H. pylori Infection
Also known as: Helicobacter pylori, H. pylori gastritis
Helicobacter pylori, usually called H. pylori, is a spiral-shaped bacterium that lives in the stomach lining. It is one of the most common infections in the world and is usually acquired in childhood, often through close contact, contaminated food or water, or shared utensils. Most people who carry it never have symptoms, but in some it causes chronic inflammation of the stomach (gastritis), peptic ulcers, and over many years an increased risk of stomach cancer. The infection is diagnosed with simple breath, stool, or endoscopy tests and is cured with a short course of combined antibiotics and acid-suppressing medication. Treating it heals ulcers and reduces the long-term risk of cancer.
At a Glance
- Common symptoms
- Often no symptoms at all, A gnawing or burning pain in the upper abdomen, sometimes worse on an empty stomach, Bloating, burping, and feeling full quickly
- Main treatments
- A 10- to 14-day course of two or more antibiotics (such as amoxicillin, clarithromycin, metronidazole, or tetracycline) combined with a proton pump inhibitor, Bismuth-based quadruple therapy, often used where antibiotic resistance is common or after a first course fails, Completing the entire course even if you feel better, since partial treatment encourages resistant bacteria
- Category
- Infectious · Very common worldwide; carried by a large share of the global population, most without symptoms
- See a doctor if
- Persistent upper abdominal pain, especially pain that wakes you at night or improves with eating
Symptoms
Causes
- Infection with the H. pylori bacterium, usually acquired in childhood
- Person-to-person spread through saliva, vomit, or stool, especially within households
- Contaminated food or water in areas with poor sanitation
- The bacterium produces enzymes that neutralize stomach acid and burrow into the mucus layer, triggering chronic inflammation
Risk Factors
- Growing up in crowded conditions or a household with an infected member
- Living in or coming from a region with limited clean water and sanitation
- Lack of reliable access to clean water
- Older age, since prevalence rises with each birth cohort of earlier decades
- A family history of stomach cancer or peptic ulcer disease
Diagnosis
- Urea breath test, in which you swallow a labeled compound and breathe into a container
- Stool antigen test to detect bacterial proteins
- Blood antibody test, which shows past exposure but cannot tell whether the infection is still active
- Endoscopy with biopsy of the stomach lining when ulcers, bleeding, or cancer need to be ruled out
- Repeat breath or stool testing at least four weeks after treatment to confirm the infection is gone
Treatment
- A 10- to 14-day course of two or more antibiotics (such as amoxicillin, clarithromycin, metronidazole, or tetracycline) combined with a proton pump inhibitor
- Bismuth-based quadruple therapy, often used where antibiotic resistance is common or after a first course fails
- Completing the entire course even if you feel better, since partial treatment encourages resistant bacteria
- Follow-up testing to confirm eradication, with a different antibiotic combination if the first course fails
- Continued acid suppression for a few weeks to allow ulcers to heal
- Supportive: limiting alcohol, smoking, and nonsteroidal anti-inflammatory drugs, which irritate the stomach lining and slow healing
- Supportive: some probiotics may reduce antibiotic side effects such as diarrhea; evidence is modest and they do not replace treatment
Prevention
- Wash hands thoroughly after using the toilet and before preparing or eating food
- Drink water from a safe, clean source, especially when traveling
- Avoid sharing utensils, cups, or toothbrushes
- Make sure food is properly cooked and stored
- Consider testing household members if someone has been treated and the infection recurs
- Ask about testing if you have a family history of stomach cancer
When to See a Doctor
- Persistent upper abdominal pain, especially pain that wakes you at night or improves with eating
- Black, tarry stools or vomiting blood or material that looks like coffee grounds (emergency)
- Difficulty swallowing, persistent vomiting, or unexplained weight loss
- Unexplained iron deficiency anemia
- Indigestion that does not settle after a few weeks of over-the-counter remedies
Frequently Asked Questions
Related Conditions
Have questions about H. pylori Infection?
Ask Mother Nature AI for personalized, evidence-based guidance.
Ask about H. pylori InfectionMedical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.
Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.