What is Helicobacter pylori (H. pylori)?
H. pylori is a spiral-shaped bacterium found in the stomach, which (along with acid secretion) damages stomach and duodenal tissue, causing inflammation and peptic ulcers.

How does H. pylori cause damage?
It is believed that H. pylori's shape and characteristics cause the damage that leads to ulcers.

Because of their shape and the way they move, the bacteria can penetrate the stomach's protective mucous lining where they produce the enzyme urease, which generates substances that neutralize the stomach's acids. This weakens the stomach's protective mucus, makes the stomach cells more susceptible to the damaging effects of acid and pepsin, and leads to sores or ulcers in the stomach or duodenum.

The bacteria can also attach to stomach cells, further weakening the stomach's defensive mechanisms and producing local inflammation. For reasons not completely understood, H. pylori can also stimulate the stomach to produce more acid.

What are the symptoms of H. pylori-related ulcers?
The following are the most common symptoms for ulcers, however, each individual may experience symptoms differently.

Soon after being infected with H. pylori, most people develop gastritis -- an inflammation of the stomach lining. However, most people will never have symptoms or problems related to the infection. When symptoms are present, they may include:

• dull, gnawing pain, which may:

• occur 2-3 hours after a meal

• come and go for several days or weeks

• occur in the middle of the night when stomach is empty

• be relieved by eating

• loss of weight
• loss of appetite
• bloating
• burping
• nausea
• vomiting

The symptoms of ulcers may resemble other conditions or medical problems. Consult your physician for a diagnosis.

What causes an H. pylori infection?
Researchers do not yet know what causes certain people to develop H. pylori-related symptoms or ulcers.

In 1982, Australian researchers Barry Marshall and Robin Warren discovered spiral-shaped bacteria in the stomach, later named Helicobacter pylori (H. pylori). After closely studying H. pylori's effect on the stomach, they proposed that the bacteria were the underlying cause of gastritis and peptic ulcers.

In their studies, all patients with duodenal ulcers and 80 percent of patients with stomach ulcers had the bacteria. The 20 percent of patients with stomach ulcers who did not have H. pylori were those who had taken NSAIDs (such as aspirin and ibuprofen) which are a common cause of stomach ulcers.

Although the findings seem conclusive, Marshall and Warren's theory was debated and disputed for some time. However, further evidence linking H. pylori to ulcers mounted over the next 10 years as numerous studies from around the world confirmed its presence in most people with ulcers. Researchers from the United States and Europe proved that using antibiotics to eliminate H. pylori healed ulcers and prevented recurrence in about 90 percent of cases.

To further investigate these findings, the National Institutes of Health (NIH) established a panel to closely review the link between H. pylori and peptic ulcer disease. At the February 1994 Consensus Development Conference, the panel concluded that H. pylori plays a significant role in the development of ulcers and that antibiotics, with other medications, can successfully treat peptic ulcer disease.

• blood tests to identify antibodies that indicate the presence of the bacterium.

• breath tests to determine if carbon is present after drinking a solution that breaks down urea.

• tissue tests - tissue removed during an endoscopy is used to:

• detect the presence of the enzyme urease.
• examine the bacteria that is present.
• start a culture test to grow more bacteria for examination.

Treatment for H. pylori ulcers:
Specific treatment will be determined by your physician(s) based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include:

• antibiotics to kill the bacteria
• medications to suppress acid production, including:

• H₂-blockers - block histamines that stimulate acid secretion and reduce ulcer pain

• proton pump inhibitors - halt the mechanism that pump acid into the stomach

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