Helicobacter pylori: definition, causes, symptoms, contagion and treatment

By Cristiano Antonino On May 11, 2023

Helicobacter pylori or H. pylori is a spiral-shaped (i.e. spiral-shaped) bacterium that very frequently colonizes the gastric mucosa

Just think that according to estimates, it is present in the stomach of two out of three people.

However, this is not always a problem: often, in fact, the infection is asymptomatic and does not cause damage.

In other cases, however, it should not be underestimated because it can cause problems, such as gastritis and ulcers in the stomach or duodenum, the first part of the intestine.

So here’s everything you need to know about Helicobacter pylori infection and the strategies to adopt to protect your health.

Helicobacter pylori

Helicobacter pylori infection occurs when this bacterium infects the stomach: generally in poor countries this occurs mainly during childhood, while in Western countries it can also occur during adulthood.

To date, it is not known how a person can contract the microorganism.

However, it is known that at the moment man is the only known reservoir of this bacterium.

According to the most accredited hypotheses, the most probable modes of transmission are oral (therefore through direct contact, vomiting, droplets of saliva) and oral-fecal (essentially through contact with infected feces).

However, it is also possible that transmission occurs through contact with contaminated water or endoscopic instruments.

This is why those most at risk are those who live in countries with poor sanitation.

This bacterium is particular because it manages to survive in an inhospitable and highly acidic environment such as the stomach.

Thanks to an enzyme that it self-produces, called urease, which allows it to penetrate the stomach mucosa and neutralize, at least in part, gastric acidity.

In reality, even its particular helix shape – from which it takes its name – helps it in this sense: in fact, it allows it to reach the innermost and least acidic layer of the gastric mucosa, an area that is certainly more hospitable.

Helicobacter pylori symptoms

Most people don’t realize they have an H. pylori infection because they never get sick—they don’t have any symptoms that would cause them to suspect and seek medical attention.

The reason is not clear, but it has been hypothesized that some subjects are born with a greater resistance to the harmful effects of this particular microorganism.

Other individuals, however, can develop diseases when their stomach is colonized by the bacteria.

When H. pylori infection is symptomatic, signs and symptoms can include:

burning in the abdomen
abdominal pain that gets worse when the stomach is empty
nausea
loss of appetite
frequent burps
swelling
unintentional and unwarranted weight loss
halitosis.

Complications of Helicobacter Pylori

As mentioned, in some cases the bacterium can have a negative effect on health and cause serious problems.

Complications associated with H. pylori infection include:

anemia: Sometimes the infection can cause anemia, especially from iron deficiency. That is why in anemic people it may be advisable to perform a test for the search for H. pylori, especially if the causes of the problem cannot be identified;
ulcers: once the bacterium has entered the stomach, it can damage the lining that protects it and cause an ulcer, i.e. an open sore, which in turn can be associated with complications;
gastritis: H. pylori infection can irritate the stomach, causing inflammation of the lining of the stomach;
Stomach cancer: H. pylori infection is a strong risk factor for some types of stomach cancer, so much so that the International Agency for Research on Cancer (IARC) has included it in the list of carcinogens. However, a distinction must be made: studies in recent years have shown that, on the one hand, this infection favors the development of stomach cancer, but on the other, it protects against the development of anything that can arise at the level of the cardia (the through which the esophagus opens and enters the stomach).

Several tests and procedures can be used to diagnose an H. pylori infection

These same tests are also useful after treatment, to verify that the bacteria has been eliminated and that further therapy is not needed.

The most common are:

Stool test for H. pylori;
the breath test or breath test performed on samples of exhaled air. In practice, first radioactively labeled urea is administered to the person, then the amount of carbon dioxide emitted with exhalation is measured. In the presence of urea, in fact, this gas constitutes the metabolic product of the bacterium and can help to identify the presence of the infection;
blood test for IgG antibodies specifically directed against H. pylori.

The presence of Helicobacter can also be confirmed or excluded with gastroscopy, a procedure during which samples of the lining of the stomach and intestines are taken, which are then analyzed under a microscope.

This test is more invasive because it involves inserting an endoscopic tube into the stomach, through the mouth, but it is considered the best standard for diagnosing ulcers.

Treatment of Helicobapter Pylori

H. pylori infections are usually treated with a mix of several antibiotics given at the same time.

Your doctor will also likely prescribe proton pump inhibitor (PPI) medications, which prevent the stomach from producing acid and relieve symptoms.

The therapy is usually followed for two weeks.

After four weeks it is necessary to repeat the investigations, to see if the bacterium has been eradicated.

If the first treatment has not succeeded in eradicating the microorganism, it is necessary to undertake a different antibiotic therapy, obviously always under medical supervision.

Prevention tips

There are no particular rules to follow to prevent infection.

However, given that the main routes of transmission would appear to be oral and fecal-oral, it is certainly useful:

wash your hands well, several times a day, especially before and after using the toilets;
do not touch food with unclean hands: wash your hands thoroughly before and after preparing food and before meals;
respect all the rules for the correct preparation and storage of food;
drink potable water;
when traveling in countries with poor hygienic conditions, drink only bottled water and avoid ice.

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