Helicobacter Pylori
H. pylori is a spiral-shaped bacterium found in the stomach, which (along with acid secretion) damages stomach and duodenal tissue, causing inflammation and peptic ulcers. H. pylori causes the majority of ulcers. Learn more about peptic ulcers.
It is believed that H. pylori’s shape and characteristics cause the damage that leads to ulcers. Because of their shape and the way they move, the bacteria can penetrate the stomach’s protective mucous lining where they cause inflammation. The inflammation makes the stomach cells more susceptible to the damaging effects of acid and pepsin, and leads to sores or ulcers in the stomach or duodenum (first part of the small intestine). For reasons not completely understood, H. pylori can also stimulate the stomach to make more acid.
What causes an H. pylori infection?
Researchers do not know what causes people to develop H. pylori. It is believed that H. pylori is transmitted orally from person to person through close contact or through fecal-oral contact. Most people are first exposed to it during childhood.
What are the symptoms of H. pylori?
After being infected with H. pylori, gastritis (an inflammation of the stomach lining) may develop. However, most people will never have symptoms or problems related to the infection. When symptoms are present, they may include the following:
- Abdominal discomfort that:
- Causes a dull, gnawing pain.
- Occurs two to three hours after a meal.
- It comes and goes for several days or weeks.
- Occurs in the middle of the night when stomach is empty.
- Is relieved by eating or taking an antacid medication.
- Nausea
- Vomiting
- Burping
- Bloating
- Loss of appetite
- Loss of weight.
The symptoms of H. pylori may look like other conditions or medical problems. It is important to make an appointment with a pediatric gastroenterologist if your child is experiencing these symptoms.
How is H. pylori diagnosed?
In addition to a complete medical history and physical exam, the child’s doctor may request other tests including:
- Blood tests. These tests identify antibodies that indicate the presence of the bacterium. Learn more about blood tests at CHOC.
- Stool test. This test identifies evidence of the bacterium in the stool, and is more sensitive and specific than a blood test. Learn more about stool tests.
- Breath tests. This test determines if carbon is present after drinking a solution that contains urea. The presence of carbon indicates the release of urease by H. pylori.
- Tissue tests. Tissue is removed during an endoscopy. The endoscopy or EGD is a procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube called an endoscope is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the doctor to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary). This tissue is used to:
- Detect the presence of the enzyme urease
- Examine the bacteria that is present under a microscope
- Start a culture test to grow more bacteria for examination.
What is the treatment for H. pylori?
At CHOC, our gastroenterologist team meets with each patient, his or her family and other members of the child’s medical team, including referring physicians and specialists, to create a treatment plan that is mindful of the patient’s medical, physical, social and emotional well-being. Specific treatment is typically based on:
- The child’s age, overall health and medical history
- The extent of the disease
- The child’s tolerance for specific medications, procedures, or therapies
- The expectations for the course of the disease.
Treatment may include:
- Medications to suppress acid production, including:
- H2-blockers. They reduce the amount of acid the stomach produces by blocking histamine, a powerful stimulant of acid secretion.
- Proton pump inhibitors. They more completely block stomach acid production by stopping the stomach’s acid pump, which is the final step of acid secretion.
- Stomach-lining protectors. They protect the stomach lining from acid and help kill the bacteria.
- Antibiotics to kill the bacteria.