H. Pylori Infection: Signs and Symptoms

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What is H. Pylori?

Helicobacter pylori (H. pylori) bacteria are organisms that enter the human body through the mouth by the ingestion of contaminated water or food. It is usually acquired by children, but adults may also be infected. Upon ingestion, the bacteria inhabit the stomach where the acidic environment favors their growth, which is unusual for bacteria.

H. pylori infection is a disease that affects about 20 to 30 percent of the population in industrialized countries and as much as 70 percent in less developed countries, where sanitation is often a problem. Social conditions like poor accommodations, crowded places and poor water supply are risk factors that predispose one to acquire the infection. The bacteria are passed on from one person to another through direct contact with saliva and fecal matter.

In the stomach, the bacteria release toxins that cause injury and inflammation to the lining of the stomach and the duodenum (the first part of the small intestine), but the exact mechanism leading to the disease is not well known. Although a lot of people may be harboring the bacteria in their stomachs, only a few people manifest symptoms of H. pylori infection.

Symptoms of H. Pylori Infection

Symptoms of this infection may range from mild to severe. Mild symptoms, such as frequent burping and feelings of bloated stomach, usually do not alarm affected people, as they may experience a these symptoms after a meal. Others, though, may feel nauseated and experience vomiting. These symptoms are usually felt one to three hours after eating or when one is hungry. Sometimes this condition is referred to as dyspepsia.

Stomach aches associated with H. pylori infection may be mild to severe, characterized as an aching or burning pain. Other signs and symptoms may be more alarming and require immediate medical consultation, such as:

  • Sudden, severe abdominal pain
  • Vomiting of fresh blood
  • Vomiting of dark material that looks like coffee grounds
  • Stools that are bloody or dark and sticky (appears like tar)
  • Difficulty swallowing
  • Foul breath odor

These signs and symptoms are usually associated with complications like gastritis or peptic ulcers. In these disorders, there is erosion of the lining of the stomach and duodenum, which occurs for a prolonged period. These lead to aching and burning pains. After awhile, erosions may result in ulceration and bleeding, leading to bloody vomit. Small ulcers may not directly induce vomiting, and the blood may be digested in the intestines, producing dark, tarry stools.

Chronic erosion of the stomach lining predisposes one to gastric cancer, where there is abnormal cell division and proliferation. Usually, symptoms are initially mild, consisting of bloating and gassiness, but they may later be followed by severe stomach ache and bleeding. There may also be a marked loss of weight, due to loss of appetite.

Diagnosis and Treatment of H. Pylori Infection

Diagnosis of H pylori infection is done by testing blood, urine, saliva and stool for antibodies to the bacteria. A breath test may also be done to detect infection. Finally, direct visualization of the stomach lining, to evaluate erosions and ulcers, is performed by endoscopy.

Treatment consists of antibiotics directed toward the bacteria, and this course of treatment will require at least two weeks. Antacids to decrease the acidity of the stomach and relieve symptoms will also prescribed. Anti-ulcer medications play an important role in decreasing the acidity, reducing symptoms and eventually allowing healing of the ulcers and erosions. These consist of proton-pump inhibitors and H2 (histamine) blockers.

After a few weeks of treatment, the patient will undergo repeat testing to evaluate the effectivity of treatment. Since this is sometimes a chronic condition, treatment may be prolonged.


Mayo Clinic. “H. Pylori Infection,” https://www.mayoclinic.com/health/h-pylori/DS00958/DSECTION=symptoms

Drugs.com. “Heliobacter Pylori,” https://www.drugs.com/cg/heliobacter-pylori.html