Understanding Helicobacter Pylori Infection – H.Pylori

What is H.Pylori

In my recent travels, I went to a restaurant with a colleague and as we were making our orders for breakfast, she said that she will only have a cup of black tea. I wondered why she did not want to have something ‘heavier’ or more and she informed me that she is currently on medications for H.Pylori – a common illness that I have heard over the past couple of months.

So, I decided to go out and understand what this illness is.

What is H.Pylori

Helicobacter pylori (H. pylori) is a corkscrew-shaped bacteria that was identified in 1982 as a principal cause of stomach ulcers and chronic gastritis, conditions which were formerly believed to be caused by stress and poor diet.

H.Pylori is believed to be present in the upper gastrointestinal tract of around 50 percent of the world’s population. Of these, over 80 percent of cases are entirely without symptoms. Of those who are symptomatic, an H. pylori infection is associated with an increased risk of stomach cancer.

While an H. pylori infection typically requires combination antibiotic therapy, growing rates of antibiotic resistance have made eradication of the bacteria all the more difficult.

Symptoms

Symptoms of H. pylori may include stomach pain, bloating, nausea, tarry stools, belching, loss of appetite and vomiting.

Causes

H.Pylori is a microaerophilic bacterium, meaning that it requires little oxygen to survive. While the bacteria is contagious, it is still not entirely clear how it is spread. Most evidence suggests that it is transmitted via an oral-oral route (through the direct or indirect exchange of saliva) or a fecal-oral route (through contact with unsanitized hands or surfaces, or the drinking of contaminated water).

Diagnosis

H.Pylori can usually be diagnosed with one of three minimally invasive tests:

  • Blood antibody tests can detect whether specific defensive proteins, known as antibodies, have been produced by the immune system in response to the bacteria.
  • Stool antigen tests look for direct evidence of the infection in a stool sample by detecting a specific protein, known as an antigen, on the surface of the bacteria.
  • Carbon urea breath tests are performed by breathing into a prepared packet 10 to 30 minutes after swallowing a tablet containing urea (a chemical comprised of nitrogen and a minimally radioactive carbon).

Treatment

Antibiotics

  • First–line therapy involves a 14-day course of the antibiotics clarithromycin and amoxicillin used in combination with an oral PPI.
  • Second–line therapy would involve a 14-day course of the antibiotics tetracycline and metronidazole, an oral PPI, and bismuth subsalicylate tablets (such as chewable Pepto-Bismol) which help protect the stomach lining.
  • Sequential therapy involves two separate courses of therapy. The first is conducted over five days with amoxicillin and an oral PPI. This is followed by a second five-day course comprised of clarithromycin, amoxicillin, and an oral PPI.

Coping

Avoid aspirin and other drugs that can cause stomach irritation and promote gastric bleeding.

Avoid caffeine, acidic foods, spicy foods, and carbonated beverages. Instead, focus on high-fiber fruits and vegetables, plain chicken and fish, and probiotic foods like yogurt and kombucha.

Explore stress reduction techniques that may help temper the production of stomach acid. These include mindfulness meditation, guided imagery, Yoga and progressive muscle relaxation (PMR).

Stay well hydrated, drinking around eight 8-ounce glasses of water per day. This may help dilute stomach acid.

Exercise can improve your energy levels and sense of well-being. But avoid overexerting yourself or performing exercises that either jostle or compress the stomach. Moderation is key.