We often hear about Helicobacter pylori, but few people know exactly what it is and what symptoms it can cause. If you are experiencing abdominal pain, bloating, nausea or loss of appetite, and would like to understand the cause of your symptoms, this article is for you. Our aim is to explain Helicobacter pylori infection, the diagnostic options and treatment methods in clear, medical terms, so that you can discuss possible solutions with your doctor with greater confidence.
Helicobacter pylori (H. pylori) is a bacterium found in the stomachs of around half the world’s population. Although the majority of those infected are asymptomatic, the bacterium plays a significant role in the development of chronic gastritis, gastric and duodenal ulcers, and, in rarer cases, stomach cancer. The Endomedix Gastroenterology Centre Our experts are committed to using state-of-the-art methods to help diagnose and treat Helicobacter pylori infection. Find out the most important facts about this condition!
What exactly is Helicobacter pylori?
Helicobacter pylori is a spiral-shaped, Gram-negative bacterium discovered in 1983 by two Australian researchers, Barry Marshall and Robin Warren. They were awarded the Nobel Prize in Physiology or Medicine in 2005 for their discovery, having demonstrated that this microorganism is responsible for the majority of stomach and duodenal ulcers, thereby refuting earlier theories that focused on stress and lifestyle.
What makes this bacterium unique is its ability to survive the extremely acidic environment of the stomach. It owes this to an enzyme it produces, called urease, which breaks down urea in the stomach into ammonia and carbon dioxide. The ammonia neutralises the stomach acid in the bacterium’s immediate surroundings, forming a kind of protective barrier around it. This enables it to colonise the stomach lining. The infection spreads from person to person, most commonly via the faecal-oral or oral-oral routes, for example through contaminated food, water or cutlery. The risk of infection is higher amongst people living in poor hygienic conditions.
What symptoms and illnesses can it cause?
Around 80% of those infected with H. pylori do not experience any symptoms. However, for those in whom the infection causes symptoms, the most common symptoms are as follows:
- Dull or burning abdominal pain, particularly around the pit of the stomach
- Bloating and a feeling of fullness
- Frequent burping
- Dizziness or nausea
- Loss of appetite and unexplained weight loss
Chronic inflammation caused by the bacterium can lead to more serious illnesses in the long term.
Diseases associated with Helicobacter pylori
- Chronic gastritis: H. pylori is the most common cause of chronic gastritis. The inflammation damages the stomach lining, leading to the symptoms mentioned above.
- Stomach and duodenal ulcers: Ulcers develop in approximately 10–15% of those infected. The bacterium is detectable in 90–95% of duodenal ulcer cases, whilst it is found in around 70% of gastric ulcer cases. The bacterium weakens the protective layer of the mucous membrane, allowing stomach acid to damage the walls of the stomach or small intestine.
- Stomach cancer: H. pylori infection is one of the most significant risk factors for gastric cancer (adenocarcinoma). The World Health Organisation (WHO) classifies it as a Group 1 carcinogen (cancer-causing agent). The chronic inflammation caused by the bacterium can, over a period of years or decades, lead to abnormal changes in the cells (atrophy, intestinal metaplasia) and subsequently to the development of a tumour.
- MALT lymphoma: This is a rare type of tumour arising from the lymphoid tissue associated with the gastric mucosa. More than 90% of cases are associated with H. pylori infection. The good news is that early-stage MALT lymphoma can be cured in a significant proportion of cases (approximately 70%) by eradicating the bacterium.
How is the infection diagnosed?
There are several reliable methods for detecting Helicobacter pylori. These can be divided into two main groups: invasive (requiring endoscopy) and non-invasive (without endoscopy) procedures. A specialist in gastroenterology will select the most suitable method for you based on your symptoms and medical history. The Endomedix Gastroenterology Centre It provides the necessary modern technical infrastructure for both types of examination.
Non-invasive (non-reflective) examinations
These methods are gentle and do not require gastroscopy.
