Helicobacter pylori is a bacterium that can infect the stomach and is found in many people around the world. Although many people infected with Helicobacter pylori do not show any symptoms, the bacterium can attack the stomach lining, causing inflammation and in some cases, ulcers. Read on to learn more about Helicobacter pylori symptoms, diagnosis and treatment.

What is Helicobacter pylori?

Helicobacter pylori, often referred to as H. pylori, is a small bacterium that primarily colonizes the human stomach. H. pylori is unique because it is one of the few known organisms that can survive the extremely acidic environment of the stomach (National Cancer Institute, 2023).

Worldwide, it is estimated that half of the population is infected with H. pylori, with a higher prevalence found in developing countries. It does not cause illness in most people, and many people may not realize they have an infection unless symptoms occur. Infection with H. pylori usually occurs in childhood and can last a lifetime if not treated (Hooi et al., 2017). While many people live with H. pylori infection without any adverse symptoms, an infection with the bacteria is associated with a variety of gastrointestinal diseases (National Cancer Institute, 2023).

How does Helicobacter pylori enter the body?

Although it is not yet completely clear exactly how transmission works, it is thought that H. pylori is most often transmitted through consumption of contaminated food and water or through close contact with an infected person. Contact with contaminated stool is also a potential route of transmission (MedlinePlus, 2022).

Who is at risk for H. pylori infection?

H. pylori infections are common and can affect people of all ages, regardless of gender or origin. However, there are certain risk factors that increase the likelihood of infection:

1. Geographic location: H. pylori infections are more common in developing countries, which can be attributed to a lack of access to clean water, sanitation, and hygiene.
2. Living conditions: People living in crowded housing conditions are more susceptible to H. pylori.
3. Socioeconomic status: people with lower socioeconomic status are at increased risk, which may also be attributed to living in crowded conditions or with less access to hygiene.

Source: Mayo Clinic, 2022, Hooi et al, 2017.

What symptoms does an H. pylori infection cause?

Many people infected with H. pylori do not have any symptoms and may have the bacteria for years without knowing it. However, H. pylori can cause inflammation in the stomach lining called gastritis. It can also cause sores or peptic ulcers in the stomach or the first part of the small intestine. Symptoms of gastritis or an ulcer can include:

• Nausea or vomiting
• Gas, burping, or bloating
• Pain or burning in the upper abdomen
• Loss of appetite or unexplained weight loss

The symptoms of ulcers or gastritis can look like other health conditions, so it is important to see a doctor to determine the exact cause.

Source: John Hopkins, 2023

What diseases are associated with Helicobacter pylori?

H. pylori is responsible for a variety of gastrointestinal diseases. These include:

1. Chronic gastritis: Chronic gastritis is a long-term inflammation of the stomach lining. H. pylori can attach to gastric cells and cause inflammatory reactions that result in damage to the gastric mucous membranes. This reaction can remain asymptomatic for years, but can lead to pain and further health problems without treatment (Mayo Clinic, 2022).
2. Gastric ulcers and duodenal ulcers: Ulcers or sores in the stomach or first part of the small intestine (duodenum) occur when the protective mucus layer of the stomach or duodenum is damaged. H. pylori can promote these ulcers by triggering inflammation and by damaging the protective mucus layer of the stomach or duodenum (Suerbaum & Michetti, 2002).
3. Gastric cancer: H. pylori is associated with gastric cancer because the chronic inflammation and repeated cellular damage caused by H. pylori can lead to the development of cancer cells over time. Individuals with H. pylori infection have been found to have a significantly increased risk of gastric cancer (National Institute of Cancer, 2023).

How is an H. pylori infection diagnosed?

A H. pylori infection can be diagnosed in several ways, including the following tests:

Breath test: Also called a urea breath test, this test first involves providing a breath sample by breathing into a collection bag. You will then be asked to drink a small amount of liquid that contains urea. H. pylori bacteria (if present) break down the urea in the solution you drank, releasing carbon dioxide in the air you breathe out. Several minutes later, you will be asked to provide another breath sample. If the amount of carbon dioxide in the second sample is higher than in the first sample, the test is positive for the presence of H. pylori (Cleveland Clinic, 2020).

Blood test: a blood test can detect the presence of antibodies to H. pylori in the blood. While this method is simple and inexpensive, it cannot accurately distinguish between current and previous infections with H pylori (MedlinePlus, 2021).

Stool tests:

1. Stool antigen test: This is the most common stool test for detecting H. pylori. It involves examining a stool sample for antigens to H. pylori.
2. PCR stool test: A PCR (polymerase chain reaction) test can also detect H. pylori infection in stool. However, this test is more expensive than a stool antigen test and is not available at all medical facilities (Mayo Clinic, 2022).

Gastroscopy (gastroenteroscopy): If other testing methods did not provide enough information to make a diagnosis, a doctor may perform an endoscopy test, also known as upper endoscopy. This test may also be performed to investigate symptoms caused by H. pylori, such as a stomach ulcer or gastritis. During this test, a long, flexible tube equipped with a tiny camera (endoscope) is used to examine the stomach and the first part of the intestine (duodenum) (Mayo Clinic, 2022).

How is an H. pylori infection treated?

Treatment for H. pylori aims to completely remove the bacterium from the body, thereby reducing the risk of stomach ulcers and other serious complications in the future. Standard treatment, known as eradication therapy, usually involves the simultaneous use of several medications:

1. Proton pump inhibitors (PPIs): These medications reduce the amount of stomach acid that is produced. Decreasing acid production in the stomach allows healing of injuries to the stomach lining to occur more quickly.
2. Antibiotics: In most cases, at least two different antibiotics are prescribed to treat H. pylori and reduce the chances of antibiotic resistance.
3. Bismuth salts (optional): In some cases, a bismuth salt (such as bismuth subsalicylate) may be prescribed. This medication protects the stomach lining from acid.

