What is Helicobacter pylori?

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

More than half of the world’s population is infected with it and about 3 in every 10 Australian adults are estimated to carry it. It is more common among Aboriginal and/or Torres Strait Islander people 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. This can cause open sores in the stomach (gastric ulcers), or in the upper part of the small intestine (duodenal ulcers). H. pylori is also linked to some types of stomach cancers.

What causes Helicobacter pylori?

It is not fully understood how people get infected with H. pylori. Most people become infected as children, but you can also be infected as an adult.

H. pylori is mostly transmitted through close contact with family members, or in day care centres. It may be spread if infected people don’t wash their hands after a bowel movement, or through kissing and other close contact. Better hygiene has helped reduce H. pylori in developing countries.

What are the symptoms of Helicobacter pylori infection?

Most people withH. pylori infection don’t have any symptoms. If you have symptoms, they may include:

• a burning feeling in your upper stomach area (like heartburn) — which may change with eating
• indigestion or full feeling before you have finished eating
• nausea and vomiting
• bloating and burping
• loss of appetite

When should I see my doctor?

See your doctor if you have ongoing symptoms or if you have difficulty swallowing.

How is Helicobacter pylori diagnosed?

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

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

Your doctor will advise the best test in your situation.

During a breath test, you will be given a liquid or capsule to swallow that contains a special form of carbon. After a short time, the doctor will ask you to breathe into a machine, which can detect the presence of H. pylori bacteria. This test is safe and accurate, and can help your doctor determine the best treatment.

A blood test looks for antibodies to H. pylori. It can still show positive results after treatment and the bacteria are gone, so it’s not 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 an endoscopy, a small piece of tissue or cells (biopsy) can be taken to help diagnose H. pylori and other conditions. This may be recommended when there is a family history of gastric cancer or certain symptoms are present.

How is Helicobacter pylori treated?

H. pylori is treated with eradication therapy — a combination of medicines that includes antibiotics and acid-suppressing medicine. The antibiotics kill the H. pylori bacteria. The acid-suppressing medicine helps heal stomach sores and reduces the chance of new sores from developing.

After you’ve finished treatment, you may be offered a breath test to check the medicines worked. 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 risk of getting infected again is low. Unless it is successfully treated, H. pylori will usually stay in the lining of your stomach for life.

To search medicines by active ingredient or brand name, use the healthdirect Medicines search feature.

Can Helicobacter pylori be prevented?

Most people infected with H. pylori get it in early childhood, but there is limited information on how to prevent it.

High-density living, poor sanitation and poor hygiene all increase the risk of getting H. pylori.

Complications of Helicobacter pylori

Nearly everyone who has H. pylori gets gastritis (inflammation of the stomach lining). This leads to increased stomach acid production. If you experience symptoms, it's 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 occur in the upper part of the small intestine they are known as duodenal ulcers.

H. pylori also increases the risk of certain stomach cancers. Fortunately, treating and removing H. pylori infection heals most sores and reduces the risk.

H. pylori infection leads to most cases of an uncommon disease called gastric mucosa-associated lymphoid tissue (MALT) lymphoma. This is a slow-growingcancer that starts in the stomach. If the H. pylori infection is successfully treated when the lymphoma is in its early stages, it often shrinks and may even be cured.

Resources and support

• Speak to your doctor. If you need to find a GP or health service, use the healthdirect Service Finder.
• Read the Royal Children’s Hospital fact sheet on H. pylori.
• Learn about the urea breath test that helps your doctors check for H. pylori.

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