Helicobacter Pylori: Symptoms and Treatment

Helicobacter pylori (H. pylori) is a bacterial species which grows in the digestive tract in your body especially stomach. About 60 percent of the world’s population is infected by this bacterium. It has a tendency to cause peptic ulcers that comprises of majority of stomach or duodenal ulcer. Not all infection lead to peptic ulcer. The bacteria commonly infect during childhood. The bacteria can stay alive in the harsh climate of stomach acid.

About 10 percent of the people having this infection develops peptic ulcer

Causes and Spread

The exact mechanism by which the H. pylori infects human is not known but it is thought that the bacteria spreads from one person to another when he or she ingest the food or other items contaminated with saliva or fecal matter

Signs and Symptoms

Most of the times the infection doesn’t lead to any symptoms and they are never aware of their infection but in some people, infections can be symptomatic and include

• Burning pain in the middle of your abdomen which worsens when the stomach is empty
• Nausea
• Heartburn
• Excessive burping
• Feeling bloated
• Unintentional weight loss
• Lack of appetite

These symptoms are due to the formation of stomach or duodenal ulcer

Risk Factors

Some people don’t acquire H. pylori infection but some people easily do as they have more number of risk factors associated with them and these are

Age: Children acquire this infection easily because they don’t follow the hygienic conditions

Society: developing and overcrowded societies area always at more risk of getting these infections

Alcohol

Using over the counter NSAIDs in excessive quantities

Other family member having the infection

Diagnosis

Your doctor will use your medical history, conduct a physical examination and perform some test to establish a diagnosis

Medical history: Your doctor will ask you complete details about your

• Current complaints
• Current or past medical illness
• Current or past medication
• Family history

Physical examination: your doctor will examine your body from head to the toe and examine your stomach also to look for the signs of pain, tenderness or bloating

Laboratory tests: these are done to look for the presence of H. pylori

• Blood tests: A small sample of blood is taken to look for the presence of specific antibodies against the H. pylori
• Breath test: the patient is given to ingest the tagged carbon molecules. If the bacteria are present they will utilize the molecule and the released by product is released into the blood. Now the breath of the patient is analyzed for the presence of these tagged carbon molecules

Endoscopy: Endoscope is a hollow tube through which contains light and the camera. It is passed down through your throat to look for the inside features of the gut. If ulcer is found, biopsy or part of the ulcer can be taken for the laboratory examination

Complications

If the symptomatic ulcer is left untreated then it can lead to severe complications as follows

Perforation: The ulcer can perforate making a hole in the wall of the stomach. The acidic food content can leak through the perforation into the body cavity from the stomach

Internal bleeding: If an ulcer is located near a blood vessel and then the blood can ooze out leading to black stools or vomit in the blood. Gradually iron deficiency anemia will develop.

Peritonitis: The leaked contents irritate the peritoneum and the organs present in the cavity of the body.

Stomach cancer: It is the extreme complication of chronic stomach ulcer

Treatment

Asymptomatic H. pylori infection doesn’t come to notice and doesn’t require treatment. The management of symptomatic infection includes treatment of underlying condition by giving antibiotics and reducing the signs and symptoms

Medications

Triple therapy: the drug therapy is known as triple therapy as it includes two different antibiotics and a proton pump inhibitor which blocks the acid secretion as in reduced acid concentration the antibiotics works more effectively.

Clarithromycin and amoxicillin are the common antibiotics prescribed

Lansoprazole, rabeprazole or pantoprazole are the common Proton pump inhibitors

Prognosis

For many people having asymptomatic infection, H. pylori rarely causes trouble. The outlook of patients having diseases associated with the bacteria is good after taking the medications. Some people need a second round of triple therapy to completely eradicate the bacteria. Chances of developing stomach cancer is rare and seen in chronic patients.

References:

• Kamboj AK, et al. (2017). Helicobacter pylori: The past, present, and future in management
• Helicobacter pylori and cancer. (2013)
• Peptic ulcers (stomach ulcers). National Institute of Diabetes and Digestive and Kidney Diseases
• Helicobacter pylori infection. Merck Manual Professional Version