Helicobacter pylori (H. pylori): What It Is, How It Spreads, and How to Treat It

What is H. pylori and why should you care?

H. pylori is a common type of bacteria that grows in the digestive tract and tends to attack the stomach lining. It can cause various diseases, such as peptic ulcers, gastritis, and stomach cancer. According to a meta-analysis from 2018, around 44 percent of people worldwide have an H. pylori infection. However, most people with H. pylori never have symptoms and may not even know they are infected.

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So why should you care about this sneaky bacteria? Because it can damage your stomach's protective lining and make you more vulnerable to other factors that can cause ulcers, such as stress, medications, alcohol, spicy foods, and smoking. It can also increase your risk of developing stomach cancer, especially if you have a family history or other genetic factors that predispose you to it.

Therefore, it is important to know how H. pylori infects your stomach, what are the signs and symptoms of infection, how it is diagnosed and treated, what are the possible complications, and how you can prevent it.

How does H. pylori infect your stomach?

H. pylori is adapted to live in the harsh, acidic environment of the stomach. It has a spiral shape that allows it to penetrate the stomach lining, where it is protected by mucus and the body's immune cells can't reach it. It can also change the environment around it and reduce the acidity so it can survive more easily.

H. pylori infection usually occurs during childhood and is often passed from person to person through direct contact with saliva, vomit or stool. It can also be spread through contaminated food or water. Children are more likely to develop an infection than adults because they have less developed immune systems and may have poorer hygiene habits.

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h pylori urease enzyme and its role in infection

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What are the symptoms of H. pylori infection?

Most people with H. pylori infection do not have any symptoms. However, some people may experience:

• dull or burning stomach pain (especially when you have an empty stomach)

• bloating

• nausea

• unexplained weight loss

• vomiting

• burping

• poor appetite

These symptoms are similar to those of a peptic ulcer, which is a sore in the lining of the stomach or small intestine caused by acid erosion. In fact, most peptic ulcers are caused by H. pylori infection.

How is H. pylori diagnosed?

If you have symptoms of a peptic ulcer or other signs of stomach problems, your doctor may suspect that you have an H. pylori infection and order some tests to confirm it. These tests may include:

• Blood test: This test checks for antibodies against H. pylori in your blood. However, this test may not be accurate if you have had a previous infection or treatment.

• Breath test: This test measures the amount of carbon dioxide in your breath after you swallow a pill or drink a liquid that contains a substance called urea. If you have an active infection, the bacteria will break down the urea and produce carbon dioxide, which will show up in your breath.

• Stool test: This test detects the presence of H. pylori antigens (proteins) in your stool. This test is more accurate than the blood test and can also be used to monitor the effectiveness of treatment.

• Endoscopy: This is a procedure where a thin, flexible tube with a camera and a light is inserted through your mouth and into your stomach and small intestine. Your doctor can see the inside of your digestive tract and take a biopsy (a small sample of tissue) to test for H. pylori. This test is more invasive than the others, but it can also detect other conditions, such as ulcers, inflammation, or cancer.

How is H. pylori treated?

If you have an H. pylori infection and symptoms of a peptic ulcer or other complications, your doctor will prescribe a combination of antibiotics and acid-reducing medications to kill the bacteria and heal the damage to your stomach lining. The treatment usually lasts for 10 to 14 days and may include two or three different antibiotics, such as amoxicillin, clarithromycin, metronidazole, or tetracycline. The acid-reducing medications may include proton pump inhibitors (PPIs), such as omeprazole, lansoprazole, or esomeprazole, or histamine receptor blockers (H2 blockers), such as ranitidine, famotidine, or cimetidine.

It is important to follow your doctor's instructions and take the full course of treatment, even if you feel better before it is finished. Otherwise, the bacteria may not be completely eliminated and may become resistant to the antibiotics. You should also avoid alcohol, smoking, spicy foods, and other factors that can irritate your stomach while you are being treated. You may need to have a follow-up test after the treatment to make sure that the infection is gone.

What are the complications of H. pylori infection?

If left untreated, H. pylori infection can lead to serious complications that can affect your quality of life and increase your risk of death. Some of these complications are:

Peptic ulcers

As mentioned earlier, most peptic ulcers are caused by H. pylori infection. Peptic ulcers are sores that form in the lining of the stomach or small intestine when the acid erodes the protective mucus layer. Peptic ulcers can cause severe pain, bleeding, perforation (a hole in the wall of the organ), or obstruction (a blockage that prevents food from passing through). Peptic ulcers can be cured with antibiotics and acid-reducing medications, but they may recur if the infection is not cleared.

Gastritis

Gastritis is inflammation of the stomach lining that can be caused by H. pylori infection or other factors, such as alcohol, medications, stress, or autoimmune disorders. Gastritis can cause symptoms similar to those of a peptic ulcer, such as pain, nausea, vomiting, or loss of appetite. Gastritis can also lead to atrophic gastritis, which is a condition where the stomach lining becomes thin and weak and produces less acid and enzymes. Atrophic gastritis can impair digestion and absorption of nutrients and increase the risk of stomach cancer. Gastritis can be treated with antibiotics and acid-reducing medications, but it may also require dietary changes and supplements to correct nutritional deficiencies.

Stomach cancer

Stomach cancer is a malignant tumor that grows in the stomach. It is one of the most common types of cancer worldwide and one of the leading causes of cancer death. H. pylori infection is a major risk factor for stomach cancer, especially for a type called non-cardia gastric cancer that affects the lower part of the stomach. H. pylori infection can cause chronic inflammation and damage to the stomach lining, which can lead to genetic mutations and abnormal cell growth. Other risk factors for stomach cancer include smoking, obesity, diet high in salted or smoked foods, family history, or certain genetic conditions. Stomach cancer can cause symptoms such as pain, weight loss, difficulty swallowing, vomiting blood, or black stools. Stomach cancer can be diagnosed with endoscopy, biopsy, blood tests, imaging tests, or staging tests. Stomach cancer can be treated with surgery, chemotherapy, radiation therapy, immunotherapy, or targeted therapy, depending on the stage and type of the cancer. The prognosis of stomach cancer depends o