Helicobacter pylori (H. pylori) is a bacterium that causes chronic inflammation of the inner lining of the stomach (gastritis) in humans. This bacterium also is considered as a common cause of ulcers worldwide; as many as 90% of people with ulcers have detectable organisms.
H. pylori infection is most likely acquired by ingesting contaminated food and water, and through person to person contact. The prevalence of infection is decreasing because there is increasing awareness about the infection, and treatment is common. About 50% of the world population is estimated to have detectable H. pylori in their gastrointestinal tract (GI tract, but stomach, mainly).
Poor hygiene with hand touching the food |
The infection is more common in crowded living conditions with poor sanitation. In countries with poor sanitation, approximately 90% of the adult population can be infected. Infected individuals usually carry the infection indefinitely (for life) unless they are treated with medications to eradicate the bacterium.
Eat using dirty hand |
One out of every six patients with H. pylori infection may develop ulcers of the duodenum or stomach. H. pylori also are associated with stomach cancer and a rare type of lymphocytic tumor of the stomach called MALT (mucosa-associated lymphoid tissue) lymphoma. In addition, several recent research papers have shown a link between diabetes, infections, elevated hemoglobin A1C levels, and H. pylori.
What does H. pylori Cause in Humans?
H. pylori infections start with a person acquiring the bacterium from another person (via either the fecal-oral or oral-oral route).
Although the majority of individuals that have these bacteria in their GI tracts have few if any symptoms (see symptoms), most people develop stomach inflammation (gastritis) from the body's response to the bacterium itself and to a cytotoxin termed Vac-A, a chemical that the bacterium produces.
Researchers also suggest that the stomach acid stimulates the bacterium in addition to the cytotoxin, and increases invasion of the lining of the stomach, inflammation, and ulcer formation. Other investigators have shown that these bacteria and their products are associated with alterations in the cells lining the stomach that when altered are associated with stomach and other cancers, although these are infrequently seen diseases.
What are the symptoms of H. pylori infections?
Most individuals infected with H. pylori have few or no symptoms. Some may experience a few episodes of gastritis like:
- minor belching,
- bloating,
- nausea,
- vomiting, and
- abdominal discomfort.
Often, these symptoms simply go away. However, those individuals who have a more serious infection exhibit symptoms of stomach and duodenal ulcers or gastritis which include the following:
- abdominal pain and/or discomfort that usually does not wax and wane
- nausea and vomiting sometimes with blood or coffee-ground like vomitus
- dark or tar-like stools (black color of feces due to bleeding ulcers)
- fatigue
- low red blood cell count due to bleeding
- full feeling after a small amount of food
- decreased appetite that is more constant
Other symptoms may include:
- diarrhea,
- heartburn, and
- bad breath (halitosis).
If a person has symptoms of black, tarry stools and fatigue they should seek medical help or go to an emergency department to be evaluated for intestinal bleeding.
Black, tarry stools suggesting intestinal bleeding |
Is H. pylori contagious?
Yes, H. pylori are contagious. However, sometimes there is a grey area between the terms contagious and colonized. Contagious usually implies a disease-causing agent is transferred from person to person, while colonization usually implies a non-disease-causing agent simply populates a body surface but does not cause disease, even when transferred from person to person.
Transmission can occur even with Hp negative |
The grey area occurs when many people have the agent that causes disease in some of them, but not in many others. Some microbiologists consider such organisms as adapting to their human hosts by slowly changing from infecting humans to colonizing them. Although this is speculation, it seems to fit the ongoing situation with H. pylori.
Screening test can be use for detection |
However, others think the bacteria become infecting agents when their genes and surrounding environment trigger H. pylori to produce and release enough toxic chemicals to cause the GI tract to become inflamed.
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