H Pylori

Is H Pylori Contagious?

Given the prevalence of H pylori infection, many people want to know.. is H pylori contagious? With such high infection rates, what can I do to prevent myself or my child from catching it?


About H Pylori

If you did not know already, Helicobacter pylori (typically abbreviated as H pylori) is a bacterium which makes its home in the human stomach and intestines. It burrows itself in the lining and once there it can complete its entire life-cycle. In other words, once in place, H pylori can live inside of our digestive tract for our entire lifetime.

The problem with this bacterium is that it causes Helicobacter pylori gastritis, an inflammation of the stomach lining, which may lead to stomach ulcer symptoms and ultimately ulcers or even gastric cancer in old age.

By now you must be wondering, how do you catch H pylori? And if you do have it, is H pylori contagious?


Is H Pylori Contagious?

The true answer to this is that we do not really know how H pylori is spread from one person to another. We do however know four important things about it which can help us come up with ways to protect yourself and your loved ones from this infection:

1. If one person in a family has H pylori, is is likely that everyone in the household is infected.

This makes us want to believe that H pylori is contagious if it seems to spread in the family. Given that it does not seem to spread with casual contact, the most commonly suspected vector of transmission is via fecal matter. Note that this suspicion is also due to the fact that most digestive tract diseases (such as E. coli) are transmitted via fecal matter.

Before you dismiss that vector of transmission, think about someone using the bathroom and not washing their hands adequately, then preparing food for the family or even putting their hands in a bag of chips that the rest of the family eats out of.

However, this may not be the case. It could be just that all family members partook in a certain event, such as traveling abroad or drinking contaminated water (see below).

2. H pylori is much more prevalent in developing nations (once called “third-world countries”) than it is modernized countries.

There is a strong correlation between lack of a good sewage system and H pylori rates. In many developing nations, the majority of the population has H pylori. In more industrialized nations, less than half have H pylori. This is more evidence that H pylori may spread from fecal contamination.

3. H pylori can be found in the drinking water in developing nations.

Many developing nations do not treat H pylori as re-infection via drinking water is practically guaranteed. H pylori is usually not treated in these nations unless necessary, such as in the case of an advanced ulcer. Gastritis is frequently not considered a medical condition in places where medical care is not widely available.

4. If you catch H pylori once, you are much more likely to catch it again, particularly if you live in a third-world nation.

This is in part due to the drinking water and lack of a sewer system. However, this also could be that family members who have the infection but do not know it are passing it on to their relatives.


The Bottom Line

The bottom line is that while we do not know if H pylori is contagious, we do know that there are certain risk factors for contracting it:

  • Not practicing good hygiene
  • Having a family member with H pylori
  • Traveling in developing nations

You can mitigate your and your loved ones risks of catching H pylori by practicing good hygiene (always washing hands before eating and after using the bathroom) and by avoiding travelling in developing nations.

If you do end up traveling or if another member of your household tests positive for H pylori, you could always get tested. Ask your doctor about a H pylori test, particularly the urea breath test; a non-invasive, inexpensive, and quite accurate test for H pylori infection.

The African Enigma: What Do We Really Know About Ulcers?

In this feature article on stomach ulcer symptoms, we are going to dig into perhaps the most influential, controversial, and innovative study on ulcers in the 25 years. The paper, entitled Helicobacter pylori: the African enigma, manages to challenge everything we thought we knew about Helicobacter pylori and ulcers in just two short pages.


A History of Helicobacter Pylori

We believe that most ulcers are caused by H pylori infection. This bacteria, which lives in the stomach and intestines, has been pegged as being the cause of most upper-gastrointestinal diseases, including ulcers and cancer. In western nations, if you come to the doctor with stomach ulcer symptoms, the most common response is the test-and-treat model, which involves testing for H pylori and treating it if it is positive; endoscopies and barium swallows (an imaging test) are now much less commonly performed.


The Author’s Findings

The premise of this ground-breaking article is simple: nearly everyone who lives in Africa tests positive for H pylori infection, yet ulcer rates are no higher than in western nations (1). In fact, in many cases they are much lower! Additionally, gastric cancer, which is attributed to H pylori, is virtually non-existent in Africa (1). By contrast, in 2007 it was estimated that 66,000 U.S. citizens will contract stomach cancer (2). This inexplicable lack of relationship between H pylori infection and gastrointestinal disease on the content of Africa has been dubbed “the African enigma”.

