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H.pylori Infection: Symptoms, Diagnosis, Treatment


One of the oldest bacteria on earth, Helicobacter pylori (H.pylori) has been infecting humans for thousands of years, and up to two-thirds of the world's population harbor this microbe. H.pylori spreads via contaminated food and water, or directly through mouth-to-mouth contact. Luckily, this infection can be easily detected, and effective treatments are available.

H.pylori Symptoms

Most people have no symptoms at all. If these develop, the most common are indigestion, acid reflux, burping, bloating, bad breath and loss of appetite. Changes in bowel movement – either diarrhea or constipation – also occur frequently, and some people experience weight loss without dieting.

H.pylori infections can complicate gastritis, and cause ulcers or even stomach cancer. Stomach upset and nausea suggest the development of gastritis, while ulcers tend to cause a dull pain in the stomach area, nausea, vomiting, heartburn, decreased appetite, and tarry stools. If ulcers further progress to cancer, the symptoms become more serious. There is significant weight loss, fluid buildup in the abdomen, and lab tests will show signs of anemia.

Conditions Associated With Infection

Recent studies reveal that H.pylori infections can cause many other symptoms, as it creates inflammation throughout the body. In the past, it was believed that this bacterium is found exclusively in the stomach. However, scientists have found evidence of H.pylori in other parts of the body including the mouth, skin, ears, and blood vessels.

Furthermore, H.pylori disrupts digestion, hormones and metabolism. As a result, the infection has been associated with:

  • fatigue
  • stress
  • anxiety
  • depression
  • headaches
  • skin rashes (especially rosacea)
  • hair loss
  • changes in heart rate and blood pressure
  • sleep problems
Hpyoriimage
H.pylori found throughout the body

Other conditions such as IBS (irritable bowel syndrome), SIBO (small intestinal bacterial overgrowth), and fibromyalgia are associated with H.pylori infections as well.

This infection causes inflammation, disrupting digestion and the gut-brain axis, which connects various centers in the brain with the gut intestinal functions. This leads to brain fog, fatigue, food intolerances, and multiple nutrient deficiencies. It is important to see a doctor to evaluate your condition, as these symptoms can be related to other infections or diseases.

H.pylori and Cancer

According to the National Cancer Institute, H.pylori is responsible for the majority of ulcers in the stomach and upper small intestine, and may also increase the risk of pancreatic cancer. This bacterium is currently classified as a carcinogen.

In 2018, there were an estimated 2.2 million cases of cancer in the US. About 13% of all cases in the country were caused by treatable infections, and H.pylori infections were the top culprit.

Certain strains of H.pylori, such as cagA-positive, seem to be more likely to cause stomach cancer. Interestingly, H pylori infection may also protect against other types of cancer. Although more research is needed, it appears that H.pylori infections lower the risk of esophageal adenocarcinoma.

H.pylori Diagnosis

Lab tests are important for detecting the H.pylori infection and proceeding to effective treatment.

  • Breath test. This is a great option, because it confirms an active infection and is very accurate. Antibiotics and acid blockers may interfere with the accuracy of this test, so to avoid false negatives it is best to take a test about eight weeks after finishing treatment with such medicines.
  • Stool tests. An antigen test evaluates foreign proteins associated with H.pylori infection in your stool. Drugs like antibiotics or acid blockers can interfere with the results. A stool polymerase chain reaction test can detect the infection and also strains that may be resistant to antibiotics. However, this test is more expensive.
  • Endoscopy. This allows the doctor to observe stomach tissue, look for evidence of infection, and take samples. These are sent to a lab to confirm diagnosis. Endoscopy is used only in select cases, however, because it is invasive.
  • Blood tests are rarely used because they are less accurate. They do not confirm infection, or if treatment has eradicated it.

H.pylori Treatment

Infection is typically treated with two or more antibiotics at the same time, so the bacterium does not become resistant to the medicine. Examples of this dual treatment include metronidazole and tetracycline, and amoxicillin and clarithromycin, for 10-14 days.

Sequential therapy is a new, improved version of antibiotic treatment, where two antibiotics are given during the first five days, followed by another antibiotic combination for the remaining five.

Along with antibiotics, an acid blocker is given. Some H.pylori protocols include bismuth subsalicylate to further increase the efficacy of the treatment and protect the stomach tissue. Another test is indicated to confirm the bacteria was eradicated.

Useful resources

National Cancer Institute: H.pylori fact sheet

Helicobacter pylori Infection

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