Things you need to know about H pylori

Helicobacter pylori (HEL-ik-oh BAK-ter pie-LOR-ee) is an infection that when found in the stomach is known to cause some stomach problems, including stomach ulcers. In fact, while spicy foods can make an ulcer feel worse, they are not the cause of stomach ulcers as once believed—most ulcers are caused by H pylori infection.

Another important thing to know about H pylori is that it is considered to be something that causes cancer in humans. Although most people with H pylori don’t get cancer, most people with stomach cancer get it as a result of H pylori infection.

Who gets H pylori?

Anyone can get H pylori. About half of the people in the world have it. In the United States about 1 in 3 people are affected, although it is more common among non-Hispanic black and Hispanic Americans, and most common among people from Southeast Asia.

How does H pylori make you feel sick?

The H pylori infection is a spiral-shaped bug—that’s what helicobacter means—“helico” for “helix” or “spiral” and “bacter” for “bacterium.” The bug spirals into the stomach’s protective lining, damaging it and allowing stomach acids to get through to the stomach wall. The bug can also irritate stomach cells and cause too much stomach acid.

In many cases H pylori won’t become active and make someone sick. When it does, problems can include "heartburn" located below the chest and above the stomach (an area called the upper abdomen) that lasts or keeps happening.

How is it spread?

H pylori is thought to spread through contaminated food and water and through direct contact with saliva. In most cases, the infection happens during childhood, especially in children living in poor, crowded areas with poor waste removal.

H pylori: Are you 1 in 3?

Roughly a third of people in the United States have an H pylori stomach infection. In most cases, this infection doesn’t become a problem. But if you suffer from indigestion that either won’t quit or keeps coming back, talk to your doctor about H pylori testing. It’s easy and can only help.

How can I learn whether I have H pylori?

For many people 55 and under, medical guidelines recommend two types of testing to learn if you’re infected with H pylori:

  • Breath test. For this test you breathe into a collection bag to provide a first breath sample. You then drink a harmless solution, and after a short wait, breathe into a second collection bag. The lab checks for changes between the first and second sample that tell whether you have H pylori. Request testing from your doctor, or visit to learn how you can order without a doctor’s order.

  • Stool test. A stool sample is required for this test; the lab checks it for the presence of
    H pylori.

Both tests are highly accurate, FDA-cleared and recommended by the American Gastroenterological Association (AGA) and the American College of Gastroenterology (ACG). Both tests may be covered by insurance. Important: although a blood test for H pylori may be available, it is not as accurate as the other two tests and is no longer recommended. For these reasons, some insurers will no longer pay for blood testing for H pylori.

A third option: the “scope” test

If you are older than 55 or have what doctors call “alarm symptoms” such as stomach bleeding, medical experts recommend testing for H pylori using a procedure called anendoscopy (en-DOSS-ko-pee). This test is performed in the hospital. It involves snaking a tube with a camera through to the stomach and small intestine to examine both organs. A tiny tool can be passed through the tube to remove some tissue for doctors to test for H pylori. This test is considered very accurate but is only used in certain cases.

What is the treatment for H pylori?

Once active H pylori infection has been diagnosed, treatment may include the following:

  • A combination of bacteria-killing drugs called antibiotics

  • A medication such as Pepto-Bismol

  • Another medicine to reduce the acid in the stomach

At least two weeks after treatment is finished, you should be tested again to make sure the H pylori is gone. The AGA recommends it. Just remember test-treat-test.

Does treatment prevent stomach cancer?

There is some proof that early treatment of H pylori can reduce the risk of stomach cancer, although more proof is needed for doctors to be sure. Fortunately, only a very small number of H pylori patients—fewer than 1 in 1,000—will get stomach cancer, so it is very rare.


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