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Helicobacter Pylori Infection (HPI)

Helicobacter Pylori Infection (HPI): Symptoms, Diagnosis, and Management

Helicobacter Pylori Infection (HPI) is caused by Helicobacter pylori (H. pylori) which is a bacterium that infects the stomach lining, causing gastritis, peptic ulcers, and increasing stomach cancer risk. Below is a synthesis of its key aspects, supported by current evidence.

Symptoms

Most infected individuals are asymptomatic, but complications like gastritis or ulcers may cause:

Common Symptoms	Severe/Advanced Signs
Upper abdominal pain (burning, aching)	Unexplained weight loss
Bloating, nausea, or vomiting	Black/tarry stools (bleeding ulcer)
Burping or indigestion	Fatigue (anemia from chronic bleeding)
Early satiety	Difficulty swallowing (rare)

Pain patterns: Often worsens when the stomach is empty (e.g., nighttime) and may improve temporarily after eating or antacids137.

Causes and Risk Factors

1. Transmission:
   • Childhood exposure: Spread via contaminated food/water or close contact.
   • Socioeconomic factors: Higher prevalence in crowded, low-sanitation areas7.
2. Bacterial Mechanism:
   • H. pylori produces urease, neutralizing stomach acid and enabling colonization.
   • Inflammation: Triggers gastritis and ulcers by damaging the stomach lining48.

Diagnosis

1. Non-Invasive Tests:
   • Breath test: Detects urease activity via carbon dioxide.
   • Stool antigen test: Identifies bacterial proteins.
2. Invasive Tests:
   • Upper endoscopy: Biopsy for histology or rapid urease test67.

Complications

1. Gastritis: Chronic inflammation of the stomach lining.
2. Peptic Ulcers:
   • Duodenal ulcers: Linked to acid hypersecretion.
   • Stomach ulcers: Risk of perforation or bleeding14.
3. Stomach Cancer: Rare but associated with long-term infection38.

Treatment

1. First-Line Therapy:
   • Triple therapy: Proton pump inhibitor (PPI) + clarithromycin + amoxicillin/metronidazole for 7–14 days67.
2. Follow-Up:
   • Test of cure: Breath/stool test 4–8 weeks post-treatment.
3. Supportive Care:
   • Avoid NSAIDs: Aggravate ulcers.
   • Dietary changes: Reduce spicy/salty foods58.

Prevention

• Hygiene: Avoid contaminated water/food.
• Screening: High-risk populations (e.g., family history of stomach cancer)7.

Conclusion
H. pylori infection is treatable but requires early diagnosis to prevent complications like ulcers and cancer. Asymptomatic carriers should be tested if at risk.

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References

1. Patient.info: H. pylori
2. Healthline: H. pylori
3. WebMD: H. pylori
4. Johns Hopkins: H. pylori
5. Samitivej: H. pylori
6. MSD Manuals: H. pylori
7. Cleveland Clinic: H. pylori
8. Siloam Hospitals: H. pylori