H Pylori Bacteria Infection: Symptoms Diagnosis Treatment Prevention
- How H. pylori Makes You Sick
- What can I expect after H. pylori infection?
- Where can I find information or support?
Helicobacter pylori is a type of bacteria. These germs can enter your body and live in your digestive tract. After many years, they can cause sores, called ulcers, in the lining of your stomach or the upper part of your small intestine. For some people, an infection can lead to stomach cancer.
Infection with H. pylori is common. About two-thirds of the worlds population has it in their bodies. For most people, it doesnt cause ulcers or any other symptoms. If you do have problems, there are medicines that can kill the germs and help sores heal.
As more of the world gets access to clean water and sanitation, fewer people than before are getting the bacteria. With good health habits, you can protect yourself and your children from H. pylori.
H Pylori As An Infectious Disease
Not until the late 1980s was H pylori recognized as the cause of peptic ulcer disease, which until then accounted for hundreds of thousands of hospitalizations and more than 100,000 surgical procedures each year. Now, peptic ulcer disease is routinely treated by eradicating H pylori. In addition, the World Health Organization has recommended considering H pylori eradication to reduce the risk of gastric cancer, which causes 738,000 deaths worldwide per year.
The problems of how to diagnose and treat H pylori infection were taken on by gastroenterologists, and not by specialists in infectious disease.Even now, almost all the major reviews and consensus statements on H pylori come from gastroenterologists and are published in gastroenterology journals.,,
But infectious diseases differ from most gastrointestinal diseases. In gastrointestinal problems such as constipation or inflammatory bowel disease, the causes are generally unknown, and there is a large placebo response to therapy. In contrast, in infectious diseases, the cause is generally known, there is no placebo response, and treatment success depends on susceptibility of the organism. Failure of proven regimens is generally due to resistant organisms, poor adherence, or, in the case of H pylori, poorly designed regimens in terms of doses, frequency of administration, or duration of therapy.
Current H pylori recommendations may also contribute to the global increase in antimicrobal resistance.
How To Eradicate H Pylori
Helicobacter pylori is a hardy spiral shaped bacterium which multiplies and colonizes in the stomach. H. pylori can survive gastric acids due to its ability to produce an enzyme called urease. Urease neutralizes stomach acid, making it easy for the bacteria to survive in it own acide-free zone.
H. Pylori is the only bacterial organism that can survive in the hydrochloric acid in the stomach.
The bacteria can easily penetrate the stomachs protective mucous lining. It can even trick the stomach into making more stomach acid which makes the stomach lining more susceptible to damage through exposure to acid and pepsin. This can cause stomach ulcers.
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H Pylori Testing: How Can We Find It
A number of H. pylori testing options are available for identifying the presence of an infection. We have listed the main ones below. In our experience, DNA stool testing is the most reliable but is also prone to false negatives infections not showing up on testing like all of the options listed.
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Relationship Between Metabolic Traits And Gut Microbiota Modifications Induced By H Pylori Infection And Therapy
As detailed above, evidence has shown that H. pylori infection as well as its eradication treatment lead to gut dysbiosis. However, despite the fact that gut microbiota is closely linked to metabolic health, the role of gut microbiota in the relationship between H. pylori infection and metabolic dysregulation has been scarcely studied. Several studies from our group, which analyzed gut microbiota from H. pylori infected patients before and after eradication treatment as well as non-infected control patients, addressed this issue . It was found that H. pylori eradication treatment produces specific bacterial shifts associated with changes in glucose homeostasis-related parameters , GLP-1 , ghrelin and HDL-C levels .
Table 3 Relationships between H. pylori eradication therapy-induced bacterial changes and metabolic variables.
To be more specific, changes in the amount of Rikenellaceae, Butyricimonas, E. biforme, B. fragilis, and Megamonas were inversely associated with changes in glucose levels or glucose-related parameters, i.e. HbA1c, in H. pylori subjects after eradication treatment . Several studies have shown that these bacteria are involved in the fermentation of non-digestible carbohydrates and the generation of SCFAs such as acetate, propionate and butyrate . In addition, Rikenellaceae and Butyricimonas members are also able to use the environmental glucose to produce SCFAs, which could contribute to glucose level regulation .
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How H Pylori Makes You Sick
For decades, doctors thought people got ulcers from stress, spicy foods, smoking, or other lifestyle habits. But when scientists discovered H. pylori in 1982, they found that the germs were the cause of most stomach ulcers.
After H. pylori enters your body, it attacks the lining of your stomach, which usually protects you from the acid your body uses to digest food. Once the bacteria have done enough damage, acid can get through the lining, which leads to ulcers. These may bleed, cause infections, or keep food from moving through your digestive tract.
You can get H. pylori from food, water, or utensils. Itâs more common in countries or communities that lack clean water or good sewage systems. You can also pick up the bacteria through contact with the saliva or other body fluids of infected people.
Many people get H. pylori during childhood, but adults can get it, too. The germs live in the body for years before symptoms start, but most people who have it will never get ulcers. Doctors arenât sure why only some people get ulcers after an infection.
