What is H. Pylori?

May 2, 2016

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Could my pain be from a peptic ulcer?

Approximately 25 million Americans suffer from a peptic ulcer at some point during their lifetime. There are several clues that might signal that you have a peptic ulcer such as feeling a dull or burning pain in your belly. It may come and go, but you’ll probably feel it most when you have an empty stomach such as between meals or in the middle of the night. It can last for a few minutes or a few hours. You may feel better after you eat, drink milk or take an antacid.

Exactly what is a peptic ulcer?

A peptic ulcer is caused by Helicobacter pylori (H. pylori) which is a type of bacteria. These germs can enter your body and live in the lining of your stomach or the upper part of your small intestine. Every year there are 500,000 to 850,000 new cases and more than 1 million ulcer-related hospitalizations. In the U.S., H. pylori is more prevalent among older adults, African Americans, Hispanics and lower socioeconomic groups. However, children are more likely to develop an H. pylori infection, and their risk is higher mostly due to lack of proper hygiene.

In the early 1980s, before this bacterium was discovered, many blamed spicy food, acid, stress, alcohol, smoking and lifestyle as the major cause of peptic ulcers. But in 1982 scientists discovered the H. pylori bacterium and identified it as the culprit of most stomach ulcers.

You can get H. pylori from food, water or utensils. It’s more common in countries or communities that don’t have clean water or good sewage systems. You can also contract the bacteria through contact with the saliva or other body fluids of infected people.

Symptoms

In addition to the burning pain in your stomach, other symptoms may include:

• Frequently feeling sick to the stomach (nausea)
• Loss of appetite
• Frequent burping
• Sudden, sharp abdominal pain
• Weight loss
• Vomiting
• Bloody or black stools

Diagnosis

A physician may inquire about the patient’s medical history and family history of the disease. Patients should report medications including vitamins or supplements.  During a physical exam, the physician will examine your stomach to check for signs of bloating, tenderness or pain. They also will listen for any sounds within the abdomen. Many physicians also order a blood test to look for antibodies against H. pylori.

In addition, a person suspected of have H. pylori might undergo a breath test. During a breath test, a person drinks a liquid containing a carbon marker known as carbon-13 (¹³C). The person then provides a breath sample by blowing up a balloon or blowing bubbles. The sample is checked for the presence of the ¹³C marker. If the person has
an H. pylori infection, there will be traces of ¹³C present in the carbon dioxide gas molecules of the person’s breath.

There are several other methods physicians can use to make a diagnosis. One of the most common ways to check for it is with an endoscopy. The patient is given medication to relax and numb the throat. Then the physician inserts an endoscope (a thin, flexible tube with a camera and light on the end) down the throat, through the esophagus, and into the stomach and intestines. The camera on the end of the endoscope allows the physician to view the digestive system and take pictures of it. The physician also can take a biopsy, removing a small amount of tissue for study. The biopsy tissue can be sent to a laboratory for further testing and to check for evidence of H. pylori infection.

While less helpful than endoscopy, the patient might be given an upper gastrointestinal series, a set of x-rays of the gastrointestinal system. A person taking this test first drinks a white, chalky liquid called barium, which helps highlight the ulcer and makes it visible on the x-ray. A person’s blood can also be checked for the presence of antibodies to H. pylori, indicating infection.

Treatment

In the past patients who were diagnosed with H. pylori were given medication to lessen the production of stomach acid. This treatment reduced the pain by allowing the ulcer to heal, but it did not treat the infection that caused the inflammation in the first place. It was not uncommon for ulcers to return after the treatment ended.

Today physicians prescribe a two week treatment of a combination of two or three antibiotic medications that kill H. pylori bacteria, in addition to about a month of other prescribed medications that limit acid production as the ulcer heals. Treatment with antibiotics greatly reduces the chances that peptic ulcers will reoccur.

In addition to medication, the patient is usually advised to eat regular small meals to prevent having an empty stomach for long periods of time. The physician might also suggest avoiding ibuprofen or other medications that can cause stomach irritation.

Complications

1. pylori infections can lead to peptic ulcers, but the infection or the ulcer itself can lead to more serious complications such as:

• Internal bleeding, which can happen when an ulcer breaks through your blood vessel
• Obstruction, which can happen when an ulcer blocks the food from leaving your stomach
• Perforation, which can happen when an ulcer breaks through your stomach wall
• Peritonitis, which is an infection of the peritoneum, or the lining of the abdominal cavity.

A person who goes untreated for an H. pylori infection has an increased risk of developing stomach cancer later in life. While the infection is a major cause of stomach cancer, most people infected with H. pylori never develop stomach cancer.

Prevention

To protect yourself from H. pylori, simply follow the same steps you take to keep other germs at bay:

• Wash your hands after you use the bathroom and before you prepare or eat food. Teach your children to do the same.
• Avoid food or water that’s not clean
• Don’t eat anything that isn’t cooked thoroughly
• Avoid food served by people who haven’t washed their hands

While stress, spicy foods, alcohol and smoking don’t cause peptic ulcers, they can keep you from healing quickly or make your pain worse. Talk to your physician about ways to manage your stress, improve your die, and, if you smoke, how you can get help to quit.