Why are people living on the continent of Africa so much less likely to experience an ulcer and cancer despite H pylori being ubiquitous? When we can answer that question, we will have come a long way in our approach to preventing both ulcers and gastric cancer.


Why H Pylori Does Not Cause Ulcers in All Africans

One unusual reason why Africans may not get ulcers in response to H pylori infection proposed by the author is that Africans seem to produce less stomach acid when infected by H pylori, whereas westerners seem to produce more (1). Indeed, advances in genetic mapping since the time of the study have found that individuals with a certain gene may benefit from H pylori infection, as it reduces acid production and significantly reduces occurrence of gastroesophageal reflux disease (3).

While an interesting thought, our current technology and the burgeoning expenses of modern medicine cannot support genetic mapping and individualized treatment protocols until advances in technology make such a procedure affordable.


Other Proposed Mechanisms

There are several other proposed reasons why Africans may not be negatively affected by H pylori, including differences in H pylori strains, the idea that H pylori infections in children may be less harmful (not unlike chicken pox), and environmental and social factors may come into play.

The most interesting thing finding of these other mechanisms was that certain diets may be protective against H pylori. The diets of populations which seem to be protected from ulcers consists heavily of millet (a seed rarely grown or eaten in Western nations) and various legumes (1). Millet is a tiny seed, not very flavorful, and is thought to be one of the oldest grains consumed by humans. It was largely replaced by rice as civilizations advanced, but some pockets of the world still consume this crop. These same pockets also seem to have lower ulcer rates (1).


Overall Implications and Future Research

The most important thing about the African enigma is to realize that H pylori infection alone may not be enough to cause ulcers and cancer. Other factors, both genetic and environmental, may be at play. As future research is able to isolate these factors, we may be able to refine the approach we use to treat these conditions and develop methods for preventing ulcers and gastric cancer from occurring in the first place.

References

1. Holcombe, C. Helicobacter pylori: the African enigma. Gut. 1992 Apr;33(4):429-31.

2. Altekruse SF, et al. SEER Cancer Statistics Review, 1975-2007, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2007/.

3. Ghoshal UC, Chourasia D. Gastroesophageal Reflux Disease and Helicobacter pylori: What May Be the Relationship? J Neurogastroenterol Motil. 2010 Jul;16(3):243-50.

H Pylori Test and Treat: Pros and Cons

In recent years, the “test and treat” model has become increasingly popular for the treatment of H pylori and other stomach illnesses.


What Test and Treat Means

The test and treat model was developed in order to help cut down on the health costs associated with dyspepsia (the medical term for chronic stomach pain and (or) indigestion).

The idea is that H pylori is behind most infections, so if someone comes to the doctor with stomach ulcer symptoms, it is much cheaper for the patient if the doctor opts straight for an H pylori test (and subsequent treatment if the test is positive) than it is for him to investigate for an ulcer.


Traditional Approach versus Test and Treat

In order to understand the test and treat approach, it is easier to compare it to the traditional approach to see how the treatment of ulcers and dyspepsia has changed.


Traditional Approach

  • Patient reports to doctor with symptoms of dyspepsia or a peptic ulcer, such as stomach pain, indigestion, burning pain
  • The doctor orders and endoscopy to investigate for the presence of ulcers or another abnormality
  • If an ulcer was found, an H pylori test would be ordered
  • If H pylori was found, then a treatment plan would be administered for its elimination, typically triple therapy


Test and Treat

  • Patient reports symptoms of dyspepsia or ulcer, is otherwise relatively healthy (no symptoms of bleeding) and young (under 45-55; depending on various risk factors)
  • Doctor orders H pylori test
  • If H pylori test is positive (most of the time it is), triple therapy or another treatment plan is ordered

As you can see, the test and treat approach involves removing the endoscopy from the procedure as this saves the patient a lot of money and pain and suffering, as the end result is typically the same: H pylori infection is usually found and treated.


Results of Research

Several large-scale meta-analyses have been performed investigating the efficacy and cost of the test and treat procedure. One study found that there was no difference between the two treatments and remarked that physician and patient preference should decide (1). To the contrary, another group of researchers found that the Test and Treat model offered significant savings over the traditional approach, and an initial endoscopy for dyspepsia was not a cost effective solution (2).