What Else Can I Do
If certain foods bother you, do not eat them. You may heal faster if you do not smoke or use aspirin or ibuprofen. Acetaminophen will not hurt your stomach.
Read the full article.
Do you know whats been called the most successful pathogen in human history? Its a type of bacteria known as Helicobacter pylori and its been around for at least two hundred thousand years. And, its actually not uncommon for a person to have this bacteria living inside of them for an entire lifetime and not even know it!
According to the CDC, about 66 percent of the worlds human population is infected with Helicobacter pylori. In developing countries, the numbers are even worse, with up to 80 percent of adults and 10 percent of children likely having a H. pylori infection. If you have this infection, youre actually most likely not to have any symptoms. But, having this bacteria living in your body can make your risk of developing gastric cancer up to six times higher. Plus, H. pylori bacteria is often at the root of other major digestive problems, like peptic ulcers and gastritis. So, not only can H. pylori cause stomach ulcers, it can also cause ulcers in your esophagus or small intestine.
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Outcome Measurements And Follow
Follow-up studies to assess treatment responses were carried out for 1 week for drug compliance and adverse events assessment and 8 weeks later for H. pylori testing by urea breath tests. The primary outcome of this study was the eradication rate by intention-to-treat and per-protocol analyses of the two therapeutic groups. Eradication therapy failure was confirmed after treatment by a positive 13C-urea breath test 8 weeks after treatment. Poor compliance was the failure to finish 80% of all medication due to adverse effects.15,16 The secondary outcomes were drug compliance and adverse events. In the PP analysis, patients who were lost during follow-up or did not follow the protocol or with unknown H. pylori status posttherapy were excluded. Adverse events were compared.
H Pylori Increases The Risk Of Stomach Cancer Especially A Type Called Non
Some stomach cancer cases in the UK are caused by these bacteria. But, as H. pylori infection has become much less common in the UK, stomach cancer rates have dropped.
In the UK, there are other ways to reduce stomach cancer risk that are likely to have a bigger impact than treating H. pylori. This includes stopping smoking, and eating a healthy, balanced diet, high in foods with lots of fibre, like wholegrains, and low in red and processed meat.
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Triple Therapy And Other Treatments For H Pylori
One of the more common treatments for H. pylori is known as triple therapy, which includes 1-2 weeks of three different medications .
- A proton pump inhibitor to reduce stomach acid
Triple therapy has become less successful at treating H. pylori over the past decade. This is mostly because more people are becoming resistant to clarithromycin.
People whove frequently used antibiotics may need different antibiotics, and a second course of treatment may be needed if the first doesnt work .
Summary: The first line of treatment for H. pylori is often triple therapya combination of antibiotics and acid reducers. H. pylori can be difficult to treat, in part because many people have become resistant to clarithromycin, a key antibiotic in triple therapy.
- By Wynne Armand, MD, Contributor
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
In 1982, two Australian scientists discovered that a certain bacterium, Helicobacter pylori, was a common cause of persistent stomach inflammation and stomach ulcers. This realization revolutionized ulcer treatment.
Advice On Taking Nsaids
If your stomach ulcer has been caused by taking NSAIDs, your GP will want to review your use of them.
You may be advised to use an alternative painkiller not associated with stomach ulcers, such as paracetamol.
Sometimes an alternative type of NSAID that’s less likely to cause stomach ulcers, called a COX-2 inhibitor, may be recommended.
If you’re taking low-dose aspirin to reduce your risk of embolism , your GP will tell you whether you need to continue taking it.
If you do need to keep taking it, long-term treatment with a PPI or H2-receptor antagonist may be prescribed alongside the aspirin to try to prevent further ulcers.
It’s important to understand the potential risks associated with continued NSAID use.
You’re more likely to develop another stomach ulcer and could experience a serious complication, such as internal bleeding.
Page last reviewed: 14 January 2022 Next review due: 14 January 2025
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The Prevalence Of H Pylori Infection
In the USA, the weighted mean prevalence of H. pylori infection was 35% , which was lower than that in China. As a developed country, no increasing or decreasing trends in H. pylori infection rate were observed over time in the USA . In an interesting study conducted among 1,200 veterans, 347 were diagnosed with H. pylori infection, and even higher rates of H. pylori infection were observed in Blacks and Hispanics with lower education levels . Although socioeconomic and hygienic conditions have improved recently, disparities in the prevalence of this condition remain among different racial groups. Of 176 American children who were evaluated for H. pylori infection using the 13Câurea breath test , 48 were infected . Herrero et al. investigated the prevalence of H. pylori infection in six Latin American countries, and the rate of H. pylori prevalence was 79.4% among 1,852 eligible adults. Dattoli et al. investigated anti-H. pylori IgG antibody levels in 1,104 Brazilian children, and H. pylori was present in 28.7% .
Taken together, these findings show decreasing rates of H. pylori infection with improvements in socioeconomic and hygienic conditions in most countries . However, the H. pylori infection rate remains high in some areas .
Figure 1. Helicobacter pylori prevalence in populations worldwide.
Detection Of Clarithromycin Resistance
Table 10
Molecular methods for Helicobacter pylori testing of clarithromycin resistance
A recent development is the application of this technology, not to gastric biopsy samples, but to stool samples, which offers a non-invasive method of performing susceptibility testing. Preliminary results have been presented and look promising.
