Helicobacter pylori Infection

Helicobacter pylori (H. pylori) infection occurs when this bacterium colonises the stomach, usually during childhood. It is very common, affecting approximately two-thirds of the world’s population. In most cases, the presence of the bacterium causes no symptoms, but it may lead to the development of peptic ulcers, which are sores or bleeding in the lining of the stomach (gastric ulcer) or the first part of the small intestine (duodenal ulcer).

Symptoms may include:

• Stomach pain or burning sensation;
• Abdominal bloating;
• Loss of appetite;
• Nausea and vomiting;
• Frequent belching;
• Unexplained weight loss.

When gastric or duodenal ulcers caused by H. pylori infection are present, bleeding is a possible complication. Individuals should be alert to signs of internal bleeding, such as dark stools (tar-like), stools with fresh blood, vomiting blood, dizziness, chest pain, fatigue and pallor. This condition may progress to anaemia.

The bacterium is transmitted from person to person, mainly via the oral–oral or faecal–oral route, such as by sharing food or utensils without proper hygiene, or through contact with faeces or vomit. Children and people living in environments with poor sanitation, overcrowding or lack of clean water are at higher risk.

Diagnosis is made by a gastroenterologist using complementary tests, such as:

• Breath test to detect H. pylori;
• Stool analysis;
• Upper gastrointestinal endoscopy with biopsy, which confirms the presence of the bacterium and allows assessment of gastric or duodenal lesions.

Treatment of H. pylori infection, even when asymptomatic, is essential due to the risk of serious complications. Therapy usually combines multiple antibiotics to reduce bacterial resistance, along with proton pump inhibitors to reduce stomach acid production. Avoidance of non-steroidal anti-inflammatory drugs (NSAIDs) is also recommended, as they increase the risk of peptic ulcer disease.

Prevention involves hygiene measures and safe food practices, such as drinking potable water, washing hands before meals and after using the toilet, consuming well-cooked food and avoiding meals prepared by individuals with poor hygiene. Although stress and spicy foods do not cause the infection, they may hinder treatment and worsen symptoms and should therefore be avoided whenever possible.