H. Pylori (Helicobacter pylori) Treatment Specialist
Helicobacter pylori (h. pylori) is a common bacterial infection of the stomach world-wide. In 2005 the Nobel prize in Physiology and Medicine was awarded for the discovery of h. pylori as the causative agent of the majority of stomach and duodenal ulcers. In some patients h. pylori can lead to the development of stomach cancer thus h. pylori has been classified as a carcinogen.
What are symptoms of h. pylori infection?
upper abdominal or epigastric pain
halitosis (bad breath) - though limited data exists to support this association
no symptoms (some patients never know they have it)
How is H. pylori Spread?
The exact mechanism of spread is not known but is believe to be a fecal-oral route. Exposure to contaminated food or water is believe to be the mode of transmission. Rates of infection are higher in developing countries compared to developed countries
Who should get tested?
Anyone with lingering symptoms of nausea, upper abdominal pain, a history of peptic ulcers or someone closely related or partnered with someone previously infected.
What tests are available for diagnosis?
Urease breath testing: high sensitivity for detection and low false positive rates. Requires patients to not have used Proton pump inhibitors, pepto bismol, or antibiotics in the 4 weeks preceding therapy to ensure negative results are true negatives (false negative rate of 10-30%)
Stool h. pylori antigen test: similar in performance to breath testing
Blood testing: No longer used, rarely covered by insurance. Does not indicate active infection, high false positive rate
Upper endoscopy: Biopsies can be obtained of the antrum and body of the stomach and a pathologist can stain the tissue to detect the bacteria
What is the treatment for H. pylori?
Typical treatments involve 10-14 days of a twice daily proton pump inhibitor with two antibiotics. Dr. Motola favors the use of Quadruple therapy which also includes pepto bismol.
How does one know the bacteria is killed?
Resolution of symptoms in setting of a repeat negative h. pylori testing 4 weeks after treatment completed.
What can be done if the bacteria does not get killed?
Repeat treatment with different regimen.
Perform Upper Endoscopy with biopsy of the stomach, culture the bacteria and determine antibiotic resistance profile.
Disclaimer: This information is intended to educate but not provide treatment or diagnostic information. Self-diagnosis should not be made base on this or any other online information. Please consult with a doctor about your specific condition. Dr. Motola is available for office consultations. A thorough history and physical exam is needed to make accurate diagnosis before treatment provided.
Dr. Motola is a Best in class Gastroenterologist in NYC. For more information about the diagnosis and treatment of helicobacter pylori call the office at 212-227-3688 the schedule an appointment with Dr. Motola or conveniently book online via Zocdoc.