The largest study found that while the traditional approach has slightly better results in the long-term, test and treat saved patients on average nearly $400 (3).


Test and Treat Conclusion

As a patient, you should discuss both options with your doctor. The major pro of an endoscopy is mildly increased accuracy (and hence more accurate treatment), with the major con of being expensive.

References

1. Mahadeva S, Chia YC, Vinothini A, Mohazmi M, Goh KL. Cost-effectiveness of and satisfaction with a Helicobacter pylori “test and treat” strategy compared with prompt endoscopy in young Asians with dyspepsia. Gut. 2008 Sep;57(9):1214-20.

2. Ford AC, Moayyedi P, Jarbol DE, Logan RF, Delaney BC. Meta-analysis: Helicobacter pylori’test and treat’ compared with empirical acid suppression for managing dyspepsia. Aliment Pharmacol Ther. 2008 Sep 1;28(5):534-44.

3. Ford AC., et al. Helicobacter pylori “test and treat” or endoscopy for managing dyspepsia: an individual patient data meta-analysis. Gastroenterology. 2005 Jun;128(7):1838-44.

Triple Therapy for H Pylori

H pylori is a bacterium that colonizes the stomach and is the leading cause of peptic ulcers. H pylori also has been linked to increased rates of gastric cancer. As a result, once an H pylori infection is detected, medication is usually prescribed to eradicate it. The most popular combination of drugs is known as triple therapy.


Triple Therapy for H Pylori

Unlike many other bacterial infections, H pylori requires a course of several medications to be eradicated. H pylori is a survivor; it has adapted to live in the harsh conditions of the stomach and also has adapted to the use of regular antibiotics. As a result, several medications are used together in a treatment plan commonly called triple therapy.


Triple Therapy Medications

Triple therapy typically consists of two antibiotics and one proton-pump inhibitor. The two antibiotics are used to take out H pylori whereas the proton-pump inhibitor promotes healing of damaged tissue in the stomach. The usage of a proton-pump inhibitor is also thought to weaken H pylori.

The actual choice of medications varies from region to region and doctor to doctor. Many types of antibiotics and proton-pump inhibitors have proven to be effective in H pylori treatment.

The combination approach is used because a single antibiotic is not effective at combating H pylori. In fact, one study attempted to replace one of the antibiotics with fish oil and the success rate for treatment dropped from over 80% to under 40% (1).


Triple Therapy for H Pylori Success Rate

As you can see from the study above, triple therapy for H pylori does not have a 100% success rate. This is not unusual; the success rate of any antibiotic therapy typically decreases over time as the bacteria develops resistance to the medications used.

As a result “Quadruple Therapy”, which involves adding in a fourth medication, has increased in popularity over the years to help combat particularly resistant H pylori infections. However, triple therapy for H pylori is still the gold standard and is much more studied than quadruple therapy.

One of the more intriguing new treatment methods is sequential therapy. This involves the some of the same medications as triple therapy but rather than taking them all at one, they are taken in a specific sequence. An initial trial saw that sequential therapy had success rates of over 90% (2). This is an area that certainly deserves more research in the future.


Life After Triple Therapy for H Pylori

If you received triple therapy for H pylori, there are a few things to keep in mind:

  • H pylori typically has no symptoms; most reported H pylori symptoms are actually stomach ulcer symptoms. As a result, you may not necessarily “feel better” as soon as H pylori is eradicated. If you have an ulcer, it will take some time for it to heal before you feel better.
  • Triple therapy is a strong course of antibiotics and as such it wipes out the “good” bacteria in the digestive tract. Taking a probiotic can help restore these good bacteria. Make sure the probiotic contains Lactobacillus and Bifidobacterium as these have been shown to help combat H pylori infection when taken with triple therapy (3,4,5).
  • Triple therapy does not have a 100% success rate. H pylori can become “suppressed” by triple therapy. Suppressed bacteria are not active and cannot be detected easily by an urea breath test. As a result, it is recommended to be retested for H pylori infection both 4 and 12 weeks after triple therapy.

