H. Pylori Infection

H. pylori Infection & Gastritis

Gastritis is an inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of non-steroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin, ibuprofen and naproxen. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria; primarily Helicobacter pylori (H. pylori), chronic bile reflux, stress and certain autoimmune disorders can cause gastritis as well. An upper endoscopy (EGD) can diagnose gastritis. Biopsies of the lining of the stomach can determine if the gastritis is caused by H. pylori.  Treatment includes taking acid reducers or antibiotics, and avoiding hot or spicy foods. For those with pernicious anemia, B12 injections are given.

Signs & Symptoms
Many people with gastritis experience no symptoms at all. However, upper central abdominal pain is the most common symptom; the pain may be dull, vague, burning, aching, gnawing, sore, or sharp. Pain is usually located in the upper central portion of the abdomen, but it may occur anywhere from the upper left portion of the abdomen around to the back.

Other signs and symptoms may include:

  • Indigestion
  • Nausea
  • Vomiting (if present, may be clear, green or yellow, blood-streaked, or completely bloody, depending on the severity of the stomach inflammation)
  • Belching (if present, usually does not relieve the pain much)
  • Bloating
  • Feeling full after only a few bites of food
  • Loss of appetite
  • Unexplained weight loss

H. pylori Infection

Helicobacter pylori (H. pylori) colonizes the stomach of more than half of the world's population, and the infection continues to play a key role in the pathogenesis of a number of gastroduodenal diseases. Colonization of the gastric mucosa with Helicobacter pylori results in the development of chronic gastritis in infected individuals and in a subset of patients chronic gastritis progresses to complications including:

  • Ulcers
  • Stomach Cancer

Diagnosis
An upper endoscopy (EGD) can diagnose gastritis. Biopsies of the lining of the stomach can determine if the gastritis is caused by H. pylori. 

Treatment
Treatment for routine gastritis not due to H. pylori includes taking acid reducers and avoiding hot or spicy foods. Gastritis due to H. pylori infection is treated with a combination of acid reducers and two antibiotics and bismuth for ten to fourteen days.  A urea breath test is done six weeks after the completion of treatment to confirm that the H. pylori infection has been cured.  It is possible to become re-infected in the future. For those with pernicious anemia, Vitamin B12 injections are given, as this disorder inhibits the proper absorption of Vitamin B12 through the gut.