What exactly is H. pylori?
DEAR DR. ROACH: My 82-year-old husband was diagnosed with H. pylori and was treated with two antibiotics and omeprazole. Would you please expand on what exactly H. pylori is?
ANSWER: Helicobacter pylori is a bacteria species that is able to live in the stomach. It was identified in a paper from 1984 and is now recognized as a major contributor to gastrointestinal ulcers and inflammation. In addition, it plays a role in the development of certain types of stomach cancers.
H. pylori is the underlying cause of most stomach and duodenal ulcers, and people who have these ulcers are tested for H. pylori and treated if the bacteria is present. Treatment helps speed recovery and prevent recurrence of disease.
H. pylori is hard to kill. A common regimen is clarithromycin, amoxicillin and omeprazole. Diagnosis can be made with biopsy specimens taken at the time of upper endoscopy, or by a breath test or stool test. Blood testing is not reliable.
In people with stomach symptoms but who do not require endoscopy, many clinicians choose to look for H. pylori by stool or breath testing, and treat if present. Unfortunately, treating the infection is effective at curing symptoms only a minority of the time.
H. pylori increases the risk of stomach cancer and is the cause of most cases of a cancer called a MALToma. People with this unusual cancer often are cured (or at least have no evidence of disease after multiple years) with successful treatment of H. pylori, making it the first known cancer to be cured with antibiotics.
The risk for stomach cancer in North America is relatively low, so experts do not advise screening for H. pylori solely for the purpose of treating people to reduce their risk of stomach cancer. However, some people at high risk due to family history or other risk factors may elect screening.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth @med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.