References

1. Meier R, Wettstein A, Drewe J, Geiser HR. Fish oil (Eicosapen) is less effective than metronidazole, in combination with pantoprazole and clarithromycin, for Helicobacter pylori eradication. Aliment Pharmacol Ther. 2001 Jun;15(6):851-5..

2. Vaira D et al. Sequential therapy versus standard triple-drug therapy for Helicobacter pylori eradication: A randomized trial. Ann Intern Med 2007 Apr 17; 146:556-63.

3. de Bortoli N et al. Helicobacter pylori eradication: a randomized prospective study of triple therapy versus triple therapy plus lactoferrin and probiotics. Am J Gastroenterol. 2007 May;102(5):951-6.

4. Sheu BS, Wu JJ, Lo CY, Wu HW, Chen JH, Lin YS, Lin MD. Impact of supplement with Lactobacillus- and Bifidobacterium-containing yogurt on triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther. 2002 Sep;16(9):1669-75.

5. Kim MN et al. The effects of probiotics on PPI-triple therapy for Helicobacter pylori eradication. Helicobacter. 2008 Aug;13(4):261-8.

What is H Pylori

Many people have heard of H pylori before but still really want to know the answer to the question.. what is H pylori?


What is H Pylori?

Helicobacter pylori (often abbreviated as H pylori) is a corkscrew-shaped bacterium which has a nasty habit of colonizing the gastrointestinal tract of humans.

Its claim to fame is that it is the primary cause of ulcers and stomach ulcer symptoms in humans. It also has been linked to stomach cancer and general symptoms of indigestion (heartburn, nausea, and loss of appetite).

Much of the world’s population (some estimates point to as high as 50%) is infected with H pylori. Understandably, you may wonder why H pylori is only now becoming a household word despite its prevalence. That in and of itself is a different story altogether.


What is H Pylori – The “Discovery”

The unusual thing about H pylori is that while a few scientists and doctors have over the last hundred years have discovered H pylori and presented evidence that it was the cause of ulcers, this was written off for many years by the medical community at large.

It was only after a medical doctor (Marshall) met a medical researcher (Brown) that these two could collaborate and bring H pylori to the forefront of the medical community.

This was not an easy task. Despite Warren being able to clearly demonstrate biopsy materials containing H pylori, much of mainstream medicine resisted the idea that bacteria could colonize and even thrive in the harsh conditions of the stomach.

After enduring years of ridicule, having scientific papers rejected, the Warren and Marshall movement finally gained enough traction and firmly secured the use of antibiotics (surgery was the treatment of choice at the time) that modern H pylori treatment protocols were established.

For their contributions, Warren and Marshall were awarded the Nobel Prize in Medicine in 2005.


How Do People Catch H Pylori?

Naturally, if you want to know what is H pylori, you also want to know how people catch it. Unfortunately, science has not advanced that far yet. The vector of transmission is quite unclear.

The only thing that is well-established is that hygiene plays a very important role in the prevention contracting this infection. As a result, developing nations have an increased rate of infection. As a result, we know it is at least somewhat contagious. However, we have no idea whether it is something that could pass between spouses and family members by simple interaction or if direct contact is needed.

In his official Nobel Prize interview, Marshall remarked that although the transmission vector is unknown, 30% of the people in Peru will catch H pylori simply by drinking the water. The sanitation practices of a country (including having running water and toilets) seems to be important.

As a result, any traveling abroad risks the contraction rate of H pylori, as does eating in places where food could be contaminated. Restaurants and particularly buffets are notorious for food contamination.


What to Do

If you have H pylori symptoms, the first step is is to get an H pylori test.

H Pylori Diet

H pylori is a common gastrointestinal infection which has been known to cause stomach ulcer symptoms and general gastritis. While H pylori is generally treated with antibiotic therapy, did you know that an H pylori diet can significantly improve your response to the infection?

In this article, we will be revealing the super foods and dietary practices which can suppress H pylori infection and minimize its impact.


High Protein Diets, Fruits, and Vegetables

High protein diets can mitigate the damage caused by H pylori infection (1). In the study cited, researches found that cell damage suffered by gerbils was minimized when given a high protein diet.

