Helicobacter Pylori ABC

Did you know that almost half of the world has a bacteria called Helicobacter pylori (H. pylori) in their stomach? This is very common, typically with no noticeable effect on your everyday life. However, in some people, the H pylori bacteria can cause a lot of upset stomachs.

H. pylori infection usually occurs in childhood (though some are at higher risk than others), and remains asymptomatic in most people throughout their lives. When it does cause trouble, it is associated with stomach ulcers (peptic ulcer disease), and can be a risk factor for stomach cancer in those affected. This does not mean you should rush to your doctor for testing if you have no symptoms. In fact even in people who show signs of infection, there is minimal cancer risk if treated with a short course of medications.

So how do you know you have H pylori? Here is an example.

You wake up in the morning, maybe with a nagging cough. Your mouth tastes bitter. As you eat each meal, your chest burns, and you feel bloated and uncomfortable. The acid rushes back up into your throat, burning as it trickles back down to the stomach. You are nauseated, burping, perhaps embarrassed to even be near your friends for a meal. You regularly chew on over the counter antacid medications for some minor relief, and you cannot remember the last time you tried that spicy taco sauce at your favorite Mexican restaurant, for fear of hours of agony. Maybe there was even a time you noticed your stools turned tarry-black and you vomited dark, almost coffee-ground like material. You brushed it off and avoided those triggering foods, but the symptoms still come, daily and frequently.

The above symptoms do not guarantee you have H. pylori without testing, but they certainly warrant a visit to the doctor. Since H. pylori is just one of the causes of ulcer disease and reflux, your doctor will likely try a medication to block acid first and advise you to avoid eating trigger foods or eating before bedtime. If this does not work, or you fall into a higher risk group, they may test your stool or blood, or even perform an EGD (esophagogastroduodenoscopy, or looking at the stomach and throat with a camera) to test for the bacteria. If positive, you will need to take a 2 week course of 3-4 medications, including an acid blocker, 2 antibiotics, and possibly some bismuth. The symptoms should heal up quickly if the bacteria is to blame, and many people do not have issues afterwards.

Never wait if you are bleeding, losing a lot of weight unintentionally, or having troubles swallowing. These can be signs of more worrisome issues. You are not alone in your symptoms, so if in doubt, ask.