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H. Pylori infection is the most common cause of stomach and duodenal ulcers worldwide. It is one of the risk factors for gastric cancer. Eradication of this bacterium from the stomach is a prerequisite for the successful healing of an ulcer. Early eradication prevents the complications of gastric ulcer.

H. Pylori makes certain changes in the inner wall of stomach that make it more susceptible to the acidic damage. The excessive acidic damage causes erosion of stomach wall that ultimately results in ulcer formation. If H. pylori. ulcer is not treated timely, it may lead to the perforation, which is a serious complication of gastric ulcer.

Symptoms of H Pylori associated ulcers include

  • Discomfort or pain in abdomen
  • Bloating
  • Early satiety (A feeling of fullness of stomach after eating some food)
  • Loss of appetite
  • Nausea or vomiting
  • Blood in the stools or dark-colored stools (from a bleeding ulcer)

If the ulcer is not treated timely it may bleed into the stomach. An untreated ulcer can also cause a perforation which means that the ulcer has eroded through the entire thickness of the stomach wall or in simple words it has created a hole in the gastric wall. Early eradication of H Pylori and healing of the ulcer is therefore very important in preventing these serious complications.

Diagnosis of H Pylori  

The following three tests are most commonly used for diagnosis an H pylori infection of the stomach.

  • Breath test- also known as urea breath test is a quick procedure in which you drink a solution containing special substance, H pylori breaks down this substance and the products can detected in your breath.
  • Stool Test- detects the antigens of H pylori in the stools
  • Blood Test-detects the antibody to H pylori in the blood

Treatment of H. Pylori Infection

The most popular and effective treatment for eradication of H pylori is the “Triple Therapy” in which a three drug regimen is given to the patient for a certain amount of time. These regimens include two antibiotics (to kill the bacteria) and a proton pump inhibitor (to decrease the acid secretion and to protect the stomach wall). Most commonly used regimens include

  • OAC regimen- which includes Omeperazole, Amoxicllin and Clarithromycin for 10 days
  • BMT regimen- includes Bismuth Subsalicylate (which is a protective agent), metronidazole and Tetracycline for 14 days
  • LAC regimen- includes Lansoperazole, Amoxicillin and Clarithromycin for 10-14 days

These regimens are usually effective in most of the patients and result in a complete recovery of the ulcer. Side effects of these drugs include abdominal cramps, constipation, vomiting, diarrhea, metallic taste in mouth (metronidazole) and black stools (bismuth).

Possible Causes of Treatment Failure or Relapse

More than 80 percent of the patients are treated successfully after a complete course; however about 20 percent people continue to have the same symptoms. The possible causes of treatment failure include;

  • Non-compliance of the patient 
  • Antibiotic resistance
  • Side effects

Some patients stop the treatment early due to side effects. In this case, you should contact your health care provider. The doctor will change an antibiotic or may even switch to another regimen. Do not do it by yourself. Any change in the medicine should be done under medical supervision.

It’s important to complete the full course of antibiotics, even if your symptoms are gone on the seventh day. Stopping the treatment early will cause incomplete eradication and symptoms may return after some time.   

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