Treatment for H. pylori is usually given for 10-14 days, and after therapy is completed, a retest may be done at approximately 4 weeks to ensure that the infection has been cleared.

Source: Mayo Clinic, 2022

How can I keep my stomach healthy?

A healthy stomach and gastrointestinal tract is essential for overall well-being. Here are some practical tips to promote gut health:

1. Eat a balanced diet:Eating a varied, balanced diet rich in fruits, vegetables and whole grains can help keep your stomach healthy. These foods provide fibre, which aids digestion and can prevent inflammation in the gastrointestinal tract. Inflammation-promoting foods should be avoided, while anti-inflammatory foods such as berries or avocado can help. In addition, certain fruits and vegetables may contain phytonutrients that support the health of their stomachs.
2. Stay hydrated: Adequate fluid intake is important for overall health as well as digestive health. Water helps move food through the digestive system and can reduce the risk of constipation and other digestive problems.
3. Avoid alcohol and smoking: Both alcohol and tobacco can irritate the stomach lining and increase the risk of stomach ulcers and gastritis. If possible, alcohol and tobacco consumption should be avoided or at least limited (Chuang, 2017).
4. Regular exercise: Regular physical activity can improve digestive function and help reduce the risk of constipation and other digestive problems.
5. Stress management: chronic stress and associated high blood cortisol levels can affect digestive system function and lead to symptoms such as stomach pain and bloating. Stress management techniques such as yoga, meditation or deep breathing exercises can help lower stress and cortisol levels and promote stomach health.
6. Regular medical checkups: Regular health checks can help identify and treat potential health problems early, particularly if you have been experience symptoms that could indicate H. pylori.
7. Practice good hygiene: H. pylori and other gastrointestinal illnesses are often spread through contaminated food and water. To reduce your risk, practice regular hand washing after you use the bathroom and before preparing food.
8. Be mindful of medications: Certain medications can irritate the stomach lining. If you take medications regularly, talk to your doctor about their potential risks.

Please note that these tips are general advice and are not specific to individual health needs or conditions. It is always advisable to consult a physician before making any changes to your diet, exercise, or medications.

Sources: NHS, 2023; Klein, 2022

Summary

H. pylori is a common bacterium that can infect the stomach and cause symptoms such as nausea, bloating, and abdominal pain. Infections are usually diagnosed using a breath test, blood test, or stool sample. Treatment includes a combination of antibiotics and stomach acid inhibitors. A healthy lifestyle and good hygiene can help keep your stomach healthy and reduce the risk of H. pylori infection.

Referenzen

Chuang, Y.-S., Wu, M.-C., & et al. (2017). Effects of alcohol consumption, cigarette smoking, and betel quid chewing on upper digestive diseases: a large cross-sectional study and meta-analysis. Oncotarget, 8(44), 78011-78022. https://www.oncotarget.com/article/20831/text/

Good foods to help your digestion. (n.d.). NHS. Retrieved June 15, 2023, from https://www.nhs.uk/live-well/eat-well/digestive-health/good-foods-to-help-your-digestion/

Helicobacter Pylori. (n.d.). Johns Hopkins Medicine. Retrieved June 15, 2023, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/helicobacter-pylori

Helicobacter pylori (H. pylori) and Cancer – NCI. (2023, April 12). National Cancer Institute. Retrieved June 15, 2023, from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/h-pylori-fact-sheet

Helicobacter pylori (H. pylori) infection – Diagnosis and treatment. (2022, May 5). Mayo Clinic. Retrieved June 15, 2023, from https://www.mayoclinic.org/diseases-conditions/h-pylori/diagnosis-treatment/drc-20356177

Helicobacter Pylori (H. Pylori) Tests. (2021, March 3). MedlinePlus. Retrieved June 15, 2023, from https://medlineplus.gov/lab-tests/helicobacter-pylori-h-pylori-tests/

Hellström, P.M. (2006). This year’s Nobel Prize to gastroenterology: Robin Warren and Barry Marshall awarded for their discovery of Helicobacter pylori as pathogen in the gastrointestinal tract. World Journal of Gastroenterology, 12(19), 3126. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124396/

Hooi, J. K.Y., & et al. (August). Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology, 153(2), 420-429. https://www.sciencedirect.com/science/article/pii/S0016508517355312

H. pylori (Helicobacter pylori ) Breath Test: What is It, How is it Done. (2020, November 20). Cleveland Clinic. Retrieved June 15, 2023, from https://my.clevelandclinic.org/health/diagnostics/5217-h-pylori-helicobacter-pylori-breath-test–urea-breath-test

Madison, A., & Kiecolt-Glaser, J. K. (2019). Stress, depression, diet, and the gut microbiota: human–bacteria interactions at the core of psychoneuroimmunology and nutrition. Current Opinion in Behavioral Sciences, 28, 105-110. https://www.sciencedirect.com/science/article/pii/S2352154618301608?via%3Dihub

Suerbaum, S. (2002). HELICOBACTER PYLORI INFECTION. The New England Journal of Medicine, 347(15), 1175-1185. https://www.nejm.org/doi/pdf/10.1056/NEJMra020542Taylor, C., & Dix, M. (n.d.). Improve Gut Health: Recognize the Signs of an Unhealthy Gut. Healthline. Retrieved June 15, 2023, from https://www.healthline.com/health/gut-health#foods-for-gut-health