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Helicobacter pylori (H. pylori) – Everything You Need to Know

Posted 5/10/2024 by Dan Jackowiak Nc, HHP


Helicobacter pylori (H. pylori) is a gram-negative bacterium usually found in the stomach and can live in your digestive tract for years. It is the most common type of bacteria causing digestive problems in children and adults. About two-thirds of the world's population is affected by it. A mild attack of H. pylori does not cause prominent symptoms and serious complications; but if the bacterium remains in your stomach for years, it may lead to stomach and peptic ulcers. (1)


Helicobacter-pylori-bacteria

How Helicobacter pylori (H. pylori) Causes Infection?

H. pylori bacterium enters your stomach and grows in the mucus layer lining that protects your stomach. It damages the tissues of the mucosal lining by releasing harmful chemicals for their survival in the acidic and harsh environment of the stomach. (2)

H. pylori survives in the acidic environment of the stomach by releasing the enzyme urease. In the stomach, urease converts the chemical urea to ammonia that neutralizes the acidity of the stomach. Thus, it creates a favorable environment for H. pylori to grow and infect the stomach. (2)

Moreover, H. pylori is a helically shaped bacterium that penetrates the less acidic mucus layer and immune cells are unable to enter the stomach lining to kill the H. pylori bacteria. Immune cells are only effective in killing bacteria surrounding the mucosal layer of the stomach. Additionally, H. pylori can make the immune response ineffective which allows the bacteria to grow rapidly. (3)

Infection by H. pylori mostly occurs during childhood, but adults can also get it. Most people remain unaware of the infection. They may not experience any signs and symptoms of H. pylori infection, which ultimately leads to stomach or peptic ulcers – a severe digestive problem. (3)


What Are the Symptoms of an Helicobacter pylori (H. pylori) Infection?

An H. pylori infection usually doesn't cause illness in most infected children and adults. So, the majority of people infected with H. pylori won't have signs or symptoms. They may have the bacteria for years without knowing it. Due to this reason, H. pylori has become the major risk factor for stomach and peptic ulcers. (4)

Only 20% of people may have symptoms, including:

  • Loss of appetite
  • Sudden weight loss
  • Bloating
  • Burping
  • Nausea
  • Vomiting (bloody)
  • Having upset stomach
  • Dark stools
  • Anemia
  • Dull pain in your stomach, especially after eating and at night

The symptoms of H. pylori infection may mimic the symptoms of other health problems. If you notice blood in your vomit or feces, immediately consult your healthcare professional for proper diagnosis.


How do People Get Helicobacter pylori (H. pylori) Infections?

H. pylori bacterium is found more commonly in developing countries. Poor sanitation, contaminated food, and water are major factors responsible for the rapid spread of an H. pylori infection. You may get the infection by eating unhygienic food and drinking contaminated water. Not properly washed utensils can also become the cause of infection. (5)

You may get an H. pylori infection from an infected person. In infected people, H. pylori are present in their saliva, feces, and other body fluids. So, you may get it by kissing or by shaking your hand with someone who may not have washed their hands properly after fecal excretion. (5)


How Can Helicobacter pylori (H. pylori) Infection Be Diagnosed?

H. pylori bacterium can cause a variety of stomach infections. These include:

  • Gastritis: inflammation and irritation of stomach lining
  • Peptic ulcers: sores in the lining of the small intestine, which later in life develops into stomach cancer
  • Certain types of digestive issues such as indigestion, bloating, and naseua

If you have digestive symptoms, then testing and treatment can prevent further complications.

The first step in the diagnosis of the infection is physical examination. You make an appointment with your healthcare professional for proper analysis. During a physical examination, your healthcare professional will look for symptoms of bloating, soreness, or discomfort in your stomach. Your healthcare professional will also listen for any noises coming from the abdomen.

