What is Helicobacter pylori?

Helicobacter pylori (H. pylori) is a type of bacteria that lives in the lining of your stomach.

More than half of the world's population is infected with H. pylori. About 3 in every 10 Australian adults are estimated to carry it. It is more common among Aboriginal and/or Torres Strait Islander peoples and in developing countries.

H. pylori causes inflammation of the stomach lining, known as gastritis. This leads to the stomach making more acid than usual. Over time, this may cause open sores in the stomach (gastric ulcers) or in the upper part of the small intestine (duodenal ulcers).

What causes Helicobacter pylori infection?

It is not fully understood how people become infected with H. pylori. Most people are infected as children, but infection can also happen in adulthood.

H. pylori is mostly spread through close contact with family members or in daycare settings. It may spread if infected people don't wash their hands after a bowel movement (poo) or through kissing and other close contact.

Better hygiene has helped reduce H. pylori infection in developing countries.

What are the symptoms of Helicobacter pylori infection?

Most people with H. pylori infection don't have any symptoms. If you have symptoms, they may include:

• a burning feeling in your upper stomach area (similar to heartburn) — which may change with eating
• indigestion or a feeling of fullness before finishing a meal
• nausea and vomiting
• bloating and burping
• changes to your appetite

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When should I see my doctor?

If you vomit blood or notice dark blood in your stool (poo) or black poo, go to the nearest hospital emergency department or call triple zero (000). This may be a sign of a bleeding stomach ulcer.

It is important to diagnose and treat H. pylori infection to help prevent peptic ulcer disease and certain types of gastric cancer (stomach cancer). See your doctor if you have unusual symptoms.

See your doctor promptly if you:

• have sudden, unintentional weight loss
• have blood in your vomit or poo
• have difficulty swallowing
• are over 55 years of age and have any symptoms

These can be signs of a more serious illness.

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How is Helicobacter pylori infection diagnosed?

A range of tests can be used to diagnose H. pylori, including:

• breath test
• blood test
• stool (poo) sample
• endoscopy with a tissue biopsy of the stomach lining

Discuss with your doctor which test is best for your situation.

During a breath test, you will swallow a liquid or capsule containing a special form of carbon. After a short time, you will breathe into a machine that can detect the H. pylori bacteria. This test is safe and accurate and helps guide your treatment.

A blood test looks for antibodies to H. pylori. It can still show positive results after treatment, even when the bacteria are gone. For this reason, it may not be the best test for most people.

A laboratory can test your stool (poo) sample for proteins (antigens) from H. pylori.

An endoscopy is a procedure where a thin tube with a camera is inserted through your mouth to view your stomach. During the test, a small tissue sample (biopsy) may be taken to check for H. pylori and other conditions. This test may be suggested when there is a family history of stomach cancer or if certain symptoms are present.

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How is Helicobacter pylori infection treated?

Treatment for H. pylori aims to completely get rid of the infection from the body — known as eradication therapy. A combination of medicines is used to achieve this. Antibiotics kill the H. pylori bacteria, and acid-reducing medicine helps heal the stomach lining and lowers the chance of new sores forming.

After treatment, you may have a breath test to check that the infection is gone. It is important to follow your doctor's instructions and finish the full course of treatment to get rid of the infection.

Sometimes, the first treatment doesn't work because the bacteria aren't affected by the antibiotics. This is known as antibiotic resistance. In this case, a specialist doctor (gastroenterologist) may prescribe different medicines.

Once H. pylori is successfully treated, your chance of getting infected again is low. Without treatment, the bacteria usually stay in the lining of your stomach for life.

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Can Helicobacter pylori infection be prevented?

There is limited information on how to prevent H. pylori infection.

Living in crowded conditions, poor sanitation and poor hygiene can increase your risk of infection.

What are the complications of Helicobacter pylori infection?

Most people with H. pylori develop gastritis (inflammation of the stomach lining). You may not notice symptoms at first, but over time this leads to increased stomach acid production. When symptoms occur, this is known as H. pylori-associated dyspepsia (indigestion).

Because your stomach produces more acid than usual, you are more likely to develop open sores in the stomach (gastric ulcers). If these happen in the upper part of the small intestine, they are known as duodenal ulcers.

H. pylori also increases your chance of certain stomach cancers. Treating and removing H. pylori infection heals most sores and reduces this risk.

H. pylori infection may also lead to an uncommon disease called gastric mucosa-associated lymphoid tissue (MALT) lymphoma. This is a slow-growing cancer that starts in the stomach. If treated early, the lymphoma often shrinks and may be cured.

Resources and support

• The Royal Children's Hospital Melbourne has a fact sheet on Helicobacter pylori.
• The Gastroenterological Society of Australia (GESA) has information on Helicobacter pylori.
• SA Pathology has information about the urea breath test that helps your doctors check for Helicobacter pylori.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Information for Aboriginal and/or Torres Strait Islander peoples

Find an Aboriginal Community Controlled Health Organisation (ACCHO) or Affiliate near you.