H. Pylori Infection

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Your doctor has determined that you are infected with Helicobacter pylori bacteria, which is a relatively common condition. In the U.S., some 20% of people under the age of 40 and half of those over age 60 are infected with H. pylori.

About the Condition

The stomach is a hollow, muscular pouch in the upper-left region of the abdomen, typically 10 inches long in adults. Its main purpose is to process and store food. The walls of the stomach contain layers of muscles and glands that produce enzymes and gastric acid to aid in digestion. A protective and sticky mucous coating normally protects the walls of the stomach from its own corrosive acid.

H. pylori are spiral-shaped bacteria that are found in the stomachs of infected persons and can be transmitted between people. These bacteria are the cause of most cases of chronic stomach inflammation (gastritis) as well as ulcers, or sores, in the lining of the stomach and the duodenum, which is the top part of the small intestine. In addition, H. pylori infection increases the risk of stomach cancer if left untreated.

Although common in the U.S., H. pylori infection occurs more often in developing countries. It is estimated that more than 65% of people in the world are infected with the bacteria, although most of them never suffer any symptoms. Certain factors increase a person's risk for developing ulcers from H. pylori, including:

•  Genetic inheritance of certain strains of the bacteria
•  Abnormal intestinal immune response
•  Lifestyle habits such as smoking

H. pylori infection causes ulcers to form when the bacteria weaken the protective coating of the stomach or duodenum, allowing gastric acid to penetrate. The acid and bacteria both irritate the organ's lining, resulting in sores. Often the stomach produces more acid in response, which leads to further irritation.

Although the majority of ulcers are caused by H. pylori infection, they can also be caused by the use of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.

Treatment Options

The typical treatment plan for H. pylori infection uses medication to eliminate the bacteria causing the infection and includes one or more other drugs to protect the stomach lining and reduce symptoms such as excess acid secretion. The following treatment possibilities are available:

Antibiotics Antibiotics are commonly used to kill the bacteria causing H. pylori infection. In most cases, two different antibiotics are prescribed along with a proton pump inhibitor, called triple therapy, which is a very effective method that kills the bacteria nearly 90% of the time.

Acid Blockers Acid-blocking medications — often referred to as histamine or H2 blockers — work by decreasing the amount of acid the stomach produces. Some are available over the counter (OTC); others require a prescription.

Proton Pump Inhibitors A more powerful way to suppress gastric acid is to block the stomach's ability to secrete it with drugs that stop the action of acid "pumps" within specific stomach cells. These proton pump inhibitors also seem to hinder the activity of H. pylori bacteria.

Coating Agents A different type of medication helps protect the tissues that line the stomach and small intestine. These coating agents are often recommended for patients who take NSAIDs regularly. Stomach coating drugs are available by prescription and over the counter. One such OTC medication is bismuth subsalicylate, which also appears to inhibit H. pylori activity.

Once the H. pylori bacteria are eliminated after treatment, the chance of recurrence is very low. Additionally, researchers are working to develop a vaccine to prevent H. pylori infection.

What You Can Do

To reduce any symptoms of H. pylori infection that you may have and prevent other digestive problems, you should avoid potential stomach irritants such as smoking, caffeine and alcohol. You can also eat smaller, more frequent meals to buffer stomach acid secretion. Be sure to wash your hands thoroughly too, especially at mealtimes and after using the bathroom, since H. pylori bacteria are contagious.

In addition, pain relievers containing acetaminophen are generally recommended to use instead of aspirin and NSAIDs. Talk with your doctor about what prescription and OTC medications are best for your individual situation. Also be sure to tell your doctor if your symptoms get worse or linger.

Additional Resources

American College of Gastroenterology, 301.263.9000, http://www.acg.gi.org/
Digestive Diseases Information Clearinghouse, 800.891.5389, http://www.digestive.niddk.nih.gov/

This patient resource sheet is provided to you as a service of CBLPath® and is intended for information purposes only. It may not fully describe all aspects of your diagnosis and is not meant to serve as medical advice or a substitute for professional medical care. Your physician can provide you with a thorough explanation of your diagnosis and appropriate treatment options, which may vary. Only you and your physician can determine your best treatment plan.

Updated 9.07