a chronic infection of the stomach usually acquired in childhood. It is found in approximately 50% of the world’s population. Most people have no symptoms, but in some it causes pain, bloating, nausea, vomiting or ulcers.
What does H.Pylori do?
As part of its normal activity the stomach produces acid. The inside of the stomach wall is protected from this by a thick layer of mucous. H.Pylori weakens this protective layer and also causes inflammation of the stomach lining. Over time some acid may get through and damage the lining of the stomach. This can lead to erosions which can lead to the following diseases;
Gastritis (inflammation of the lining of the stomach) – All people with H.pylori infection have inflammation but mostly without symptoms. In some people, this inflammation progresses to other diseases, but disappears if treated successfully.
Duodenal ulcers – H.pylori is the cause of about 90% of ulcers in the duodenum. The most common symptom is pain the upper part of the abdomen.
Stomach (gastric) ulcers – H.pylori is the cause of about 70% of stomach ulcers.
Cancer of the stomach – H.pylori increases the risk of some forms of cancer of the stomach. Note: only a small minority of infected people ever develop this problem.
Who should be tested for H.Pylori?
People who have had an ulcer should be tested for H.Pylori. Successful treatment of H.Pylori will speed up ulcer healing and prevent recurrence.
People who have dyspepsia should also be tested.
How can I be tested for H.Pylori?
Breath test – There is a simple, effective breath test to measure for the presence of H.pylori. The infection in the stomach converts a naturally occurring substance called urea into the gas carbon dioxide. If specially labelled urea is swallowed, labelled carbon dioxide can be detected for a short time in the breath.
Blood test – This can detect current or recent infection but because the test can remain positive for several years after successful treatment, there are other more useful tests.
Stool Test – A stool sample can be used to determine if there is an active infection.
Gastroscopy – During a Gastroscopy the specialist can take small samples (biopsies) from the lining of the stomach which are sent to the laboratory for analysis. This test is very accurate and the preferred test.
How is H.pylori treated?
Treatment is usually oral drug therapy which includes an ulcer healing drug and two antibiotics. The success rate is 90% if taken as directed.
Eradication can be checked through either breath test, stool test, or re-biopsy. These tests must be performed at least four weeks after all treatment is stopped, as H.pylori can grow again within this time. If the treatment has not been successful, a different combination of drugs may be tried.
Am I likely to become infected again?
No. The chance, after successful treatment, is only 0.5-1% per year.