{"id":105050,"date":"2017-07-10T01:52:22","date_gmt":"2017-07-10T07:52:22","guid":{"rendered":"http:\/\/www.granitepeaksgi.com\/?p=105050"},"modified":"2019-04-18T10:26:04","modified_gmt":"2019-04-18T16:26:04","slug":"ten-faqs-about-helicobacter-pylori-h-pylori","status":"publish","type":"post","link":"https:\/\/www.granitepeaksgi.com\/ten-faqs-about-helicobacter-pylori-h-pylori\/","title":{"rendered":"10 FAQs about Helicobacter pylori"},"content":{"rendered":"<p><em><strong>By <a href=\"http:\/\/www.granitepeaksgi.com\/physician\/christopher-s-cutler-md-2\/\">Christopher S. Cutler, M.D.<\/a><\/strong> <\/em><\/p>\n<ul>\n<li><strong>1) What is Helicobacter pylori?<\/strong> Helicobacter pylori (H. pylori) is one of the most common bacterial infections in the world, present in half of the population. The prevalence of H. pylori is generally lower in the United States than in many other parts of the world. It is more common in African Americans and Hispanics than in Caucasians. H. pylori is found in the stomach and is a very common cause of peptic ulcer disease.<\/li>\n<\/ul>\n<p><strong>2) How is it spread?<\/strong> The route by which the infection is spread is unknown. People could be infected by contaminated water in developing countries. Person to person transmission probably also occurs. The infection is usually acquired in childhood. Risk factors include low socioeconomic status, increasing number of siblings, and having an infected parent. Reinfection is rare, seen in less than 2% of persons per year. A repeat positive <a href=\"http:\/\/www.granitepeaksgi.com\/procedure\/h-pylori-breath-testing\/\">test for H. pylori<\/a> usually signifies a recurrence of the bacteria which was not adequately treated.<\/p>\n<p><strong>3) What can H. pylori infection lead to?<\/strong> pylori infection may cause:<br \/>\n\u2022 peptic ulcer disease<br \/>\n\u2022\u00a0chronic gastritis<br \/>\n\u2022\u00a0gastric cancer<br \/>\n\u2022\u00a0gastric MALT lymphoma.<\/p>\n<p><strong>4) What are common symptoms of H. pylori?<\/strong> Symptoms that patients experience are usually from an ulcer caused by H pylori. These can include: upper abdominal pain, bloating, feeling full after a small meal, poor appetite, <a href=\"http:\/\/www.granitepeaksgi.com\/condition\/gas-bloating-nausea-vomiting\/\" target=\"_blank\" rel=\"noopener noreferrer\">nausea and vomiting<\/a>, intestinal bleeding, and fatigue from anemia.<\/p>\n<p><strong>5) Who should be tested for H. pylori?<\/strong> There is no reason for universal screening in North America. The following conditions warrant testing for H. pylori:<br \/>\n\u2022\u00a0active peptic ulcer disease<br \/>\n\u2022\u00a0a past history of peptic ulcer disease if cure of H. pylori has not been documented<br \/>\n\u2022\u00a0low grade gastric MALT lymphoma<br \/>\n\u2022\u00a0early gastric cancer resected during an endoscopy<br \/>\n\u2022\u00a0dyspepsia (upper abdominal pain) in people younger than 60 years old with no other worrisome symptoms<br \/>\n\u2022\u00a0prior to starting chronic treatment with NSAIDs or low-dose aspirin<br \/>\n\u2022\u00a0unexplained iron deficiency anemia<br \/>\n\u2022\u00a0idiopathic immune thrombocytopenia in adults<\/p>\n<p><strong>6) What tests can be performed to diagnose H. pylori?<br \/>\n<\/strong>\u2022\u00a0upper endoscopy with stomach biopsies \u2013 shows active infection, sensitivity of 95%<br \/>\n\u2022\u00a0urea breath test \u2013 shows active infection, sensitivity up to 95%<br \/>\n\u2022\u00a0stool antigen test \u2013 shows active infection, sensitivity of 94%<br \/>\n\u2022\u00a0blood test for H. pylori antibody &#8211; this can\u2019t distinguish between active and past infection<\/p>\n<p><strong>7) What interferes with testing for H. pylori?<\/strong> The following may decrease the sensitivity of H. pylori tests:<br \/>\n\u2022\u00a0active bleeding from an ulcer<br \/>\n\u2022\u00a0use of a <a href=\"http:\/\/www.granitepeaksgi.com\/safe-proton-pump-inhibitors\/\">proton pump inhibitor<\/a> (Prilosec) within 1-2 weeks of testing<br \/>\n\u2022\u00a0bismuth or antibiotic use within 4 weeks of testing.