Helicobacter pylori (H. pylori) is a spiral-shaped bacterium that colonizes the stomach lining. Gastritis describes a condition where the stomach lining becomes inflamed. When H. pylori infects the stomach, it can lead to this inflammation, known as H. pylori gastritis. This bacterium is widespread, affecting over half the global population and can persist for a lifetime if untreated, causing chronic inflammation.
Causes and Transmission of Helicobacter Pylori
H. pylori infection is most commonly acquired during childhood. The bacterium primarily spreads from person to person through direct contact with saliva, vomit, or fecal matter, often within families. Contaminated food or water also serves as a route for acquiring H. pylori, especially in unsanitary conditions. Risk factors include crowded environments, poor sanitation, or lack of clean drinking water.
Signs and Symptoms of Gastritis
Many individuals infected with H. pylori experience no symptoms. When symptoms do manifest, they typically relate to stomach lining inflammation. Common signs include a dull or burning ache in the upper abdomen, which may worsen when the stomach is empty and sometimes improves after eating. Other frequent symptoms include nausea, bloating, and frequent burping. Loss of appetite or unintentional weight loss may also occur.
The Diagnostic Process
Healthcare providers employ several diagnostic methods to confirm an H. pylori infection, often starting with non-invasive tests. One common method is the urea breath test, where a patient swallows a substance with tagged carbon. If H. pylori is present, its urease enzyme breaks down urea, releasing tagged carbon detected in exhaled breath. Another non-invasive option is the stool antigen test, which identifies H. pylori antigens in a stool sample.
For more direct assessment, an upper endoscopy may be performed, especially if other digestive conditions are suspected or if symptoms are severe. During this procedure, a flexible tube with a camera inspects the stomach lining and small intestine. Tissue samples (biopsies) can be collected during endoscopy and analyzed for H. pylori.
Standard Medical Treatments
Treatment for H. pylori infection typically involves a combination of medications to effectively eliminate the bacteria and promote healing of the stomach lining. This approach often includes at least two different antibiotics to target the bacterium, alongside an acid-suppressing medication. Common antibiotic choices include amoxicillin, clarithromycin, metronidazole, tetracycline, or rifabutin. These are chosen to reduce the likelihood of antibiotic resistance developing against a single drug.
Acid-suppressing medications, such as proton pump inhibitors (PPIs) like omeprazole, lansoprazole, or pantoprazole, are usually prescribed. PPIs work by blocking the production of stomach acid, which helps the inflamed stomach lining or any ulcers to heal. In some cases, bismuth subsalicylate may be added to the regimen, as it coats and protects the stomach lining. Completing the entire course of prescribed medication, which typically lasts 10 to 14 days, is important to ensure the infection is fully eradicated and to minimize the chance of recurrence.
Complications of Untreated Infections
Leaving H. pylori infections untreated can lead to several long-term health problems. One of the most common complications is the development of peptic ulcers, which are open sores that form on the lining of the stomach or the first part of the small intestine. These ulcers can cause persistent abdominal pain and, in severe instances, may lead to bleeding, perforation of the stomach wall, or blockages. Approximately 10% to 15% of individuals with H. pylori infection will develop an ulcer.
Beyond ulcers, chronic H. pylori infection is a known risk factor for certain types of stomach cancer. While only a small percentage of infected individuals develop gastric cancer, the bacterium significantly increases this risk over time. The persistent inflammation caused by the infection can alter stomach cells, potentially progressing to conditions like atrophic gastritis, which is a precursor to some gastric cancers.