Gastritis - Helicobacter pylori

Definition

Helicobacter pylori (H. pylori) is a bacteria responsible for most ulcers and many cases of chronic gastritis

Alternative Names

Causes

As many as half of the world's population is infected with H. pylori. Those living in developing countries or crowded, unsanitary conditions are most likely to contract the bacteria, which is passed from person to person. H. pylori only grows in the intestines, and is usually contracted during childhood.

Interestingly, many people have this organism in their gastrointestinal tract but don't get an ulcer or gastritis. It seems that other factors must also be present for the damage to take place. The factors that increase your risk for an ulcer from H. pylori include:

• Inheritance, through your genes, of certain strains of the bacteria that are more dangerous than others
• Abnormal immune response in your intestines
• Certain lifestyle habits, like coffee drinking, smoking, and ongoing stress

Symptoms

If you are a carrier of H. pylori, you may have no symptoms. If you have an ulcer or gastritis, you may have some of the following symptoms:

• Abdominal pain
• Dyspepsia or indigestion
• Bloating and fullness
• Mild nausea (may be relieved by vomiting)
• Belching and regurgitation
• Feeling very hungry 1 to 3 hours after eating

Exams and Tests

Simple blood, breath, and stool tests can determine if you are infected with H. pylori. If you have symptoms, your doctor will determine if you are an appropriate candidate for these screening tests.

The most accurate way to diagnose H. pylori, however, is through upper endoscopy of the esophagus, stomach, and first part of the small intestines (duodenum). Because this procedure is invasive, it is generally reserved for people at high risk for ulcers or other complications from H. pylori, like having stomach cancer. Such risk factors include being over 45 or having alarming symptoms like:

• Unexplained weight loss
• Gastrointestinal bleeding
• Anemia
• Difficulty swallowing.

Once diagnosed and treated, the breath and stool tests are used to determine if you have been cured of the infection.

Treatment

One to two weeks of antibiotics (like clarithromycin and amoxicillin) along with a proton-pump inhibitor such as omeprazole (Prilosec), lansoprazole (Prevacid) or esomeprazole (Nexium) is generally the treatment regimen to get rid of H. pylori and treat symptoms present including an ulcer or gastritis.

Outlook (Prognosis)

Once the H. pylori bacteria are eliminated, recurrence rates are very low in the United States.

Possible Complications

H. pylori infection is linked to stomach cancer and ulcer disease.

When to Contact a Medical Professional

Call your health care provider if you have blood in your stool, abdominal pain, ongoing indigestion or heartburn, or any of the other symptoms mentioned above.

Call immediately, or get safely to the closest emergency room, if you are vomiting blood.

Prevention

• A clean and hygienic environment may help decrease your risk of H. pylori infection.