H. pylori infection

Helicobacter pylori is a common type of bacteria that can infect the lining of the stomach, often without causing any symptoms, though in some people it leads to gastritis, peptic ulcers, or increases the risk of stomach cancer over time. It is one of the most common chronic bacterial infections worldwide. Infection often occurs in childhood and can persist for years if untreated.

It is caused by the bacterium Helicobacter pylori, thought to spread through close contact, contaminated food or water, or from person to person, particularly within households. Poor sanitation and crowded living conditions in childhood increase the risk of acquiring infection. Once acquired, it can persist indefinitely unless specifically treated.

Many people with H. pylori have no symptoms at all, but when present, symptoms can include indigestion, bloating, nausea, and upper abdominal pain, particularly if it has caused gastritis or a peptic ulcer. More severe symptoms, such as vomiting blood or black stools, indicate a bleeding ulcer and need urgent attention. Symptoms often prompt the testing that leads to diagnosis.

While many people carry H. pylori without harm, it is a significant cause of peptic ulcers and is linked to an increased long-term risk of stomach cancer, which is why it is generally treated once found, particularly in people with symptoms or ulcers. Treating the infection significantly reduces these risks. It is not typically an emergency, but persistent symptoms should always be properly investigated.

Testing can be done using a breath test, a stool antigen test, or during an endoscopy with a biopsy of the stomach lining. Blood antibody tests are less commonly used now as they cannot distinguish current from past infection. Your doctor will choose the most appropriate test based on your symptoms and situation.

Treatment typically involves a one to two week course combining two antibiotics with a medication that reduces stomach acid (a proton pump inhibitor), known as eradication therapy. A follow-up breath or stool test is often done a few weeks after treatment to confirm the infection has cleared. Completing the full course of treatment is important for successful eradication.

Yes, H. pylori infection can usually be successfully cured with the correct combination antibiotic treatment, with cure rates generally high, though some strains show antibiotic resistance requiring a different treatment combination. Reinfection after successful treatment is uncommon but possible, particularly in areas with poor sanitation. Confirming eradication with a follow-up test gives reassurance that treatment has worked.

Indigestion has many possible causes, including H. pylori infection, acid reflux unrelated to infection, and other digestive conditions, and symptoms alone often cannot reliably distinguish between them. Specific testing for H. pylori, through a breath, stool, or endoscopy-based test, is needed to confirm or exclude this particular cause. Identifying H. pylori matters because, unlike many other causes of indigestion, it is treated with antibiotics rather than acid-suppressing medication alone.

Get tested if you have persistent indigestion, upper abdominal pain, or a known or suspected peptic ulcer, or if a close family member has had H. pylori-related stomach problems. A private gastroenterology or GP assessment with testing can typically be arranged within about one to two weeks. Seek urgent care instead if you have symptoms of a bleeding ulcer, such as vomiting blood or passing black, tarry stools.