Additional progress for those using the more traditional PCR-RFLP method was the description of a new restriction enzyme allowing detection of the A2142C mutation.
All of the techniques described highlight the fact that mixed infections between clarithromycin susceptible and resistant bacteria are frequent. In a study performed in our laboratory, multiple genotypes were found in 21.1% of cases. Usually the essential part of the bacterial population corresponds to the susceptible genotype, indicating that resistance occurs spontaneously, remains at a low concentration, and is subsequently selected by administration of the drug.
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Sequential Therapy Is Obsolete
Sequential therapy for H pylori infection consisted of amoxicillin plus a proton pump inhibitor for 7 days, followed by clarithromycin, tinidazole, or metronidazole plus a proton pump inhibitor for a further 7 days. This regimen should not be used any more because concomitant therapy will always be superior .
What Kills H Pylori Naturally
There is a protocol that can clear up an H pylori infection and stop symptoms quickly so that you can go back to enjoying life free of constant stomach discomfort:
A combination of raw manuka honey and black seed oil. Yep, a simple, inexpensive treatment may improve your symptoms overnight!
Heres the protocol:
1 tsp per day black seed oil
Thats it. Treatment should last for a minimum of two weeks, until symptoms have cleared. Stomach discomfort may return if a dose is missed.
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Do Antibiotics Cure H Pylori Or Are They A Poor Treatment Option
When you have H pylori, its natural to ask, do antibiotics cure H pylori?
For various reasons, the answer is not as straightforward as you may think and you have a right to learn the truth about this important topic.
Antibiotics cure H pylori in some people, but not in others, and the results depend on several factors such as antibiotic resistance and adherence to the treatment regimen.
Unfortunately, many doctors assume that antibiotics always cure H pylori and this can lead to a lot of confusion.
Fortunately, there are highly effective natural H pylori treatments should antibiotics not be effective for you.
How do antibiotics cure H pylori?
When you are diagnosed with H pylori, your doctor will recommend a course of antibiotics to treat the infection.
The standard H pylori antibiotic treatment is called triple therapy.
It consists of two separate antibiotics taken alongside a proton pump inhibitor, which reduces your stomach acid level and makes the antibiotics more effective.
The specific antibiotics included in the treatment include any two of the following:
This regimen is usually taken for 7, 10 or 14 days, depending on which country you live in.
How well do antibiotics cure H pylori?
Do antibiotics cure H pylori when taken properly? Not always.
This means that for every 10 people taking H pylori antibiotics, 3 people do NOT clear their H pylori infection.
The good news
Best,
Detection Of Metronidazole Resistance
An interesting approach based on the detection of the RdxA protein by immunoblotting with specific rabbit anti-RdxA antibodies has been proposed. A 24 kDa immunoreactive band corresponding to the RdxA protein is observed in all metronidazole susceptible isolates while it is not found in most metronidazole resistant isolates. However, this band was present in approximately 10% of metronidazole resistant isolates in the two studies performed. Complementary experiments proved that these isolates contained mutations associated with inactivation of the rdxA gene.
Despite this limit, this new approach looks promising, given the high discrepancies observed when using different phenotypic methods and even the lack of reproducibility with a given method.
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Antibiotic Treatment For Helicobacter Pylori: Is The End Coming
Correspondence to: Jun-Won Chung, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, Gachon University, Gil Medical Center, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon 405-760, South Korea.
Telephone: +82-32-4603778 Fax: +82-32-4603408
Prevalence Of H Pylori Resistance To Rifabutin
The prevalence of H pylori resistance to this group of antibiotics is not known but is probably extremely low as these drugs, until recently, were used only in a limited number of patients to treat mycobacterial infections. For example, Heep et al did not find a single resistant strain from 81 tested in 1999 in Germany and nor did Fujimura et al among 52 strains in Japan. However, the use of these drugs could also lead to the emergence of resistant strains, as was observed in one case of treatment failure. Again, resistance is due to point mutations in the rpoB gene, as for other bacteria, and concerns all rifamycin drugs.
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How To Choose A Therapy
Since rational infectious-disease therapy is based on susceptibility, one should start by considering the susceptibility pattern in the local population and, therefore, the likely susceptibility in the patient in front of us.
Unfortunately, we do not yet have local or regional susceptibility data on H pylori for most locales. Until those data are available, we must use the indirect information that is available, such as the patients history of antibiotic use.
Other Supplements To Consider
In addition to learning how to treat H pylori with honey and black seed oil and changing your diet, you may want to incorporate some supplements that support digestive health.
Probiotics- we like these because they are gentle, allergen-free, and effective. Plus, one tiny bottle lasts for months and months for multiple people! Probiotics help to repopulate your gut with good microbes so that undesirable ones die out.
Digestive enzymes- if an H Pylori infection is impairing your digestion, especially if youre experiencing indigestion and heartburn, you may need to try digestive enzymes. Those with ulcers should not take enzymes with HCL. These enzymes will help to break down sugars, fats, proteins, and carbohydrates.
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