Helicobacter pylori (H. pylori) is a bacterium commonly found in the stomachs of about one-half of the world's population. Most of the time, H. pylori infection does not cause any problems but for some people, H. pylori infection can cause digestive problems, including ulcers and, less commonly, stomach cancer.
Treatment for H. pylori infection usually involves taking two antibiotics along with a proton pump inhibitor (PPI) to reduce the risk of treatment failure and antibiotic resistance for 14 days.
Many patients with H. pylori have an infection that is resistant to antibiotics, so it is important for patients to take the entire course of all medications prescribed.
After H. pylori treatment is completed, repeat testing is recommended to ensure the infection is gone. Repeat testing is usually performed with a breath or stool test.
What Are Symptoms of H. pylori?
H. pylori infection usually does not cause any symptoms or problems for most people. For those who develop ulcers due to H. pylori infection, early symptoms of ulcers include:
- Pain or discomfort in the upper abdomen
- Feeling full after eating a small amount of food
- Nausea
- Vomiting
- Belching (burping)
- Bloating
- Gas
- Loss of appetite
Later symptoms of stomach ulcers include:
- Severe abdominal pain
- Dark or black-colored stools
- Ulcers that bleed can cause a low blood count (anemia)
- Fatigue
- Unusual weight loss
- Shortness of breath
What Causes H. pylori?
H. pylori is a bacterial infection believed to be spread by consuming food or water contaminated with fecal matter, swimming in contaminated bodies of water, or oral/oral exposure (such as kissing or sharing toothbrushes).
It is not known why some people with H. pylori develop problems while others do not.
How Is H. pylori Diagnosed?
H. pylori infection is diagnosed with a patient history and physical examination, and tests that may include:
- Blood tests
- Stool tests
- Breath tests (urea breath tests)
- Biopsy of tissue from the lining of the stomach
- Endoscopy
What Is the Treatment for H. pylori?
Treatment for H. pylori infection usually involves taking a few different medications for 14 days.
- Proton pump inhibitors (PPIs) to decrease the stomach acid production
- Dexlansoprazole (Dexilant)
- Lansoprazole (Prevacid)
- Omeprazole (Prilosec)
- Pantoprazole (Protonix)
- Rabeprazole (aciphex)
- Esomeprazole (Nexium)
- Two antibiotics are usually recommended along with a PPI to reduce the risk of treatment failure and antibiotic resistance
- Bismuth quadruple therapy: bismuth subsalicylate, metronidazole, tetracycline, and a PPI given for 14 days
- Clarithromycin triple therapy: clarithromycin, amoxicillin, and a PPI, all given twice daily for 14 days
- Concomitant therapy: a clarithromycin, amoxicillin, a nitroimidazole (tinidazole or metronidazole), and a PPI administered together for 10 to 14 days
- Hybrid therapy: amoxicillin and a PPI for seven days followed by amoxicillin, clarithromycin, a nitroimidazole, and a PPI for seven days
- Levofloxacin triple therapy: levofloxacin, amoxicillin, and a PPI for 10 to 14 days
- Levofloxacin sequential therapy: amoxicillin and a PPI for five to seven days followed by levofloxacin, amoxicillin, a nitroimidazole and a PPI for five to seven days
- Levofloxacin quadruple therapy: levofloxacin, omeprazole, nitazoxanide, and doxycycline (LOAD) for 7 or 10 days (additional studies are needed to confirm the efficacy of this regimen and its cost-effectiveness)
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https://www.uptodate.com/contents/h-pylori-infection-the-basics?search=H.%20pylori&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.medscape.com/answers/176938-44719/what-are-possible-complications-of-helicobacter-pylori-h-pylori-infection
https://www.uptodate.com/contents/bacteriology-and-epidemiology-of-helicobacter-pylori-infection?search=H.%20pylori&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4#H5
https://www.uptodate.com/contents/helicobacter-pylori-infection-and-treatment-beyond-the-basics#H15