H. Pylori: Symptoms, Causes, & Treatments

Formally known as Helicobacter pylori, H. pylori is a type of gram-negative bacterium that resides in the digestive tracts of approximately 50 percent of the global population. It’s acquired as early as childhood, and if left untreated, can live in the gut for years before leading to chronic gastritis (stomach inflammation). However, about 80 percent of people with H. pylori remain asymptomatic. This is why H. pylori is often known as a “silent” infection. 

If and when symptoms of H. pylori infection do appear, it’s common to experience acid reflux, heartburn, bloating, nausea, abdominal pain, and other GI issues (especially upper GI issues). In some cases, however, untreated H. pylori infections can lead to more severe health complications such as cardiometabolic dysfunction, gut dysbiosis, gastric ulcers, autoimmune disease, and potentially even stomach cancer. We’ll take a closer look at the link between H. pylori and cancer later in this post. 

For now, let’s take a deeper dive into the topic of H. pylori and discuss its potential causes, symptoms, risks, and treatments. 

H. pylori causes and symptoms: what to know

There are several potential causes of H. pylori, with contaminated food and water consumption being the most common. However, H. pylori can also be transmitted from person to person through “fecal-oral, gastric-oral, oral-oral, and sexual routes” (Zamani et al., 2017). 

Although most people with H. pylori never experience symptoms of infection or develop related conditions like stomach cancer and ulcers, others might develop high or low levels of stomach acid and one or more gastrointestinal issues. This is because the bacterium can infect the stomach, stomach lining, and duodenum, leading to GI symptoms in susceptible individuals. 

Some common H. pylori infection symptoms include:

• Acid reflux & Heartburn.
• Abdominal pain or burning.
• Bloating.
• Nausea.
• Vomiting.
• Dyspepsia (indigestion). 
• Weight loss.
• Dark stool.

Unless eradicated, H. pylori infections can also inflame the stomach lining, induce mucosal atrophy, and lead to peptic and duodenal ulcers. Less commonly, the bacterium can cause precancerous lesions and stomach cancer as well. 

Can H. pylori cause autoimmune disease?

H. pylori has even been associated with everything from vitamin B12 deficiency and iron deficiency anemia to Alzheimer’s disease and skin disorders like rosacea. It’s associated with an increased risk of autoimmune thyroid diseases like Hashimoto’s thyroiditis and Graves’ disease as well.

The bacterium may also play a role in triggering other autoimmune conditions, including idiopathic thrombocytopenic purpura (ITP), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC). What’s more, chronic H. pylori infection can affect our mood, cognition, appetite, food intake, and susceptibility to stress (because of the gut-brain axis). The list goes on!

H. pylori and cancer: is there a risk?

As mentioned earlier, H. pylori infections can increase the risk of gastric cancer in some people. However, less than three percent of those with H. pylori infections develop stomach cancers such as gastric adenocarcinoma and gastric MALT lymphoma. The link between H. pylori and gastric cancer comes down to the presence of virulence factors: genes that can make the bacteria more virulent (or toxic). 

For instance, the virulence factors BabA, CagA, OipA, and VacA are associated with an increased risk of gastric cancer. If an individual is infected with H. pylori, the presence of one or more of these virulence factors can make the bacterium more toxic — increasing the risk of certain types of cancer. 

On the other hand, some virulence factors (like DupA and IceA) aren’t associated with cancer but are associated with other complications such as ulcers and dyspepsia. Still, as a group one carcinogen — meaning Helicobacter is a known cancer-causing agent — H. pylori is something we want to detect and eradicate as quickly and effectively as possible. 

How to test for H. pylori infection

To test for H. pylori infections and virulence factors, I prefer to use the GI-MAP™ stool test from Diagnostic Solutions. The GI-MAP is a comprehensive test that measures microorganisms in the gut, including the type and amount. It can be used to look for:

• The presence of H. pylori in stool.
• The presence of positive virulence factors such as BabA, CagA, DupA, IceA, OipA, VacA, VirB, and VirD.

In addition to GI-MAP stool testing, urea breath tests (UBT) and stool antigen tests can be used to diagnose H. pylori. An upper endoscopy is another type of H. pylori test that can be used, but this is the most invasive method. For most people, stool testing is a great starting point. 

H. pylori treatments and considerations

In most cases, treating H. pylori is individualized and depends on the specific situation. For instance, eradicating H. pylori depends largely on each patient’s symptoms, overall gut health, clinical history, and the presence of one or more virulence factors. 

Treatment options may include probiotic supplements; herbal formulas like mastic gum and deglycyrrhizinated licorice (DGL); and one or more antibiotics. Commonly used antibiotics for H. pylori infections include Fluoroquinolones, Clarithromycin, Amoxicillin, and Tetracycline. 

Dietary interventions can also be helpful when addressing H. pylori, as many fruits, vegetables, oils, herbs, and spices can effectively reduce inflammation and support gut health.

Diets high in fruits, vegetables, and fiber have shown protective effects.

On the other hand, a diet low in micronutrients, as well as smoking, alcohol, and hyperglycemia increase the risk of H. pylori infection.