Another interesting feature of the study was that damage suffered by cells was directly related to inflammation. In humans, it is accepted as common knowledge that certain foods have anti-inflammatory properties. It is not unreasonable to think that consuming these foods could reduce inflammation and help minimize damage caused by H pylori. Here is a list of foods:

  • Omega-3 fatty acids (fish oil, krill oil)
  • Nearly every fruit and vegetable (no sugar added)

On the other hand, trans fats, omega-6 fats (soybean and corn oils are the most common), nearly every type of grain, and red meat (due to high iron content) has some inflammatory capacity.

Note that while grass-fed red meat is certainly healthier and can be made part of a balanced, healthy diet, it still contains high amounts of iron. Iron is a powerful oxidant so avoiding red meat is a good idea for an H pylori diet.

In theory it could be quite beneficial to minimize red meat and grain intake, and eat a higher-protein diet of lean meats and fish, along plenty of fruits and vegetables.

Additionally, a few cultures which seem “ulcer resistant” tend to have a large portion of their carbohydrate intake come from legumes (i.e. various beans) and a particularly fibrous grain known as millet. These groups which have low ulcer rates consume very little wheat, rice, or typical western grains despite living in areas with high H pylori infection rates.


Probiotics

Probiotics, or bacteria-promoting compounds, represent an interesting addition to an H pylori diet. Various studies have concluded that H pylori treatment can be improved by adding probiotics including Lactobacillus and Bifidobacterium to the diet (2, 3, 4).

The type of probiotic used in an H pylori diet used is important. As one study found that yogurt containing probiotics was not adequate, you need to check the label of your supplement to make sure it contains everything you need (5).

We recommend making sure the supplement of choice contains both Lactobacillus and Bifidobacterium and has been refrigerated. Do not buy a probiotic that has not been refridgerated as you could be paying for dead bacteria.

Why do probiotics help and why would you want to include them in an H pylori diet? Healthy humans have bacteria in their gastrointestinal system which help us digest food (giving us Vitamin K among other nutrients) and even do battle against harmful invaders.

The problem is that typical antibiotic courses used to treat H pylori also kill off this healthy, “good bacteria” as well. Probiotics can help reintroduce this good bacteria into our system which is conducive to digestive health, especially given how intense the antibiotics for H pylori treatment are.


Helicobacter Pylori Diet Conclusion

While we definitely still recommend following appropriate medical avenues for treatment, modifying your diet can certainly help. To sum it up, we recommend eating plenty of fruits and vegetables (fresh or frozen are fine but make sure there is no sugar added), regular portions of protein from lean meat sources, choosing legumes, beans, and millet over traditional grains, and supplementing with fish oil and probiotics. We recommend minimizing sugars, trans fats, red meat, and omega-6 fats.


References

1. Shinozaki K, Kamada T, Sugiu K, Kusunoki H, Manabe N, Shiotani A, Hata J, Teramoto F, Haruma K. High-protein diet suppresses corpus atrophic gastritis in Helicobacter pylori infected Mongolian gerbils. Nutr Cancer. 2010 Nov;62(8):1067-73.

2. de Bortoli N et al. Helicobacter pylori eradication: a randomized prospective study of triple therapy versus triple therapy plus lactoferrin and probiotics. Am J Gastroenterol. 2007 May;102(5):951-6.

3. Sheu BS, Wu JJ, Lo CY, Wu HW, Chen JH, Lin YS, Lin MD. Impact of supplement with Lactobacillus- and Bifidobacterium-containing yogurt on triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther. 2002 Sep;16(9):1669-75.

4. Kim MN et al. The effects of probiotics on PPI-triple therapy for Helicobacter pylori eradication. Helicobacter. 2008 Aug;13(4):261-8.

5. Yaşar B et al. Efficacy of probiotics in Helicobacter pylori eradication therapy. Turk J Gastroenterol. 2010 Sep;21(3):212-7.

Helicobacter Pylori Gastritis

H pylori is one of the most common bacterial infections in the world with some estimates suggesting that as much of half of the world’s population is infected with this bacterium.

Gastritis literally just means stomach illness or inflammation and does not specifically refer to Helicobacter pylori gastritis.

Just because you have gastritis does not necessarily mean you are infected with H pylori. Likewise, you can be infected with H pylori but not have gastritis. Only testing can conclude one way or another cause of gastritis.


