Peptic ulcers are open sores in the lining of the stomach or the upper part of the small intestine. Peptic ulcers are often called "ulcers" or "stomach ulcers."
For years, medical experts believed that peptic ulcers were caused by stress or certain foods. After the discovery of H. pylori, however, this belief was put to rest. A study in Digestive and Liver Disease suggests that 60 to nearly 100 percent of peptic ulcers are associated with H. pylori.
Peptic ulcers may also be caused by long-term use of certain medicines. These may include pain relievers such as ibuprofen, aspirin, and naproxen. These medicines are called NSAIDs, or non-steroidal anti-inflammatory drugs. A study in The Lancet found that ulcers are rare in people who don't take NSAIDs and who don't have H. pylori in their stomachs.
Ulcers aren't the only problems associated with H. pylori. The researchers also discovered H. pylori causes gastritis, a condition that causes inflammation of the stomach's lining. H. pylori infection is also linked to stomach cancer. However, the American Cancer Society state that most people with H. pylori in their stomach never develop stomach cancer.
Contents of this article:
How does H. pylori make you sick?
Many people have H. pylori in their stomachs and do not have ulcers or other problems. In fact, two-thirds of the world's population have H. pylori, according to the Centers for Disease Control and Prevention (CDC). But for reasons not yet understood, some people get ulcers, gastritis, or stomach cancer from an H. pylori infection.
H. pylori bacteria attack the protective lining of the stomach.
The stomach has a layer made of mucus that is designed to protect it from stomach acid. H. pylori attacks this mucus lining and leaves part of the stomach exposed to acid. Together, the bacteria and the acid can irritate the stomach, causing ulcers, gastritis, or stomach cancer.
How do you get H. pylori?
No one knows for sure how people catch H. pylori. In some cases, contaminated food or water may be to blame. It has been found in human saliva, so experts think it may be able to spread from person to person.
There is no known way to prevent H. pylori infection, but experts recommend:
- Washing hands before eating and after using the restroom
- Eating food that has been handled and prepared safely
- Drinking only clean, safe drinking water
H. pylori infections are more common in developing countries where people may not have access to clean, safe food and water.
Symptoms of an H. pylori infection
Many people with H. pylori don't have any signs or symptoms. If people get an illness caused by H. pylori, however, they may have various symptoms.
If someone has a stomach ulcer, their symptoms may include a dull or burning pain in the upper belly area. The pain may be worse at night, or when their stomach is empty They may get temporary relief from taking an antacid, but the pain comes back.
Symptoms of gastritis often include upper belly pain, nausea, and vomiting.
A study in Alimentary Pharmacology & Therapeutics states that people with H. pylori infection may be up to six times more likely to get stomach cancer. Quick treatment of H. pylori can help reduce the damage that H. pylori may cause. This, in turn, may help reduce the risk of stomach cancer and other problems.
Most stomach ulcers are caused by H. pylori bacteria.
Possible symptoms of stomach cancer include:
- Belly pain or swelling
- Loss of appetite
- Nausea or indigestion
- Feeling full without eating very much
People with any of these symptoms should talk with their doctor. These symptoms may be caused by other conditions, so proper medical care is needed to diagnose the issue.
An ulcer can lead to serious complications if left untreated. These may include:
- Internal bleeding that can become life-threatening
- A hole in the stomach that can lead to infection
- Scar tissue that can block the stomach or intestine, preventing it from emptying food
These complications require immediate medical attention. Possible warning signs include:
- Severe stomach pain
- Black or tarry stool
- Stool with bright red blood
- Vomit with bright red blood
- Vomit that looks like coffee grounds
- Feeling weak or short of breath
- Feeling dizzy or faint
- Chills or fever
Testing and treatment for H. pylori infections
People who have symptoms of an ulcer, gastritis, or another stomach issue may be tested for H. pylori or other problems. H. pylori can be detected with blood, breath, or stool tests.
Ulcers, gastritis, and stomach cancer are often diagnosed with a combination of the following tests:
- Medical history: Past medical problems and symptoms are discussed
- Physical exam: Examining and listening to the belly
- Special X-rays that show the inside of the stomach
- Endoscopy: Doctors view the inside of the stomach with a special instrument while the patient is sedated or put to sleep
Problems caused by H. pylori such as stomach ulcers can be diagnosed with an endoscopy.
If an ulcer is found, patients may be treated with a variety of medications, including some or all of the following:
- Antibiotics to kill H. pylori
- Medicines that reduce stomach acid called proton pump inhibitors (PPIs) or histamine receptor blockers
- Medicines that coat the ulcer and help it heal
Sometimes, a peptic ulcer can come back after treatment. To help avoid this, experts recommend:
- Stopping NSAIDs or taking a much smaller dose
- Only taking NSAIDs with special medicines that protect the stomach
- Avoiding alcohol
- Not smoking
Antibiotic resistance and H. pylori
Most H. pylori infections can still be successfully treated with antibiotics. However, research suggests that some H. pylori infections are becoming resistant to certain antibiotics. This means H. pylori is able to survive antibiotic treatment and the patient may need another drug in order to kill the bacteria.
A study in the journal Clinical Gastroenterology and Hepatology found some patients in the U.S. had H. pylori infections that were resistant to two different antibiotics. The American Journal of Gastroenterology reported a high number of resistant H. pylori bacteria in Latin American countries.
Antibiotic resistance is a growing problem across the globe. The CDC say that more than 23,000 people die each year as a result of an antibiotic-resistant infection. Many people may have heard of methicillin-resistant Staphylococcus aureus (MRSA) but there are many other types of bacteria that have become resistant to antibiotics.
Everyone can do their part to help fight the problem of antibiotic resistance. The CDC say that people should:
- Use antibiotics only when prescribed by a doctor
- Never use antibiotics for colds or the flu - these are viruses, and antibiotics won't work against these illnesses
- Take the entire course of antibiotics
- Never share antibiotics with others
- Never use old or leftover antibiotics
Fortunately, H. pylori is still treatable with several different antibiotics. Quick treatment will help prevent damage to the stomach and the possible problems of ulcers, gastritis, and stomach cancer.