Helicobacter Pylori
What are the symptoms?
In most people Helicobacter pylori does not cause symptoms. It can however cause a low level of inflammation in the stomach known as ‘gastritis’, which may result in symptoms of abdominal pain, nausea and bloating.
There are however two serious complications of long term Helicobacter infection:
(i) stomach ulcers – these can occur many years after the initial infection and tend to occur close to the junction of the stomach and small bowel. Life threatening bleeding or perforation can be a consequence.
(ii) stomach cancer which develops because of the long term irritation the helicobacter causes to the stomach lining. In response to this irritation the lining of the stomach progresses through ‘changes’ to become more and more abnormal, called ‘metaplasia / dysplasia’, to eventually turn cancerous. The risk of cancer is also affected by a person’s genetics, diet, environment and geographical location.
How do you diagnose?
A Breath Test – this is a pathology test performed by swallowing a capsule containing 13C Urea and then blowing into a balloon. This test can be used to initially diagnose Helicobacter and to confirm clearance after treatment.
A blood test – this detects your body’s antibodies against Helicobacter, however does not tell you if you have an active infection or not. It simply indicates if you have been exposed to H. pylori before.
A stomach biopsy – this can be taken during gastroscopy and allows the organism to be seen directly under the microscope.
A faecal ‘poo’ sample – this identifies parts of the Helicobacter organism that have been shed from the stomach lining and passed through into your faeces.
How do you treat?
Given Helicobacter pylori is known to cause both stomach ulcers and stomach cancer, we recommend that anyone with evidence of an active H. pylori infection undergo treatment. This involves taking a combination of medications including 2 to 3 types of antibiotics as well as an ‘acid suppressing’ medication. Most courses of treatment last between 7 – 10 days and are approximately 75-90% effective at eradicating the infection.
After taking a course of treatment it is important to confirm its success with additional testing (Breath Test at least 4 weeks after completing treatment).
Sometimes H. pylori is stubbornly resistant to the common antibiotic protocols. In these cases, a sample of the bacteria through gastroscopy from the patient’s stomach is test in the lab for antibiotic resistance so that a personalized antibiotic plan can be made to get rid of the bacteria.