Many people have heard that ulcers are caused by too much spicy food, excessive stomach acid, certain medications, or simply from stress. But did you know that the vast majority of ulcers are actually caused by bacteria called Helicobacter pylori? Also known as H. Pylori, the bacteria that lodge itself in the stomach lining. According to the Centers for Disease Control and Prevention (CDC), this bacteria causes more than 90 percent of duodenal (first part of the small intestine) ulcers and up to 80 percent of gastric (stomach) ulcers. And this bacteria are more prevalent in Asian countries.
H. Pylori isn’t a new or isolated bacteria. It’s present in more than half of the world’s population. Most people infected with these bacteria have no symptoms at all and luckily will never develop problems. However, H. pylori is capable of causing a number of digestive problems, including duodenal and gastric ulcers. It also contributes to gastric cancer, so it is a bacteria still worthy of mention.
According to Cancer.gov, infection with H. pylori is the primary cause of gastric cancer, and those infected with H. Pylori have a two-to-six-fold increased risk of developing gastric cancer. It is thought that chronic gastritis (upset stomach) leads to chronic inflammation, which causes abnormal changes in the stomach lining, eventually leading to gastric cancer. With so much of the world infected with it, it is still an important topic to consider getting tested for these bacteria.
Keep in mind that there are other risk factors to consider for gastric cancer besides ulcers such as older age, cigarette smoking, and nutrition. If you want to minimize your risks, just be aware that those that eat a diet high in salted, smoked, or poorly preserved foods—which typically is associated with a diet low in fruits and vegetables—are at a higher risk of developing gastric cancer, according to the National Cancer Institute. As evidenced by the high prevalence of infection worldwide, it seems H. Pylori can really infect anyone, no matter the age, race, and gender, or where they live. But note that H. Pylori is more prevalent among African Americans, Hispanics, and Asian Americans, according to the CDC.
HOW TO TEST FOR H. PYLORI?
There are a few ways to diagnose H. Pylori. UpToDate.com lists the following testing options:
• Urea breath tests: A simple test may be available at your primary care provider’s office where you drink a solution containing a substance that is broken down by the H. pylori bacteria if present.
• Stool tests: Checks for H. Pylori proteins in stool.
• Biopsies of the stomach or small intestine done by a gastroenterologist.
What are the symptoms of an H. Pylori infection?
Most people with H. Pylori have no symptoms. However, some eventually develop more serious problems like gastric or duodenal ulcers. So focus on the more common ulcer signs and symptoms, which typically are:
• Pain or discomfort usually in the upper abdomen
• Feeling full after eating a small amount of food
• Lack of appetite
• Nausea or vomiting
• Tar-colored stools
• Fatigue (ulcers that bleed can cause a low blood count and fatigue)
If you have the above symptoms, and if you have a history of ulcers, consider getting tested. If you do not have any symptoms, testing is usually not recommended. But I would consider testing in those with a family history of stomach cancer, especially if you’re of Chinese, Korean, Japanese, or Central American descent. According to UpToDate.com, These groups have a higher incidence of stomach cancer.
Furthermore, if you’ve been on a long-term regimen of proton pump inhibitors like Prilosec or Omeprazole for ulcers or heartburn, you should consider getting screened for H. Pylori. These medications can definitely help symptoms and heal ulcers, but they do not kill H. Pylori. Remember, H. Pylori is bacteria that are infecting the stomach, which could potentially lead to stomach cancer, so a particular regimen of antibiotics is usually needed to eradicate it.
Lastly, it’s thought that H. Pylori is spread from oral contact with others’ saliva or fecal material. The bacteria seem to be more likely to spread within a family, so if one person gets infected, relatives might pick it up too. How often does your family eat “family style?” Exactly. Talk to your primary care provider about your risk and whether you should get tested today.
Dr. Michael Corsilles, ND, PA-C, currently practices as a naturopathic physician and a physician assistant in Bellevue.