H Pylori Gastritis Symptoms

Note that most people experience no significant symptoms as a result of H pylori infection. Out of the H pylori infections that are noticeable, the most common symptom is H pylori gastritis. This is characterized by general nausea, stomach pain, and indigestion.

More serious cases can develop into ulcers which may lead to symptoms such as burning stomach pain (which peaks at night or early in the morning) as well as bleeding (signified by dark colored stool or vomit).

If you have any of these symptoms, you should see a doctor for evaluation. Testing for H pylori is fairly inexpensive, non-invasive, and quite reliable.


Cause of H Pylori Gastritis

The Helicobacter pylori bacterium lives in the stomach. In order to escape the harsh conditions of the digestive tract, it burrows itself into the lining of the stomach. This weakens the protective coat of the stomach and small intestine.

Due to this weakening, the stomach gets irritated by the acid and digestive enzymes and as a result, inflammation and discomfort appear. This is commonly called H pylori gastritis.

However, gastritis alone is not necessarily caused by H pylori and can result from one of many bacterial infections and even from a simple food allergy. Only by testing can Helicobacter pylori gastritis be confirmed.


Other Causes of Gastritis

As mentioned above, most people with H pylori do not know that they have it. Without testing, there is no way to know for sure what the exact cause of gastritis is.

For example, it is estimated that more and more people are developing allergies to common foods such as gluten, tree nuts, peanuts, and lactose. Consuming any of these could cause gastritis in sensitive populations.

Additionally, various other infections could cause gastritis and even stress or acid reflux can cause indigestion. However, stress does not necessarily lead to ulcers as almost everyone who ends up with a stomach ulcer has H pylori (despite what you may have heard).


The Dangers of H Pylori Gastritis

The real problem of H pylori gastritis is that H pylori leads to stomach ulcers and sometimes even cancer. Most people actually have no noticeable symptoms when infected with H pylori and do not notice anything until stomach ulcer symptoms begin to present themselves.

Treating H pylori successfully is necessary to reduce the increased risk of getting cancer and ulcers. This is typically via medication such as triple therapy or sequential therapy.

Different doctors have different approaches and your specific treatment options depend on your medical history, so do not take it upon yourself to self-medicate for this condition.


H Pylori Gastritis Treatment

As a result, getting treatment for Helicobacter pylori gastritis is important. This is typically a combination of several antibiotics and a proton-pump inhibitor.

Helicobacter pylori gastritis is frequently chronic, so even after using medication patients are often recommended to get a follow-up test one to three months after their treatment. This is because H pylori has become resistant to typical treatments and frequently is just supressed by medication rather than eradicated.

Urea Breath Test

If you have an H pylori infection or an ulcer, odds are you will at some point get a urea breath test to check for H pylori.

The urea breath test is nothing to be worried about as it is a fairly simple test and is quite accurate. It is a lot more accurate than a blood test or stool test and a lot more pleasant than and endoscopy and subsequent biopsy.


The Urea Breath Test Procedure

The H pylori breath test is quite simple. Patients are asked to drink a solution containing urea and then breath into a specialized device.

The idea is simple: urea is normally a waste product created during the body’s metobolic processes, of which we have no need to ingest. However, H pylori enjoys metabolizing this substance and when it does it gives off ammonia gas.

Humans normally do not exhale ammonia. By using a meter to check for ammonia after drinking urea, a technician is able to quite accurately test for the presence of H pylori.


Why Perform an H Pylori Breath Test

The urea breath test is very important especially if you have stomach ulcer symptoms. If your ulcer is caused by H pylori, then you will have a hard time treating it without taking care of the infection.

An H pylori test is necessary to check to see if the treatment plan you are following is effective. Since getting a blood test (or another type of test) done regularly is not very convenient, the urea breath test has become much more commonplace.


When to expect an Urea Breath Test

If you have a suspected or diagnosed ulcer, odds are you will be referred by your doctor to take this test. Given the need for specialized equipment, this is not a test you can do on your own or perform with an “at home test kit”.

Mail-off lab test are generally stool or blood tests, and these are not nearly as accurate as the H pylori breath test is. As a result, you will want to go through standard medical channels to get an urea breath test done.


Do I Need to Fast For an Urea Breath Test?