After physical examination, specific tests are performed to confirm the presence of H. pylori infections. These tests include blood, stool, and breath tests. In severe cases, your healthcare professional may opt for an endoscopy. (6)

Blood Test

In this test, your healthcare professional checks for antibodies fighting the infection. You may be asked to provide blood samples, which are tested for antibodies against H. pylori. A small amount of blood will be drawn from a vein in your arm for a blood test. After that, the blood will be transported to a laboratory for examination. If you have an infection, antibodies against H. pylori will be present in your blood sample and vice versa.


Urea Breath Test

In the urea breath test, you exhale into a bag before and after drinking a urea-containing preparation or solution. The test determines the quantity of carbon dioxide in your breath before and after taking the solution. A more significant amount of carbon dioxide after drinking the solution indicates the presence of H. pylori. It occurs because H. pylori produces an enzyme called urease that breaks down the solution. As a result, more carbon dioxide is released. (7)


Stool Antigen Test

In a stool antigen test, a stool sample is required to detect H. pylori in your stool. H. pylori are present throughout your digestive tract which is why it is excreted in the stool. For this test, your healthcare professional will provide you with a container to collect a sample of your feces. Once you have returned the container to your healthcare practitioner, the sample will be sent to a laboratory for examination.

A stool antigen test checks for H. pylori antigens in your stool. Antigens are chemicals that stimulate the immune system. Although the SAT is a very accurate and exact approach. Its accuracy is impacted by numerous limiting variables, including upper gastrointestinal hemorrhage, antibiotic intake, bowel movements, and the use of proton pump inhibitors (PPIs). (8)


Endoscopy

If other tests do not offer a satisfying diagnosis of infection, then your healthcare professional may prescribe you an endoscopy. Endoscopy allows your healthcare professional to examine your esophagus, a portion of your small intestine, and stomach lining.

Your healthcare professional will insert a long, thin device called an endoscope into your mouth and down into your stomach and duodenum during an endoscopy. A camera linked to the device will send photos to a display for your healthcare professional to observe. Any unusual locations will be examined. If required, your healthcare professional will be able to collect samples from these locations using specific endoscopic equipment. (9)

If you prefer, you can test yourself by doing this stool test or this antibody blood test to verfiy if you have H. pylori or not.


How Can An Helicobacter pylori (H. pylori) Infection Be Treated?

The treatment of Helicobacter pylori (H. pylori) infection is crucial for managing gastrointestinal diseases such as peptic ulcers, stomach ulcers, and gastric cancer. Other extra-gastric diseases caused by H. pylori include mucosa-associated lymphoid tissue lymphoma, vitamin B12 insufficiency, and iron deficiency (anemia).


Triple Therapy

For the last few decades, triple therapy has been used to eradicate H. pylori infection from the body. Triple therapy is the first-line treatment for H. pylori infection, which involves a combination of two antibiotics with PPIs (Proton Pump Inhibitors). Both these antibiotics further inhibit the growth of pyloric infection. This treatment also depends on the medical history of the patient. It is not given to those patients who are allergic to antibiotics. Proton pump inhibitors are also given in triple therapy for lowering the acidity of the stomach. These drugs reduce the acidity of the stomach to increase the effectiveness of antibiotics. (10)


Bismuth Subsalicylate

Bismuth-containing quadruple therapy has been confirmed as an effective standard treatment for eradicating H. pylori infection, especially in strains with antibiotic resistance. It consists of Bismuth subsalicylate, which helps kill the H. pylori along with the antibiotics like metronidazole, tetracycline, and clarithromycin. (11)


Dual Therapy

Sometimes high-dose dual therapy is also recommended, which includes a proton pump inhibitor with amoxicillin. This medication is recommended for 14 days.


Common PPIs

Certain other drugs, such as PPIs that reduce the amount of acid in your stomach, are also recommended with antibiotics. They block the production of acid. These drugs are dexlansoprazole, esomeprazole, lansoprazole, omeprazole, and rabeprazole.


Treating Helicobacter pylori (H. pylori) Naturally

I see positive results for H. pylori on stool test results quite often; it's very common. My youngest daughter had this at one time and it progressed far enough that she would occasionally vomit acid and almost couldn't eat. This is what we did to get rid of it.

