Patient education: H. pylori infection (The Basics)

What is H. pylori infection? — 

This is when a type of bacteria called "Helicobacter pylori," or "H. pylori," infects a person's stomach.

Many people have H. pylori infection. In some cases, the infection can lead to problems such as:

●Irritation and inflammation of the stomach lining – This is called "gastritis."

●Open sores, called "ulcers," on the lining of the stomach or duodenum – The duodenum is the first part of the small intestine (figure 1).

●Cancer – Rarely, H. pylori infection can cause stomach cancer.

Doctors do not know exactly why H. pylori infection leads to problems in some people and not others.

What are the symptoms of H. pylori infection? — 

Many people have no symptoms. In some people, the infection can cause stomach upset or discomfort. It can also make it harder for the stomach to absorb certain vitamins, such as iron and vitamin B12.

People who have stomach irritation or ulcers from H. pylori can have symptoms such as:

●Pain or discomfort in the upper belly

●Feeling full after eating a small amount of food

●Not feeling hungry

●Nausea

People who have ulcers or stomach cancer from H. pylori can also have:

●Dark or black-colored bowel movements

●Feeling more tired than usual

●Vomiting, sometimes with blood

Is there a test for H. pylori infection? — 

Yes. Doctors can do different tests to diagnose H. pylori infection. These can include:

●Breath test – This measures substances in a person's breath after they drink a special liquid.

●Stool test – This is a test to check a sample of a bowel movement, or "stool," for H. pylori infection.

●Biopsy – This is done during an upper endoscopy. For an upper endoscopy, a doctor puts a thin tube with a camera on the end into the mouth and down into the stomach and duodenum. For the biopsy, they take a small piece of tissue from the lining of the stomach. Then, they look at the tissue under a microscope.

●Blood test – This is not as accurate as the other tests, so it is not often used.

Your doctor will choose a test based on your situation. If you already need an endoscopy, the doctor will probably do a biopsy. If not, they might do a breath or stool test instead.

Should I be tested for H. pylori infection? — 

You might need to be tested if you have symptoms of stomach upset or discomfort. Your doctor might also recommend testing if you:

●Have an ulcer in the stomach or duodenum

●Had ulcers in the past

●Had stomach cancer

●Need to take an anti-inflammatory medicine or aspirin for a long time

●Come from a country where stomach cancer is common

●Have a parent or sibling with stomach cancer

How is H. pylori infection treated? — 

It is treated with medicines. Most people need to take 3 or more medicines for 2 weeks. These can include:

●Medicines to reduce the amount of acid that the stomach makes – This can help cure the infection and help ulcers heal.

●Different types of antibiotics

People who are diagnosed with H. pylori infection should get treated, because treatment can:

●Help ulcers heal

●Keep ulcers from coming back

●Reduce the chance that an ulcer will get worse

●Reduce the risk of cancer caused by H. pylori

Follow all of your doctor's instructions about taking your medicines. It is important to take all of the medicines for the entire 2 weeks. If you skip pills or stop treatment early, it might not cure the infection. Tell your doctor or nurse if you have any side effects or problems with your medicines. If you are having trouble paying for your medicines, tell your doctor or nurse. They might be able to suggest different medicines instead.

What happens after treatment? — 

Your doctor or nurse will order a follow-up test to check that the H. pylori infection went away. Follow-up tests can include:

●Breath tests

●Stool test

●Upper endoscopy with biopsy

H. pylori infection is usually cured with treatment. But people who still have it after treatment usually need to take more medicines.

When should I call the doctor? — 

Call for advice if:

●You have any side effects from your medicines.

●You vomit and see blood or something that looks like coffee grounds.

●Your stools have blood in them or are black or tar colored.

●You have severe pain in your belly.

●Your belly becomes hard or swollen, or hurts if you press on it.

●You start to feel very weak, lightheaded, or like you might pass out.

More on this topic

Patient education: H. pylori tests (The Basics)
Patient education: Peptic ulcers (The Basics)
Patient education: Stomach polyps (The Basics)
Patient education: Low iron (The Basics)
Patient education: Nausea and vomiting in adults (The Basics)

Patient education: Helicobacter pylori infection and treatment (Beyond the Basics)
Patient education: Peptic ulcer disease (Beyond the Basics)