H. Pylori

What Is H. Pylori? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Julie Lynn Marks
By Medically Reviewed by 
Reviewed:
Medically Reviewed

Helicobacter pylori (H. pylori) is a type of bacteria that can cause an infection in your stomach.

If you develop an H. pylori infection, you may not have any signs or symptoms. But it can lead to peptic ulcers, gastritis, and even certain types of stomach cancer.

Up until the discovery of H. pylori in 1982 (for which the scientists responsible were awarded the Nobel Prize), it was assumed peptic ulcers were caused by stress and spicy foods. It is now understood that H. pylori bacteria cause up to 80 percent of gastric ulcers.

The good news is that H. pylori can be effectively treated with antibiotics and acid-reducing medicines.

Signs and Symptoms of H. Pylori

Most people with H. pylori don’t feel sick, but when symptoms do occur, they include the following:

  • Nausea
  • Stomachache or burning in the stomach
  • Abdominal pain that’s worse when your stomach is empty
  • Burping
  • Loss of appetite
  • Bloating
  • Weight loss

Causes and Risk Factors of H. Pylori

Doctors aren’t exactly sure how H. pylori infection is passed from person to person. Research shows that you can become infected with the bacteria by consuming contaminated food or water. H. pylori may also spread through contact with an infected person’s saliva, vomit, or fecal matter.

Most people who develop an H. pylori infection do so during childhood.

Some factors may increase your risk of developing an H. pylori infection:

  • Sharing a crowded living space
  • Living in a developing country
  • Not having access to clean water
  • Living with someone who has H. pylori

How Is H. Pylori Diagnosed?

It’s a good idea to visit your doctor any time you have unusual stomach pains or complaints, especially if they are persistent or recurrent.

See a healthcare provider right away if you experience the following symptoms:

  • Severe stomach or other abdominal pain
  • Stomach or abdominal pain that doesn’t go away
  • Difficulty swallowing
  • Bloody, black, or tarry stools
  • Vomit that’s bloody or looks like coffee grounds
There are different ways to test for H. pylori.

First, your doctor will probably perform a physical exam and ask about your medical history. Then they might recommend one or more of these tests to identify the bacteria.

Stool Test

A stool sample can help doctors detect proteins that are associated with H. pylori. You’ll need to stop taking medicines such as proton pump inhibitors, antibiotics, or bismuth subsalicylate before having this test.

One study found a stool test to be more accurate, cost-effective, and easier to perform than a breath test or blood test for H. pylori.

Breath Test

A breath test involves swallowing a pill, liquid, or pudding that contains carbon. If you have an H. pylori infection, your doctor will be able to detect carbon molecules when you exhale into a bag.

Breath tests are also considered highly accurate, and a 2021 review recommended breath tests and stool tests as the best noninvasive H. pylori tests. However, they are often difficult to perform on young kids, and you can’t take certain medicines, such as proton pump inhibitors, antibiotics, or Pepto-Bismol (bismuth subsalicylate), for a week or two prior to having the test because they affect the test’s accuracy.

Upper Endoscopy

During an upper endoscopy, your doctor will first give you a light sedative, then thread a long tube with a tiny camera on the end down your throat, past your esophagus, and into your stomach. This will allow your physician to see inside your digestive track and remove small pieces of tissue (known as biopsy samples) if necessary.

If samples of tissue are removed, they can be analyzed for an H. pylori infection. An endoscopy is considered more invasive than other methods, such as a stool sample or breath test.

Your doctor might recommend an endoscopy if a less-invasive test was inconclusive or if they are screening for other gastrointestinal concerns besides  H. pylori.

Blood Test

A blood draw may be done to look for H. pylori antibodies in your body. Although blood tests are easy to perform, they’re often not as accurate as other diagnostic approaches.

Should You Get Screened for H. Pylori?

In places where the risk of getting H. pylori is high, doctors test healthy people for the bacteria even if they have no signs or symptoms, which is known as medical screening. But there’s a debate in the medical community over whether this degree of screening is beneficial.

It might be a good idea to get tested for H. pylori if you’re at a high risk for stomach cancer.

Prognosis of H. Pylori

Many people with H. pylori don’t experience any symptoms of the illness and never even know they have the infection.

If you do have symptoms or develop complications, treatment is usually successful. H. pylori infection can often be cured with treatment consisting of antibiotics and acid-reducing medications.

Duration of H. Pylori

If it goes untreated, H. pylori can last a lifetime, and in most instances, it causes only minimal damage. Many people with the infection don’t have symptoms and never experience any health problems as a result.

If someone does have symptoms, the treatment regimen for H. pylori usually lasts two weeks. After about four weeks, patients are often tested again to make sure the infection has resolved.

Treatment and Medication Options for H. Pylori

If you have an H. pylori infection but don’t have any bothersome symptoms or develop an ulcer, you might not need to take any medications.

Medication Options

If you do need treatment, your doctor will probably prescribe an antibiotic and an acid-reducing drug. These medications are typically taken for 10 to 14 days.

Antibiotics

Usually, you’ll need two or more antibiotics at once to treat the infection. This helps prevent the bacteria from becoming resistant to one drug.

Some antibiotics are commonly prescribed for H. pylori:

It’s important to take antibiotics exactly as your doctor prescribes, including taking all doses of the medication, even if your symptoms improve.

Acid-Reducing Drugs

While these medications will not eradicate H. Pylori, they may reduce the amount of acid in your stomach and the symptoms of acid reflux in H. Pylori patients:

Also, avoid taking aspirin or any anti-inflammatory drugs, such as ibuprofen, as they may irritate your stomach and lead to stomach bleeding.