At the grocery store I bought the generic version of Prevacid, Lansoprazole; you only need this if you are having acid reflux symptoms. I had her take one capsule a day for two weeks. I also picked up some GastroMend, which contains Mastic Gum and Deglycyrrhizinated Licorice, both work against H. Pylori and she took it as directed on the label. Pylori-X will also work in place of Gastromend. We also added Tumeric and I had her take one capsule 30 to 60 minutes before meals. About an hour after breakfast and dinner, I would have her drink a cup of tea sweetened with 1 tsp of Manuka honey and a dash of Truvia.

Within a day her pain was reduced enough where she had very few problems eating. After about a week she was back to feeling normal and no longer having any symptoms, except for when she took a Midol, which made her stomach bleed a little. You do have to continue this treatment for 60 to 90 days to get all the H. pylori and prevent a relapse. 


How Can An Helicobacter pylori (H. pylori) Infection Be Prevented?

Doctors sometimes screen healthy persons for an H. pylori infection because an H. pylori infection and its complications are widespread in certain regions. Consult your healthcare professional if you are concerned about an H. pylori infection or believe you may be at high risk of stomach cancer.

An H. pylori infection can pass from one person to another or by unhygienic eating and drinking habits. So, certain preventive measures can help you in reducing the chances of getting an H. pylori infection.

The suggestions below are standard preventative measures to avoid an H. pylori infection:

  • Always practice good hygiene
  • Wash your hands during food preparation
  • Follow a healthy, balanced diet
  • Maintain proper nutrition to prevent nutrient deficiencies
  • Avoid spicy foods; they may cause burning
  • Avoid smoking and limit alcohol consumption
  • Follow the treatment procedure for a full recovery
  • Avoid exposure to family members if you're infected with H. pylori

Patients with persistent gastrointestinal symptoms should be diagnosed and treated properly to identify the main cause of digestive problems.

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Medical References

1. Zamani M, Ebrahimtabar F, Zamani V, Miller WH, Alizadeh-Navaei R, Shokri-Shirvani J, et al. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther. 2018 Apr 1;47(7):868–76.
2. Sjomina O, Pavlova J, Niv Y, Leja M. Epidemiology of Helicobacter pylori infection. Helicobacter. 2018 Sep 1;23(S1):e12514. Available from:
3. Reshetnyak VI, Reshetnyak TM. Significance of dormant forms of Helicobacter pylori in ulcerogenesis. World J Gastroenterol [Internet]. 2017 Jul 21;23(27):4867–78.
4. Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017;153(2):420–9.
5. Cover TL, Blaser MJ. Helicobacter pylori in Health and Disease. Gastroenterology. 2009;136(6):1863–73.
6. Talebi Bezmin Abadi A. Diagnosis of Helicobacter pylori Using Invasive and Noninvasive Approaches. J Pathog. 2018 May 22;2018:9064952.
7. Atherton JC, Spiller RC. The urea breath test for Helicobacter pylori. Gut. 1994 Jun;35(6):723–5.
8. Gisbert JP, de la Morena F, Abraira V. Accuracy of monoclonal stool antigen test for the diagnosis of H. pylori infection: a systematic review and meta-analysis. Am J Gastroenterol. 2006 Aug;101(8):1921–30. 9. Kiesslich R, Goetz M, Burg J, Stolte M, Siegel E, Maeurer MJ, et al. Diagnosing Helicobacter pylori in vivo by confocal laser endoscopy. Gastroenterology. 2005 Jun;128(7):2119–23.
10. Hu Y, Zhu Y, Lu N-H. Recent progress in Helicobacter pylori treatment. Chin Med J (Engl). 2020 Feb 5;133(3):335–43.
11. McNicholl AG, Bordin DS, Lucendo A, Fadeenko G, Fernandez MC, Voynovan I, et al. Combination of Bismuth and Standard Triple Therapy Eradicates Helicobacter pylori Infection in More than 90% of Patients. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2020 Jan;18(1):89–98.



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