H Pylori
Helicobacter pylori, or H. pylori, are common bacteria that can live in your gut, but for most people it causes no harm. However, for some, it causes damage to the stomach lining, which leaves it open to further damage from acids and toxins in the stomach. This may eventually lead to ulcers, where an area of lining gets worn through.
In the beginning, you may have acid reflux symptoms that give heartburn or indigestion after eating or drinking.
If this continues over time (weeks to months) without treatment, this may cause more lasting damage, causing gastritis or gastroesophageal reflux disease (GERD), where indigestion symptoms are more frequent and long-lasting.
Peptic ulcers – ulcers found in the stomach or small bowel – will cause severe abdominal pain that may leave you doubled over at times. There may be some internal bleeding, so you might notice your stools are black and tarry, or any vomit may resemble the color and consistency of ground coffee. For this, you will need to seek urgent medical attention.
It's important to get your acid reflux symptoms recognized and treated, and if you test positive for H. pylori, this should be treated promptly.
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What's the test for H. pylori?
H. pylori can be commonly detected from a small sample of stool that's sent off to the lab. It can also be tested on the breath or on a tissue sample taken from the stomach lining via camera, but these tests are not routine.
If your doctor has prescribed acid suppression medication such as lansoprazole, omeprazole, or famotidine, stop using this and wait two weeks before getting your test done, to ensure an accurate result.
When should I see my doctor?
If you've had acid reflux symptoms that haven't improved with treatment after three weeks, book a routine appointment with your doctor.
If you have signs of internal bleeding such as severe abdominal pain, you are vomiting with fresh red streaks or coffee-ground material, see your doctor as an emergency, or if after hours, go to your nearest emergency department.
If your doctor has prescribed acid suppression therapy such as lansoprazole, omeprazole, or famotidine, and symptoms have not improved after one to two months of taking it consistently, book a routine appointment for a review and your doctor may consider sending a stool test for H. pylori.
What's an endoscopy?
Depending on your symptoms, your doctor may consider sending you for an endoscopy (also called a gastroscopy), which is a small flexible camera that's inserted in your mouth and the specialist team can see your esophagus, stomach, and possibly your duodenum (the start of your small bowel). They can take tissue samples and look for any damage or ulceration. This is a bit uncomfortable, but not quite as awful as it sounds – you're given a mild sedative to help you relax, and you're awake throughout.
How is H. pylori treated?
Eradication is by triple therapy: you're given two types of antibiotics and a proton pump inhibitor, such as omeprazole or lansoprazole, over the course of one or two weeks. Let your doctor know if you've previously had allergies to any antibiotics, as they can prescribe alternatives.
If symptoms persist after treatment, you may be asked to provide a stool sample for testing. This is because some strains of H. pylori have built a resistance to the usual antibiotics, so an alternative regime will be given if you have a second positive stool test.
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