OverviewWhat is an H. pylori infection?H. pylori (Helicobacter pylori) are bacteria that can cause an infection in the stomach or duodenum (first part of the small intestine). It’s the most common cause of peptic ulcer disease. H. pylori can also inflame and irritate the stomach lining (gastritis). Untreated, long-term H. pylori infection can lead to stomach cancer (rarely). Show
Who gets H. pylori infections?H. pylori bacteria are present in some 50% to 75% of the world’s population. It does not cause illness in most people. H. pylori infection mostly occurs in children. It’s more common in developing countries. In the U.S., H. pylori bacteria are found in about 5% of children under the age of 10. Infection is most likely to occur in children who live in crowded conditions and areas with poor sanitation. Can H. pylori spread from person to person?Yes, H. pylori can spread from person to person. H. pylori are found in saliva, plaque on teeth and poop. Infection can be spread through kissing and by transferring the bacteria from the hands of those who have not thoroughly washed them after a bowel movement. Scientists think H. pylori also might be spread through H. pylori-contaminated water and food. What’s the association between H. pylori infection and stomach cancer?If you have an _H. pylori _infection, you have an increased risk for stomach cancer later in life. If you have a strong family history of stomach cancer and other cancer risk factors, even though you may not have symptoms of a stomach ulcer, your healthcare provider may recommend being tested for _H. pylori_ antibodies. In addition to screening and treatment, your provider may suggest some lifestyle changes, such as including more fruits, vegetables and fiber in your diet. Regular checkups with your provider and following their recommendations can reduce your cancer risk. Symptoms and CausesHow does H. pylori infection cause damage?H. pylori multiply in the mucus layer of the stomach lining and duodenum. The bacteria secrete an enzyme called urease that converts urea to ammonia. This ammonia protects the bacteria from stomach acid. As H. pylori multiply, it eats into stomach tissue, which leads to gastritis and/or gastric ulcer. What are the symptoms of H. pylori infection?Most children with H. pylori infection don’t have symptoms. Only about 20% do. Symptoms and signs, if present, are those that arise from gastritis or peptic ulcer and include:
Diagnosis and TestsHow is H. pylori infection diagnosed?If your healthcare provider suspects H. pylori bacteria may be causing a stomach ulcer, they may order one or more of the following tests:
Management and TreatmentHow is H. pylori treated?If you don’t have symptoms, you don’t need to be treated. If you've been diagnosed with H. pylori, avoid taking nonsteroidal anti-inflammatory drugs. These drugs can increase your risk of developing an ulcer. H. pylori-caused ulcers are treated with a combination of antibiotics and an acid-reducing proton pump inhibitor.
Combination treatment is usually taken for 14 days. One newer medication, Talicia®, combines two antibiotics (rifabutin and amoxicillin) with a proton pump inhibitor (omeprazole) into a single capsule. PreventionCan H. pylori infection be prevented?You can lower your risk of H. pylori infection if you:
Is there a vaccine to prevent H. pylori infection?Not yet, but there are promising results from a late-stage clinical trial. In this trial, children given the vaccine were protected against H. pylori infection for up to three years. Outlook / PrognosisWhat’s my child’s prognosis (outcome) if they’ve been diagnosed with an H. pylori infection?If your child follows the treatment plan and takes all medication to its completion, the chance that an infection would return within three years is less than 10%. In addition, treatment may heal stomach ulcers. It can takes weeks to months for symptoms to completely go away. How will I know if the H. pylori infection is healed?Your healthcare provider will repeat a breath and/or stool test after waiting at least two weeks after proton pump inhibitor treatment has finished and four weeks after completing antibiotic treatment. What is the best treatment for H. pylori related peptic ulcer disease?Antibiotic medications to kill H. pylori.
If H. pylori is found in your digestive tract, your doctor may recommend a combination of antibiotics to kill the bacterium. These may include amoxicillin (Amoxil), clarithromycin (Biaxin), metronidazole (Flagyl), tinidazole (Tindamax), tetracycline and levofloxacin.
Which of the following is most effective in the treatment of peptic ulcer disease?Proton pump inhibitors (PPIs) are drugs that block the three major pathways for acid production. PPIs suppress acid production much more effectively than H2 blockers. PPIs are the gold standard in medication therapy of peptic ulcer disease.
What is the best medication for H. pylori?The most important antibiotics in H. pylori treatment are clarithromycin, metronidazole, and amoxicillin. Figure 1 illustrates recently reported clarithromycin and metronidazole resistance rates worldwide. Resistance to these antibiotics is thought to be the main cause of eradication failure[27-29].
What is first line treatment for H. pylori?Clarithromycin 500 mg BID (first-line and continues to be recommended in areas where H pylori clarithromycin resistance is less than 15% and in patients without previous macrolide exposure ) or metronidazole 500 mg BID (when clarithromycin resistance is increasing) [7, 8] plus.
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