From the Guidelines
Helicobacter pylori infection often causes no symptoms, but when it does, the most common include burning or gnawing abdominal pain, nausea, bloating, burping, loss of appetite, and unintentional weight loss, as reported in the most recent study 1. The symptoms of H. pylori infection can vary widely, and some people may experience bad breath, heartburn, or vomiting. H. pylori can lead to peptic ulcers, which may cause more severe pain and potentially dangerous complications like bleeding ulcers (indicated by black, tarry stools or vomiting blood) 1.
Common Symptoms
- Burning or gnawing abdominal pain (particularly between meals or at night)
- Nausea
- Bloating
- Burping
- Loss of appetite
- Unintentional weight loss
- Bad breath
- Heartburn
- Vomiting Diagnosis typically requires breath tests, blood tests, stool tests, or endoscopy with biopsy, and the choice of test should reflect the clinical indication, local availability, and costs of the different tests, as well as patient preferences 1.
Diagnosis
- Breath tests
- Blood tests
- Stool tests
- Endoscopy with biopsy It is essential to note that serologic tests remain positive long after the infection has been eradicated, and therapeutic decisions should not entirely rely on the results of serologic testing 1. Treatment involves "triple therapy" combining two antibiotics with a proton pump inhibitor for 10-14 days, as recommended in the most recent guidelines 1. After treatment, follow-up testing is recommended to confirm the infection has been cleared, as H. pylori is associated with increased risk of stomach cancer if left untreated long-term 1.
From the Research
Symptoms of Helicobacter pylori (H. pylori) Infection
The symptoms of H. pylori infection can vary, but some common symptoms include:
- Dyspepsia 2, 3
- Peptic ulcer disease 2, 3
- Gastric cancer 2, 3
- Uninvestigated and functional dyspepsia 2
- Ulcer risk in patients taking low-dose aspirin or starting therapy with a non-steroidal anti-inflammatory medication 2
- Unexplained iron deficiency anemia 2
- Idiopathic thrombocytopenic purpura 2
- Recurrent abdominal pain 4
- Chronic gastritis 4
- Duodenal ulcerations 4
Diagnosis and Treatment
Diagnosis of H. pylori infection can be performed using endoscopic-based methods and noninvasive diagnostic tests, such as urea breath test and fecal antigen 5. Treatment regimens are based on the combination of proton-pump inhibitor and two or more antibiotics, for 7-14 days, depending on resistance rates of geographic areas 5.
Specific Patient Groups
In pediatric patients, applications of noninvasive tests are limited to verifying eradication after therapy and to investigating the presence of infection in asymptomatic patients with first-degree relatives affected by gastric cancer 5. In patients with recurrent abdominal pain, H. pylori infection may be associated with gastritis and treatment with antimicrobial therapy can result in eradication of the infection and improvement of clinical symptoms 4.