Overview and Definition

• H. pylori (helicobacter pylori) is a type of bacteria which lives in the digestive tract.
• "The “H” in the name is short for Helicobacter. “Helico” means spiral, which indicates that the bacteria are spiral shaped."
• If left untreated for years, H. pylori can cause ulcers "in the lining of your stomach or the upper part of your small intestine" and can, for some people, lead to stomach cancer.
• Once there, the bacteria "attacks the lining of your stomach, which usually protects you from the acid your body uses to digest food".
• The H. pylori infection is common, impacting about two-thirds of the global population. However, the majority of people with the bacteria never experience any symptoms.
• The spread of H. pylori has been decreasing as global sanitation has improved.
• H. pylori was first discovered in 1982 as being the primary cause of stomach ulcers.

Causes

• Ultimately, the specific cause of H. pylori is unknown, though doctors and researchers believe it "may be passed from person to person through direct contact with saliva, vomit or fecal matter...[or] through contaminated food or water".
• The bacteria is "more common in countries or communities that lack clean water or good sewage systems", suggesting that it is passed through contaminated water.
• Other risk factors for H. pylori include "living in crowded conditions", lacking a reliable source of clean water, living in or traveling to a developing country, and/or interacting or living with someone who has the bacteria.
• Because the official cause of H. pylori is unknown, it's unclear what can be done to prevent its spread. However, since it "might spread through unclean food and water, you might be able to prevent it if you wash your hands after using the bathroom and before eating, eat properly prepared food, [and/or] drink water from a clean/safe source".

Symptoms and Long-Term Effects

• For the majority of people with H. pylori, there are no symptoms.
• Additionally, the bacteria itself does not cause any symptoms. However, it can cause ulcers, gastritis, and/or stomach cancer if left untreated.
•  Symptoms such as a dull and burning or sharp stomach pain; bloating; burping; lack of hunger; unexplained weight loss; nausea and vomiting; bloody, dark red, or black stool; trouble breathing; dizziness and fainting; fatigue; pale skin; and/or "vomit that has blood or looks like coffee grounds" may be signs of an ulcer or cancer caused by H. pylori.
• Additionally, as the bacteria breaks "down the inner protective coating in some people's stomachs", it can cause inflammation and reflux or GERD.

Age

• H. pylori is most commonly diagnosed in children, though it is possible for adults to contract the bacteria as well.
• It is likely that the bacteria is more common in children because it may be passed via saliva or other liquids, such as a shared beverage. Children are more likely to encounter the bacteria in this way than adults are.
• In addition to being common in children, H. pylori is also more common in senior citizens, with the U.S. prevalence rate for the bacteria being 50 percent for those over 60 years old.

Geography

• H. pylori is most commonly found in developing countries and areas without a reliable source of clean water.
• The bacteria is also more common in these areas because they tend to be home to more crowded and/or unsanitary living conditions.
•  Globally, Africa is the region with the highest incidence rate of H. pylori infection, while the country with the highest incidence rate is Nigeria.

Race and Ethnicity

• In the United States, the Hispanic and black communities are at a higher risk of contracting H. pylori than other racial demographics in the country.
•  Specifically, the incidence rate was 60 percent in the Hispanic community and 54 percent among African Americans, compared to 20 percent in white Americans.
•  Native Americans and Alaskan Natives also had the highest rate of H. pylori in the United States according to a 2018 study which reviewed data from 2000-2015.
•  The study further found that Asian Pacific Islanders and black Americans were at the greatest risk for contracting the bacteria.
• In fact, the study found that ethnic background is the single greatest predictor for H. pylori in the United States.

H. Pylori Treatment Options

Overview

• The exact treatment method that a doctor prescribes will "depend on your symptoms, age, and general health," as well as the severity of the bacteria at the time of treatment.
• Several treatment options include antibiotics, H-2 blockers, proton pump inhibitors, stomach-lining protectors, and antacids. 
• In some cases, depending on the severity of the condition, doctors may prescribe two or more treatment methods simultaneously.

Antibiotics

•  There are a number of antibiotics which doctors can prescribe to treat an H. pylori infection, including amoxicillin, clarithromycin (Biaxin), metronidazole (Flagyl), tetracycline (Sumycin), and tinidazole (Tindamax).
• Most doctors will prescribe at least two antibiotics simultaneously for the treatment of H. pylori, "to help prevent the bacteria from developing a resistance to one particular antibiotic".
• These work by "[killing] the bacteria in your body".
• If the H. pylori infection is severe and has led to the development of an ulcer, doctors will prescribe antibiotics alongside acid-reducing medications.

H-2 Blockers

• H-2 blockers work by "[reducing] the amount of acid in your stomach by blocking the tiny pumps that produce it".
• There are a number of H-2 blockers available which doctors can prescribe, including cimetidine (Tagamet), famotidine (Fluxid, Pepcid), nizatidine (Axid), and ranitidine (Zantac).
• By reducing the amount of acid in one's stomach, doctors can help prevent the development of ulcers which can result from a severe or prolonged H. pylori infection.

Proton Pump Inhibitors

• Another treatment method used to prevent a patient's stomach from producing acid are proton pump inhibitors. "They do this by stopping the stomach's acid pump from working."
• "Some examples of PPIs are omeprazole (Prilosec, others), esomeprazole (Nexium, others), lansoprazole (Prevacid, others) and pantoprazole (Protonix, others)."
• Like H-2 blockers, proton pump inhibitors can be used to help prevent the development of ulcers.

Stomach-Lining Protectors

• An alternative to stopping the production of acid is to protect the stomach-lining from that acid.
• Stomach-lining protectors such as bismuth subsalicylate (more commonly known as Pepto Bismol) "protect your stomach lining from acid and help kill bacteria".
• Additionally, when used alongside antibiotics, this treatment method can "help kill H. pylori".