To quickly answer a common question, the common answer is no, but you should call ahead and ask. Most modern tests do not require fasting, but if your practitioner is using an older test, a 4-6 hour fast may be required. Be sure to clear this up before you go into testing.

Both fasting and non-fasting tests are very, very accurate, but different urea breath tests may use different chemical markers, some may require fasting but most do not. Just be sure to call up ahead of time if you are unsure.


Getting Regular Testing

The key thing about testing for H pylori is to get regular checks. Almost everyone with an ulcer will have H pylori, but not everyone will respond to treatment.

Generally, anywhere from 4-12 weeks after cessation of medication, a follow-up H pylori breath test is done to make sure that the bacteria has completely been eradicated. H pylori has a tendency to become chronic given its increasing resistance to antibiotics. Chronic H pylori infection is linked to stomach cancer, making follow-up testing very important in those who have ulcers.

This is the true superiority of an urea breath test over a blood or stool test; antibodies may linger in the blood long after H pylori has been eradicated whereas the H pylori breath test is a lot more accurate.

While no test is 100% accurate, the urea breath test is easily the most convenient test for the necessary regular testing recommended in H pylori cases.

H Pylori Infection

Helicobacter pylori is one of the most prevalent bacteria in our civilized society. In fact, different estimates report that H pylori infection is present in anywhere from 20%-50% of the world’s population.

Below, you will find out how we get this infection, what the symptoms of for Helicobacter pylori infection are, and what the available treatment options are.


Transmission of H Pylori Infection

Despite its prevalence, we still do not have a good idea of how H pylori is transferred from person to person. Like many other gastrointestinal infections, contaminated food and water is the number one suspect.

However, drawing any definitive conclusions about the transmission of H pylori infection from food is not likely to occur any time soon. This is because the symptoms of H pylori range from non-existent to mild and it can take quite a long time to incubate.

In other words, even if a group of people were all to catch a Helicobacter pylori infection from contaminated food at a local restaurant, no one would ever know, because people usually do not realize they are infected until they develop stomach ulcer symptoms.

Advances in the area would be very beneficial for reducing the rate of getting stomach ulcers.


Symptoms of H Pylori Infection

As alluded to earlier, most people have no idea whether they are infected or not until they get an ulcer.

Of those that do have an infection, symptoms tend to resemble gastritis, which is basically generalized upper digestive tract inflammation. This could be burning stomach pain, stomach aches in general, loss of appetite, and general nausea.

In short, it is really hard to tell if you have H pylori based off symptoms alone. Fortunately, testing can be done to check for H pylori infection.


Testing

There are several different tests that are frequently done to check for Helicobacter pylori infection. First off, no test is 100% accurate, but among the available test, biopsy and the breath test appear to be the most accurate.

Biopsy involves taking a small tissue sample from the suspected area and examining the cells to check for infection. As you can imagine, it is extremely invasive and usually reserved when there is a suspected ulcer that is resistant to treatment.

Alternatively, a “breath test” can be used, which is a non-invasive test. This involves the patient drinking a fluid and then breathing into a specialized reader.

H pylori digests this fluid and releases a gas during the digestion process. Specialized equipment can then monitor levels of this gas to check for infection. While not 100% accurate, it is improving to the point where it is becoming a regularly used test. This method will only improve as technology gets better.

  • For more information on these diagnostic tests and other possible options, see our H pylori test article.

Treatment

Since H pylori is a bacteria, it can be treated with simple antibiotics – nothing fancy required. Since some strains are resistant, frequently a course two different antibiotics are given at the same time to be safe.


Preventing Chronicity

The biggest problem of H pylori is not an acute infection but a chronic one. Chronic infections are what ultimately lead to ulcers and even stomach cancer.

If you are diagnosed with H pylori, consider the following in addition to your prescribed treatment plan:

  • Modifying lifestyle factors; try to quit smoking and reduce alcohol consumption to improve your digestive health.
  • Regularly eat fruits and vegetables; broccoli in particular has been linked to the suppression of H pylori.
  • Supplement with vitamin D, vitamin C, and zinc; these three nutrients have been linked to improved function of the immune system.

Remember that these homeopathic remedies are not meant to be a replacement for medical treatment for H pylori infection but rather are a nice addition to help prevent Helicobacter pylori infection from reoccurring.

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