<\/p>\n<p><strong>8) How is H. pylori treated? <\/strong>All patients with documented H. pylori infection should be offered therapy.<br \/>\n\u2022\u00a0<em>Triple therapy<\/em> consists of: a proton pump inhibitor twice daily, amoxicillin 1 gram twice daily, and clarithromycin 500 mg twice daily, all for 14 days. Eradication rates are approximately 80% with this regimen. If the patient is allergic to penicillin, metronidazole 500 mg three times daily can be substituted for amoxicillin. Previous exposure to clarithromycin reduces the efficacy of this regimen.<br \/>\n\u2022\u00a0<em>Quadruple therapy <\/em>consists of: a proton pump inhibitor twice daily, bismuth subsalicylate 300 mg 4 times daily, metronidazole 250 mg 4 times daily, and tetracycline 500 mg 4 times daily, all for 14 days. Eradication rates are approximately 91% with this regimen.<br \/>\n\u2022\u00a0There are multiple other drug regimens, utilizing antibiotics such as levofloxacin, that may be used depending \u00a0on antibiotic resistance and prior response to the above.<\/p>\n<p><strong>9) Should patients be tested to prove eradication of H. pylori? <\/strong>Yes, especially because of increasing antibiotic resistance. This can be done with gastric biopsies during an endoscopy, with a urea breath test, or with stool antigen testing. Patient should be off of proton pump inhibitors for 1-2 weeks and off of bismuth and antibiotics for 4 weeks prior to testing. If someone has failed 2 courses of antibiotics, consideration should be given to an endoscopy with gastric biopsies for H. pylori culture and sensitivity.<\/p>\n<p><strong>10) Who is Barry Marshall? <\/strong>Barry Marshall is an Australian physician who won the Nobel Prize in Medicine for his discovery of Helicobacter pylori and its role in gastritis and peptic ulcer disease. This was one of my favorite stories in medical school. Dr. Marshall had an endoscopy performed which was normal. He then drank a broth of H. pylori bacteria. A few days later he developed nausea, vomiting, bloating, and bad breath. On day 8 he had a repeat endoscopy showing severe gastritis and a biopsy showing that the H. pylori had colonized his stomach. His work changed the perception that ulcers were simply due to stress.<\/p>\n<p><a href=\"http:\/\/www.granitepeaksgi.com\/gi-conditions\/\" target=\"_blank\" rel=\"noopener noreferrer\">Click here to learn more<\/a> about common GI conditions. <a href=\"http:\/\/www.granitepeaksgi.com\/request-appointment\/\" target=\"_blank\" rel=\"noopener noreferrer\">Schedule an appointment<\/a> with Granite Peaks Gastroenterology.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By<a href=\"http:\/\/www.granitepeaksgi.com\/condition\/heartburn-acid-reflux\/symptoms\/\"> <\/a>Christopher S. Cutler, M.D. 1) What is Helicobacter pylori? Helicobacter pylori (H. pylori) is one of the most common bacterial infections in the world, present in half of the population. The prevalence of H. pylori is generally lower in the United States than in many other parts of the world. It is more common [&hellip;]<\/p>\n","protected":false},"author":28,"featured_media":105056,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"wds_primary_category":0,"footnotes":""},"categories":[5,410],"tags":[411,413,255,412],"acf":[],"_links":{"self":[{"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/posts\/105050"}],"collection":[{"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/comments?post=105050"}],"version-history":[{"count":0,"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/posts\/105050\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/media\/105056"}],"wp:attachment":[{"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/media?parent=105050"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/categories?post=105050"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.granitepeaksgi.com\/wp-json\/wp\/v2\/tags?post=105050"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}