What is H. pylori?

h pylori

What is H. pylori?

Helicobacter pylori, more commonly called H. pylori, is a bacteria that can infect the lining of the stomach. It is very common with up to 50% of the world population having the infection at some point in their life. It tends to occur in childhood, but most of the time does not cause any symptoms. However, in some kids it can lead to inflammation in the lining of the stomach which can cause pain, reflux, and sometimes ulcers. We do not know exactly how people get infected with H. pylori, but we do know it can be transmitted by saliva and water. We think family members can be infected when they share silverware and cups.

What are the symptoms?

Again, most individuals who have the bacteria never develop any symptoms. However, in those that do get symptoms, it typically presents with epigastric abdominal pain, reflux, nausea, vomiting, or even GI bleeding from an ulcer. In a small portion of patients, it can also lead to gastric cancer if left untreated.
child with stomach ache

How is it diagnosed?

  • There are a few ways we can test for H. pylori, but the best test we have right now is endoscopy with biopsy. This allows us to look at the lining of the stomach for inflammation and ulcers while also getting samples of the tissue, known as biopsies, to look for the bacteria. This also allows us to look for other causes of the symptoms as it is not always H. pylori.
  • There is also a urea breath test where we have patients swallow a pill or liquid that contains a special substance that the bacteria can break down. We then check the patient’s breath for that broken down substance. The downside is that acid-blocking medicines used to treat reflux can interfere with this test and can lead to a false negative.
  • There is a stool test for H. pylori which can detect the H. pylori proteins, known as antigens, in your poop. We typically use this test to screen family members of those infected with the bacteria or to check if the H. pylori bacteria has been eradicated after treatment. It also can have a false negative if taking acid-blocking medications.

How do we treat H. pylori?

We treat the bacteria with a combination of two antibiotics and one acid-blocking medication. This is known as triple therapy. The acid blocking medication is typically a proton pump inhibitor (PPI) such as omeprazole or pantoprazole. The antibiotics are amoxicillin, clarithromycin, and/or flagyl. The antibiotics are taken for 14 days while the PPI is taken for a full month. 

Doctor holding chart
Sometimes this fails and we have to use a different combination, or add a fourth medicine known as bismuth. We check the stool antigen test to make sure the bacteria has been cured once the treatment course is complete. It is important that we also screen and treat any family members who may be infected as the risk of re-infection is high.
PB Digestive Pediatric Doctors

Your Pediatric Team at PB Digestive

Sari M. Kay, MD is a board-certified Pediatric Gastroenterologist. She has a specialties and expertise in treating patients with inflammatory bowel disease, celiac disease, eosinophilic esophagitis, constipation, infant reflux, and functional GI disorders.

Laura E. Irastorza, MD is a board-certified Pediatric Gastroenterologist. She has expertise in treating patients with eosinophilic esophagitis, constipation, reflux, and functional GI disorders such as irritable bowel syndrome.

 Palm Beach Digestive Associates
Palm Beach Digestive Associates

As the premier Gastroenterology Practice & Colonoscopy Clinic in South Florida, Palm Beach Digestive Associates offers the knowledge and experience valued by patients who are suffering from Digestive Problems and Liver Disease. From the most common stomach ailments to the most serious gastrointestinal issues, our Board Certified specialists are highly skilled in evaluating and treating every type of Liver and Digestive Disorder, as well as the detection and treatment of Colon Cancer.

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