What is Helicobacter pylori? Helicobacter pylori (H. pylori)



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What is Helicobacter pylori?

Helicobacter pylori (H. pylori) is a bacterium

(germ) that lives in the inner lining of the stomach.

It produces a number of chemicals that damage

the lining of the stomach. Once the infection is

present, it persists for many years, if not for life. 

How common is Helicobacter pylori

infection in Australia? 

About 40% of persons over 60 years of age have



Helicobacter pylori. Most people are infected in

childhood and in Australia the risk of becoming

infected is now much less than in the past. There

is no difference in infection rate between men

and women. H. pylori is more common in older

people and in certain ethnic populations (e.g.

Middle Eastern, Asian and eastern European). 

How do I catch Helicobacter pylori? 

Doctors aren’t quite sure. It probably happens

when people share food or eating utensils.

Spread between family members (e.g. mother

and child) is not uncommon. There is no

evidence that pets, farm animals or infected 

food or water are sources of infection. It is 

very rare to catch H. pylori as an adult.  

How is Helicobacter pylori diagnosed? 

The infection may be found at the same time 

as a peptic ulcer, at a test call endoscopy.

However, your doctor can organise other tests. 

1. Breath Tests 

A breath test shows if you are infected by

analysing a sample of your breath. Breath tests

are accurate, safe, simple and quick to perform.

They are a particularly useful test to check

whether the infection has been successfully

treated. Accuracy is reduced if you have been

taking certain drugs (e.g. antibiotics in the

previous month and some ulcer-healing drugs 

in the previous one to two weeks).



2. Blood Tests 

These can detect current or recent infection. They

are not useful for checking whether the infection

has been successfully treated because the antibody

to H. pylori remains in the blood for years.

3. Endoscopy 

During endoscopy your doctor passes a flexible

tube into your stomach. This allows small

samples to be taken, to detect H. pylori using 

a number of methods including looking under

the microscope, detecting it with a chemical

reaction (rapid urease test) or growing it in 

the laboratory.  These tests are very accurate,

although recent use of antibiotics or drugs 

that treat ulcers can cause false results. 

4. It is also possible to check for H. pylori

using a sample of bowel motion. This method 

is used to check children.  

What diseases does Helicobacter Pylori

cause? 

Most infected people have no symptoms.



However, H. pylori can cause: 

• Inflammation of the lining of the stomach

(gastritis). 

• Duodenal ulcers (ulcers in the first part 

of the small bowel).

• Stomach (gastric) ulcers. 

• Some cancers of the stomach, including 

a rare type called lymphoma. 



Peptic Ulcers

An ulcer is a break in the lining of the stomach or

upper small bowel (the duodenum). Ulcers

occurring in this area are often called peptic ulcers. 



1. Duodenal ulcers 

Helicobacter pylori is the cause of about 90% 

of ulcers in the duodenum. 



2. Stomach ulcers

H. pylori is the cause of about 70% of stomach

ulcers. Most of the remaining 30% are due to

drugs taken for arthritis (non-steroidal anti-

inflammatory drugs), or aspirin taken to 

prevent heart attacks or strokes. Some patients

have both risk factors, and this increases the

chance of a stomach ulcer. Modern anti-ulcer

drugs heal virtually all duodenal and stomach

ulcers but there is a very high chance that the

ulcer will come back if a person stops the

medication if H. pylori is not eliminated. If 

H. pylori infection is cured, the risk of the 

An information leaflet for patients and interested members of the general public prepared by the Digestive Health Foundation



ulcer returning is very low (unless aspirin or

anti-inflammatory drugs need to be taken).

Paracetamol does not cause ulcers. 

Cancer of the Stomach 

Cancer of the stomach is very rare in Australia

but H. pylori infection increases the risk. Although

stomach cancer is very common in many parts of

the world, it is becoming even more uncommon 

in Australia as the number of people infected

declines. Only a very small minority of infected

people ever develop this problem. 



Non-ulcer dyspepsia

Dyspepsia is a word used to describe pain,

discomfort or other symptoms in the upper

abdomen. Most people with dyspepsia do not

have an ulcer, they have “non-ulcer” dyspepsia.

This is a very common problem and is thought 

to have many possible causes. Some of these

people have H. pylori infection, but treatment to

get rid of the H. pylori does not always help. 