- Urea Breath Test (UBT): This is the most accurate non-invasive method for detecting the active presence of the infection. During the test, the patient is asked to drink a special liquid containing isotope-labelled urea. If the bacterium is present in the stomach, its urease enzyme breaks down the urea, and the labelled carbon atom becomes detectable in the exhaled air in the form of carbon dioxide.
- Stool antigen test: This test detects a specific protein (antigen) produced by the bacterium in a stool sample. Its reliability is similar to that of the breath test, and it is also used to confirm an active infection.
- Serological test (blood test): Antibodies (IgG) produced in response to the bacterium can be detected in the blood. However, this method only indicates whether the body has previously encountered the pathogen; it does not indicate whether the infection is currently active. For this reason, it is not suitable for monitoring the success of treatment.
Invasive examinations (requiring gastroscopy)
During a gastroscopy, the doctor uses a thin, flexible instrument called an endoscope to examine the oesophagus, the stomach and the initial section of the duodenum. During the examination, it is also possible to take a tissue sample (biopsy).
- Rapid urease test (RUT): A tissue sample taken from the stomach is placed in a special gel containing urea and a pH indicator. If the bacterium is present, the ammonia it produces alters the pH of the gel, causing a colour change. The result can usually be read within a few minutes or hours.
- Histopathological examination: The sample taken is examined by a pathologist under a microscope. This method not only confirms the presence of bacteria, but also provides information on the extent of inflammation of the gastric mucosa and any pathological changes (e.g. atrophy, metaplasia).
- Breeding: In the laboratory, attempts are made to culture the bacteria from the tissue sample. This is a more complex procedure, but it enables the determination of antibiotic resistance, which may be important following unsuccessful attempts at treatment.
Treatment of Helicobacter pylori
The aim of treating the infection is to completely eradicate the bacteria. This reduces gastritis, promotes the healing of ulcers and significantly reduces the risk of developing stomach cancer. Treatment usually involves a combination of medicines comprising several components:
- Acid-reducing medicine (proton pump inhibitor, PPI): These medicines (e.g. omeprazole, pantoprazole, esomeprazole) reduce the production of stomach acid. This not only helps the mucous membrane to heal, but also enhances the effectiveness of antibiotics.
- Two types of antibiotics: Two different types of antibiotics are used simultaneously to kill the bacteria, in order to reduce the likelihood of resistance developing. The most commonly used drugs are clarithromycin, amoxicillin and metronidazole.
The course of treatment usually lasts 10–14 days. It is very important that you take the medicines exactly as prescribed by your doctor, in the correct dose and for the full duration, even if your symptoms improve before then! Interrupting the course of treatment can lead to treatment failure and the bacteria becoming resistant. At least 4 weeks after completing treatment, you must have a follow-up test to check that it has been successful, usually using a breath or stool antigen test. It is important not to take antacids for at least 2 weeks or antibiotics for at least 4 weeks before the follow-up test, as these can cause false-negative results.
Tips for successful treatment and prevention
Although H. pylori infection can only be eradicated with targeted drug therapy, certain lifestyle changes can aid recovery and alleviate symptoms.
- Meals: Both during and after treatment, it is advisable to avoid foods and drinks that irritate the stomach, such as hot, spicy or fatty dishes, coffee, alcohol and fizzy drinks.
- Smoking: Smoking slows down the healing of ulcers and increases the risk of complications; it is therefore recommended that you give up smoking completely both during and after treatment.
- Hygiene: As the infection is most commonly spread due to poor hygiene, the most important means of prevention is regular, thorough hand washing, particularly before meals and after using the toilet.
When should you see a doctor?
If you experience any of the symptoms mentioned above, be sure to see your GP or a gastroenterologist. Do not delay getting checked, particularly if you experience any of the following „alarming” symptoms:
- Difficulty or pain when swallowing
- Repeated vomiting, vomiting blood
- Black, tar-like stools (indicating digested blood)
- Significant, unintentional weight loss
From Endomedix Gastroenterology Centre Its specialist doctors and state-of-the-art diagnostic facilities ensure the accurate detection and effective treatment of Helicobacter pylori infection and the conditions it causes. Don’t put up with these unpleasant symptoms – take action for your health!
