H pylori

---

Helicobacter pylori is a bacterium which infects the lining of the stomach and is responsible for a high percentage of stomach and duodenal ulcers and is associated with stomach cancer and MALT lymphoma. 

According to World Gastroenterology Organization guideline, about 50% of the world population are infected. It is thought that the bacterium is spread via person-to-person contact. It is common for H. pylori to be spread between family members. When a diagnosis of H. pylori infection is made, it is now advisable for immediate family members to be also breath tested and treated.

Bad breath.

Dull or burning pain in your stomach. 

Unplanned weight loss. 

Bloating. 

Nausea and vomiting. 

Indigestion (dyspepsia). 

Burping. 

Loss of appetite. 

Dark stools. 

The recognition that H. pylori was the cause of most duodenal ulcers and about two-thirds of gastric ulcers was a seminal, Nobel Prize–winning medical breakthrough.NSAIDs and aspirin cause most other peptic ulcers. H. pylori and NSAIDs act synergistically to increase the risk of ulcers and bleeding. Eradication of H. pylori reduces this risk before the start of chronic NSAID therapy. 

H. pylori has been estimated to confer an individual lifetime risk of gastric cancer of 1.5–2.0% in infected individuals.Eradication of H. pylori before the occurrence of adverse, precancerous histological changes has been shown to prevent gastric cancer and is the rationale for mass test-and-treat screening programs in young adults in countries with a high burden of disease and with sufficient resources to devote to this endeavor.

• Past or present duodenal and/or gastric ulcer, with or without complications

• Gastric mucosa-associated lymphoid tissue (MALT) lymphoma

• Gastric mucosal atrophy and/or intestinal metaplasia

• Following resection of gastric cancer

• Patients who are first-degree relatives of patients with gastric cancer

• Patients’ wishes (after full consultation with their physician)

• Functional dyspepsia

• To reduce the risk of peptic ulcer and upper gastrointestinal bleeding in nonsteroidal antiinflammatory drug-naive users

• Before starting long-term aspirin therapy for patients at high risk for ulcers and ulcer-related 

complications

• Patients receiving long-term low-dose aspirin therapy who have a history of upper gastrointestinal 

bleeding and perforation

• Patients with gastroesophageal reflux disease who require long-term proton-pump inhibitors

• As a strategy for gastric cancer prevention in communities with a high incidence

• Unexplained iron-deficiency anemia, or idiopathic thrombocytopenic purpura

UBT is the most investigated and best recommended non-invasive test in the context of a ‘test-and-treat strategy’. Monoclonal SAT can also be used. Serological tests can be used only after validation. Rapid (‘office’) serology tests using whole blood should be avoided in this regard.