Alternative and Complementary Therapies

There are some foods or supplements with antibacterial or antiviral properties that have been investigated for improving H. pylori infections or the ulcers that can sometimes result. These include garlic, honey, broccoli, green tea, and red wine.

Although some of the findings indicated that some agents may have good anti-inflammatory and gastro-protective activities, there are no results that any alternative treatment can truly eradicate, and therefore cure, H. pylori, according to research from 2014.

It’s recommended that any alternative therapy be discussed with your doctor and should only be used along with traditional H. pylori eradication medication.

At-Home Care

You can help relieve stomach pain and other symptoms of H. pylori infection by following a consistent meal schedule that doesn’t require your stomach to be empty for too long. That may mean you’ll have to eat five or six small meals each day rather than three moderate to large meals.

Additional tips for caring for yourself with H. pylori include the following:

  • Avoid spicy or greasy foods
  • Avoid caffeinated drinks such as coffee, tea, or soda if they bother your stomach
  • Limit alcohol intake
  • Practice good hand-washing hygiene

Follow-Up Doctor’s Visits

After you’ve been treated for H. pylori, your doctor might suggest that you get tested again for the infection four weeks later. If you still have the infection, you may need to take another round of treatment with different antibiotics.

Prevention of H. Pylori  

There’s currently no vaccine to protect against H. pylori infection. Researchers aren’t sure exactly what causes the infection or how it spreads, so there aren’t standard prevention guidelines.

Still, it’s important to practice good hygiene measures:

  • Wash your hands frequently and thoroughly
  • Drink water from a safe and trusted source
  • Don’t eat contaminated food

Complications of H. Pylori

H. pylori can lead to complications, including ulcers, gastritis, and stomach cancer.

Ulcers

About 10 percent of people with H. pylori will develop a stomach ulcer (sore). This happens when H. pylori damages the mucous coating that protects the lining of your stomach and small intestine. When this sensitive coating is destroyed, strong stomach acid can get through to the lining and cause injury.

H. pylori causes more than 90 percent of intestinal ulcers and up to 80 percent of stomach ulcers.

Ulcers themselves can lead to serious complications as well:

  • Internal Bleeding This happens when stomach acid or an ulcer tears into a blood vessel.
  • Obstruction An ulcer can block food from leaving your stomach.
  • Perforation An ulcer can grow deep and break through the stomach or intestinal wall.
  • Peritonitis Inflammation of the peritoneum (the lining of the abdominal cavity) can happen when infection or inflammation develops as a result of an ulcer.

Gastritis

Gastritis is inflammation of the lining of your stomach. People with H. pylori are at an increased risk of having this condition.

If gastritis isn’t treated, it can lead to severe blood loss and may raise your risk of developing stomach cancer.

Stomach Cancer

Having an H. pylori infection is a risk factor for certain types of stomach cancer.

 
Stomach cancer is the second most common cause of cancer-related deaths in the world. It’s more common in countries in Asia and South America than it is in Western countries.

Learn More About the Complications of H. Pylori  

Research and Statistics: Who Has H. Pylori?

About 50 percent of the world’s population is infected with H. pylori bacteria.

The infection is more prevalent in developing countries, where children get infected before age 10. In developed countries, such as the United States, infection in children is rarer, but H. pylori infection becomes more common in adulthood.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, between 30 and 40 percent of Americans get an H. pylori infection.

Black and Hispanic Communities and H. Pylori

H. pylori is more common among Black and Hispanic Americans than it is among white Americans.

Black Americans with a higher proportion of African ancestry have been reported to have higher rates of H. pylori infection than Black Americans with a lower proportion of African ancestry. This could mean that racial and genetic factors that go beyond socioeconomic factors, disparities in treatment, and access to healthcare may have some role in predisposing Black people to the infection.

Black and Hispanic Americans and Americans of East Asian and Southeast Asian descent have a higher rate of gastric and stomach cancer compared with white Americans. Although H. pylori infection is known to be a leading risk factor for stomach cancer, a study from 2019 found that many of the people in these higher risk groups aren’t given appropriate screening for the infection, which has negative impacts on outcomes.

Related Conditions of H. Pylori

Chronic Gastritis H. pylori can cause gastritis, which is abnormal inflammation in the stomach lining. If left untreated, H. pylori gastritis can lead to peptic ulcers and stomach cancer.

Stomach Cancer Long-term infection of the stomach with H. pylori can inflame and cause damage to the inner layer of the stomach. Sometimes these changes, over many years, can eventually lead to cancer, especially in the lower part of the stomach.

Rosacea Research has shown a possible link between H.pylori and the development of rosacea, but the data has been limited and inconclusive.

However, according to a 2018 review of studies, treatment for H. pylori in patients with rosacea is more effective than routine therapy for rosacea.

Resources We Love

Mayo Clinic

The Mayo Clinic’s website provides comprehensive, up-to-date medical info. Its coverage of H. pylori infections — from symptoms and treatment to what questions to ask your doctor — is thoroughly accessible and helpful.

FamilyDoctor.org

This site, from the American Academy of Family Physicians, has a wealth of educational materials and medical info for adults and kids, including a page on ulcers caused by H. pylori.

MedlinePlus

MedlinePlus is a service of the National Library of Medicine, the world’s largest medical library, and part of the National Institutes of Health. With health and wellness information in both English and Spanish, it’s a trusted source on a variety of conditions, including H. pylori infections.

Additional reporting by Becky Upham.

Editorial Sources and Fact-Checking

 

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