From the Guidelines
Helicobacter pylori infection often presents with no symptoms at all, but when symptoms do occur, they typically include burning or gnawing abdominal pain, nausea, bloating, belching, unintentional weight loss, and loss of appetite, as reported in a recent study 1.
Common Symptoms
- Burning or gnawing abdominal pain (particularly between meals or at night)
- Nausea
- Bloating
- Belching
- Unintentional weight loss
- Loss of appetite Some patients may experience more severe symptoms like vomiting, dark or tarry stools, or vomit that contains blood, which can indicate ulceration or bleeding in the stomach or duodenum 1.
Diagnosis and Treatment
H. pylori is a spiral-shaped bacterium that colonizes the stomach lining and releases enzymes and toxins that damage the protective mucous layer, allowing stomach acid to irritate the sensitive lining beneath. This bacterial infection is the primary cause of peptic ulcers and increases the risk of gastric cancer. The infection is typically diagnosed through breath tests, blood tests, stool tests, or endoscopy with biopsy 1.
Importance of Early Detection
If you experience persistent abdominal pain or other digestive symptoms, especially if accompanied by signs of bleeding, you should seek medical attention promptly for proper diagnosis and treatment, which usually involves a combination of antibiotics and acid-reducing medications for 10-14 days 1.
Key Considerations
- The diagnostic strategy utilized should reflect not only the clinical indication but also the local availability and costs of the different tests, as well as patient preferences 1.
- Noninvasive tests for active infection include the UBT and the stool antigen test, which are susceptible to any action that decreases the bacterial load in the stomach, such as use of antibiotics, bismuth, or proton pump inhibitors (PPIs) 1.
From the Research
Signs and Symptoms of H. pylori Infection
The signs and symptoms of Helicobacter pylori (H. pylori) infection can vary, but common manifestations include:
- Peptic ulcer disease (PUD) 2
- Dyspepsia 3
- Gastritis 3
- Gastric ulcer 3
- Duodenal ulcer 4, 5
- Erosive gastritis 3
- Erosive duodenitis 3
- Functional dyspepsia 3, 4
Diagnosis and Treatment
Diagnosis of H. pylori infection can be made using various methods, including:
- Urea breath test 2, 3
- Stool antigen test 2
- Serologic tests 2
- Endoscopy with biopsy 3, 5
- Histology 3, 5
- Culture 3, 5
Treatment of H. pylori infection typically involves a combination of antibiotics and a proton pump inhibitor, such as:
- Metronidazole, omeprazole, and clarithromycin 6
- Pantoprazole, clarithromycin, and metronidazole 3
- Omeprazole, amoxycillin, and clarithromycin 4
- Omeprazole, amoxycillin, and metronidazole 4
- Pantoprazole, clarithromycin, and amoxicillin 5
Complications
If left untreated, H. pylori infection can lead to complications such as: