Helicobacter Pylori Infection - What You Need to Know

Updated on July 24, 2019
Rotsucht profile image

M.D., Infectious diseases specialist, travel junkie, chocolate/coffee addict and amateur climber.

Helicobacter pylori is associated with gastritis and stomach ulcers

Helicobacter pylori (HP) is a flagellated, gram-negative bacterium which is microaerophilic (this means it needs lower levels of oxygen to survive) and thrives in the acid environment of the stomach. Herein, it can cause Inflammation by dialling up the acid production. This damages the lining of the stomach and leads to gastritis and/or ulcers. Acid reflux, epigastric pains, nausea or coughing are all possible symptoms. However, in some people, the bacteria can live in the stomach for a long time without causing any symptoms. Approximately 50% of people are infected with a higher incidence in developing countries.


Linking Helicobacter pylori to stomach ulcers

HP was first isolated in 1982. At the time, it was known as campylobacter pylori. In 1983, two Australian scientists, Barry Marshall and Robin Warren which had discovered the bacterium, performed an important experiment. This proved to the world that HP is associated with stomach ulcers. In order to demonstrate this, Marshall drank a broth in which HP had been cultivated after a baseline gastroduodenoscopy (to prove that he was not infected from the beginning). After a couple of hours, he started experiencing stomach pains and a second gastroduodenoscopy showed an ulcer from which HP was cultured. Marshall and Warren also conducted a study on 58 symptomatic patients from whom they were able to Isolate HP (from the gastric biopsies). Despite Marshall's impressive self-experiment and the published results from their study, it took more than 10 years for the medical community to accept this, although there are several facts that support this hypothesis:

  • Most patients with stomach ulcers (without documented use of NSAIDs) have an HP infection
  • HP has been isolated from the stomach before ulcers/gastritis occurs
  • After eradication, the symptoms improve

Transmission of Helicobacter Pylori

The method of transmission of HP still remains unknown. There are several theories to how it infects humans. HP has been detected in drinking water, seawater, vegetables, animals such as cat saliva, primates and sheep. However, humans seem to be the only reservoir (with 50% of the world population infected) and human-to-human transmission is very likely, since HP infections often occur in clusters within families for example. Fecal/oral transmission through contaminated water is also possible. Some scientists believe the transmission to be foodborne because of the ability of HP to survive in milk, vegetables and other foods. Additional studies will hopefully shed more light on how people contract HP.

EM of Helicobacter pylori
EM of Helicobacter pylori | Source

Diagnosis of Helicobacter pylori infection

If you suffer from nausea, heartburn, epigastric pains (especially after eating), you should speak to your treating physician about getting tested for HP infection. For this, I would recommend scheduling a gastroduodenoscopy. This is a procedure during which a physician can look into your stomach and take samples that can be tested for HP. The procedure allows the inspection of the stomach as well as the diagnosis of other pathologies which can cause the same unspecific symptoms as HP infection. This has been explained in detail in my hub Dealing with Gastritis. Check it out for more information.

The Treatment of Helicobacter Pylori

I will not go into the "when to treat and when to not treat" discussion. But most will agree that when a patient is having symptoms or has developed an ulcer even, HP eradication is necessary. A combination of antibiotic agents (at least two) is required to eliminate HP. There are different regimes for the first-line therapy and when possible, the treatment should be adapted according to an antibiogram or local data on resistances. Some resistances, especially against clarithromycin have been reported. Since this bacterium loves acid, a proton pump inhibitor is additionally prescribed in order to inhibit acid production in the stomach. This gives the antibiotics a better chance to fight it.


Helicobacter pylori and gastric cancer

Whatever the reason, constant inflammation of a certain tissue in the body can always cause it to change (this is called dysplasia), and this in return can lead to uncontrolled proliferation and carcinogenic processes. Several studies have shown that HP infection is involved in the development of certain types of gastric cancer. A wide variability has been observed from person to person. This suggests that there are other factors involved such as environment, lifestyle as well as genetic factors. Of course, this is a process which probably takes decades. Since the infection does not necessarily cause symptoms, and very few people will develop cancer it is difficult to decide whether eradication is necessary in healthy patients as a preventive measure. This is a very controversial subject which would go beyond the scope of our discussion.

Does Helicobacter pylori protect us from allergies?

Many studies have found an inverse correlation between HP infection and allergies. This has been especially observed in early onset allergic asthma in children and youths. Moreover, it can protect against airway hyper-reactivity and in a mouse model, it was shown that an infection with HP can help prevent allergic asthma. However, when the bacterium is eradicated through antibiotic treatment, this positive effect is reversed. The latter is consistent with this hypothesis. HP infection has also been associated with several other diseases. More studies are needed to understand the full impact of this infection on our health.


  • Med J Aust.1985 Apr 15;142(8):439-44.Pyloric Campylobacter infection and gastroduodenal disease.Marshall BJ, McGechie DB, Rogers PA, Glancy RJ.
  • Ann Intern Med.1994 Jun 15;120(12):977-81.Helicobacter pylori infection and the risk for duodenal and gastric ulceration.Nomura A, Stemmermann GN, Chyou PH, Perez-Perez GI, Blaser MJ.
  • Gastroenterology.1996 Apr;110(4):1244-52.Relationship between Helicobacter pylori eradication and reduced duodenal and gastric ulcer recurrence: a review. Hopkins RJ, Girardi LS, Turney EA.
  • World J Gastroenterol. 2018 Aug 21; 24(31): 3472–3487. Helicobacter pylori: A foodborne pathogen? Nicoletta C Quaglia and Angela Dambrosio.

  • Helicobacter pylori infection and gastric lymphoma.AUParsonnet J, Hansen S, Rodriguez L, Gelb AB, Warnke RA, Jellum E, Orentreich N, Vogelman JH, Friedman GD SON Engl J Med. 1994;330(18):1267.
  • N Engl J Med.2018 Mar 22;378(12):1085-1095. doi: 10.1056/NEJMoa1708423. Helicobacter pylori Therapy for the Prevention of Metachronous Gastric Cancer.
    Choi IJ, Kook MC, Kim YI, Cho SJ, Lee JY, Kim CG, Park B, Nam BH.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

    © 2019 Rotsucht


      0 of 8192 characters used
      Post Comment

      No comments yet.


      This website uses cookies

      As a user in the EEA, your approval is needed on a few things. To provide a better website experience, healthproadvice.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

      For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://healthproadvice.com/privacy-policy#gdpr

      Show Details
      HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
      LoginThis is necessary to sign in to the HubPages Service.
      Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
      AkismetThis is used to detect comment spam. (Privacy Policy)
      HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
      HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
      Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
      CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
      Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
      Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
      Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
      Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
      Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
      Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
      VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
      PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
      Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
      MavenThis supports the Maven widget and search functionality. (Privacy Policy)
      Google AdSenseThis is an ad network. (Privacy Policy)
      Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
      Index ExchangeThis is an ad network. (Privacy Policy)
      SovrnThis is an ad network. (Privacy Policy)
      Facebook AdsThis is an ad network. (Privacy Policy)
      Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
      AppNexusThis is an ad network. (Privacy Policy)
      OpenxThis is an ad network. (Privacy Policy)
      Rubicon ProjectThis is an ad network. (Privacy Policy)
      TripleLiftThis is an ad network. (Privacy Policy)
      Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
      Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
      Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
      Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
      ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
      Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)
      ClickscoThis is a data management platform studying reader behavior (Privacy Policy)