Helicobacter pylori

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Introduction

What is Helicobacter pylori?

Helicobacter pylori (H. pylori) is the name of a bacteria that can cause peptic ulcers. It can infect the stomach lining, dissolving the mucus film that protects it from the highly acidic stomach contents. This causes a burning pain in the stomach. Helicobacter pylori is the most common human bacterial infection. Most infections occur before age five.

H. pylori infection is a common cause of peptic ulcer disease in the United States. Peptic ulcer is a localized area of erosion occurring in the stomach or duodenal (the beginning of the small intestine) lining, resulting in abdominal pain, possible bleeding, and other gastrointestinal symptoms. Most people contract H. pylori at a young age and experience no symptoms. Symptoms most commonly occur in adulthood.

The signs and symptoms of peptic ulcer can be constant or sporadic, and the disease course varies among individuals. If H. pylori is the cause, the symptoms will remain as long as the infection is untreated. Some people with peptic ulcers have no symptoms at all, while others may have burning pain, severe nausea, and vomiting.

In the case of H. pylori-related peptic ulcer, the infection can be treated successfully with antibiotics. You can reduce your risk of H. pylori bacteria infection by following commonsense hygiene practices, such as washing your hands with soap and water prior to preparing food and after handling dirty diapers or using the bathroom.

Seek immediate medical care (call 911) for serious symptoms such as severe or persistent abdominal pain, bloody stool (the blood may be red, black, or tarry in texture), or vomiting blood or black material (resembling coffee grounds).

Symptoms

What are the symptoms of infection with Helicobacter pylori?

H pylori causes irritation, inflammation and damage to the stomach lining that may result in a number of symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of H pylori bacterial infection

You may experience H pylori bacteria symptoms daily or just once in a while. At times, any of these abdominal symptoms can be severe:

Serious symptoms that might indicate a life-threatening condition

In some cases, H pylori bacteria can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bloody stool (blood may be red, black, or tarry in texture)
  • Severe or persistent abdominal pain
  • Vomiting blood or black material (resembling coffee grounds)
Causes

What causes infection with Helicobacter pylori?

H. pylori infection is caused by Helicobacter pylori bacteria. These bacteria are present in the stool (feces), vomit, and saliva of infected people. When food or water sources are contaminated with feces containing H. pylori, drinking from these water or food sources spreads the bacteria.

H. pylori may also be spread by poor hygiene practices, such as touching infected human feces without proper hand washing. It can also occur among people who have close contact with the saliva of those who are already infected.

What are the risk factors for infection with Helicobacter pylori?

A number of factors increase the risk of becoming infected with H. pylori bacteria. Not all people with risk factors will get H. pylori bacteria. Risk factors for Helicobacter pylori bacteria include:

  • Crowded living conditions
  • Diets with high salt content
  • Lack of hot water to ensure sanitary living conditions
  • Living in the same home with an infected person
  • Unsanitary living conditions

How is an infection with Helicobacter pylori treated?

Treatment for H. pylori bacteria begins with seeking medical care from your health care provider. To determine if you have H. pylori bacteria, your health care provider will ask you to undergo diagnostic tests.

Treatments

How is an infection with Helicobacter pylori treated?

Treatment for H. pylori bacteria begins with seeking medical care from your health care provider. To determine if you have H. pylori bacteria, your health care provider will ask you to undergo diagnostic tests.

Antibiotic treatments for H pylori infection

Antibiotic therapy is the mainstay of treatment. It is important to follow your antibiotic regimen precisely to avoid re-infection or recurrence. Most commonly, two antibiotics are given for 14 days. Reinfection following antibacterial treatment is rare. 

Examples of antibiotic treatments include:

  • Amoxicillin
  • Clarithromycin (Biaxin)
  • Metronidazole (Flagyl)
  • Tetracycline

Other medications to treat H. pylori infection

Medications such as proton pump inhibitors and histamine H2-receptor antagonists, which decrease the amount of acid in the stomach, can also be effective treatments for peptic ulcer caused by H. pylori.

Proton pump inhibitors that are effective in the treatment of peptic ulcer include:

  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec)
  • Pantoprazole (Protonix)
  • Rabeprazole (Aciphex)

Histamine H2-receptor antagonists that are effective in the treatment of peptic ulcer include:

  • Cimetidine (Tagamet)
  • Famotidine (Pepcid)
  • Nizatidine (Axid)
  • Ranitidine (Zantac)

If you have diarrhea and vomiting, fluid and electrolyte replenishment is also a component of successful treatment.

What are the potential complications of an infection with Helicobacter pylori?

Left untreated, H. pylori bacteria can result in bleeding ulcers, a serious and even life-threatening complication. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of H. pylori bacteria include:

  • Inflammation of the stomach lining (gastritis)
  • Perforated ulcer, which can lead to bleeding
  • Malignant lymphoma
  • Stomach cancer
  • Stomach ulcers
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. H pylori and peptic ulcers. National Digestive Diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/.
  2. Helicobacter pylori and peptic ulcer disease. Centers for Disease Control and Prevention. http://www.cdc.gov/ulcer/.
  3. Amieva MR, El-Omar EM. Host-bacterial interactions in Helicobacter pylori infection. Gastroenterology 2008; 134:306.
  4. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
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