Who should be tested for Helicobacter

Pylori? 

People with Duodenal Ulcer: 

Everyone with a duodenal ulcer should be tested

for Helicobacter pylori and treated if infected.

This includes people with active ulcers and those

who have had a duodenal ulcer in the past. 

People with Stomach Ulcers: 

Everyone infected with H. pylori who has or has

previously had a stomach ulcer should be tested

and treated. This includes people who were

taking aspirin and anti arthritis drugs when the

ulcer developed. 



People with Non-Ulcer Dyspepsia:

Treatment may not cure the dyspepsia. However,

treatment may reduce the chance of getting ulcers

(or possibly stomach cancer) in the future. The

side-effects and cost of treatment need to be

weighed against the possible benefits. For instance

possible side effects might outweigh possible

benefits in an elderly, fit person with no symptoms. 

How should Helicobacter Pylori be treated? 

There is no single treatment. A number of drug

combinations are used. The most effective of

these are successful in 80-90% of people.

However, the success rate is much lower if the

drugs are not taken exactly as directed. 

Treatment combinations include at least three

drugs consisting of an anti ulcer drug and two

antibiotics. The use of drug combinations reduces

the risk of H. pylori becoming resistant to

treatment. However, taking three drugs increases

the risk of side effects, which may include nausea,

taste disturbances, diarrhoea, skin rashes and

interactions with other medications or an

unpleasant reaction to alcohol. Very rarely, more

serious side effects may occur, such as bacterial

infection of the large bowel (pseudomembranous

enterocolitis) or a sudden drop in blood pressure

(anaphylaxis). It is important to tell your doctor if

you have ever had any side effects with antibiotics. 

How do I know if the treatment has worked? 

If you take the treatment exactly as directed, the

chance of success is high. Helicobacter pylori

elimination should be checked if you have had 

a serious ulcer complication (bleeding or

perforation) or if your ulcer has often recurred.

If you have to have another gastroscopy, it is 

very simple to look H. pylori using one of the

tests describe above. If you do not need another

gastroscopy, your doctor may order a breath test.

It is important that these tests are performed at

least four weeks after all treatment is stopped, to

give an accurate result. Not everyone has a follow

up test. If treatment has not been successful, a

different combination of drugs may be tried.  

Am I likely to become infected again? 

No, the chance of becoming infected again after

successful treatment is only about 0.5-1.0% 

per year. This is because most infection occurs 

in childhood. 

Do my family members need to be tested if

I am infected? 

This is not usually recommended. Occasionally

there are special circumstances and these can 

be discussed with your doctor. 

Further questions

The information given here is current in 2005,

but may change in the future. If you have 

further questions you should raise them with

your own doctor.

Digestive Health Foundation

This information booklet has been designed by the Digestive

Health Foundation as an aid to people who have helicobacter

pylori or for those who wish to know more about it. This is not

meant to replace personal advice from your medical

practitioner. 

The Digestive Health Foundation (DHF) is an educational body

committed to promoting better health for all Australians by

promoting education and community health programs related

to the digestive system.

The DHF is the educational arm of the Gastroenterological

Society of Australia, the professional body representing the

Specialty of gastrointestinal and liver disease in Australia.

Members of the Society are drawn from physicians, surgeons,

scientists and other medical specialties with an interest 

in GI disorders. 

Since its establishment in 1990 the DHF has been involved in

the development of programs to improve community

awareness and the understanding of digestive diseases.

Research and education into gastrointestinal disease are

essential to contain the effects of these disorders on all

Australians.

Further information on a wide variety of gastrointestinal

conditions is available on our website.

Digestive Health

Foundation

c/-GESA


145 Macquarie Street

SYDNEY NSW 2000

Australia

Phone (02) 9256 5454

Fax (02) 9241 4586

dhf@gesa.org.au



http://www.gesa.org.au

This brochure is promoted as 

a public service by the Digestive

Health Foundation. This leaflet 

cannot be completely comprehensive

and is intended as a guide only. 

The information given here is 

current at the time of printing, 

but may change in the future. 

If you have further questions 

you should raise them with your 

own doctor. 

© Copyright. 

Digestive Health Foundation, 

updated April 2003.

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