Should I Get Tested for H. Pylori?

Frequent heartburn plus stomach pain, gas and nausea that keep returning are more than bothersome indigestion.

These persistent symptoms reflect a variety of gastrointestinal conditions. If you’re popping antacids every day and possibly losing weight without trying, it’s time to see your primary care physician or a gastroenterologist. This combination of symptoms could indicate a common bacterial infection in your digestive tract called Helicobacter pylori (H. pylori).

What is H. pylori, and who gets infected?

H. pylori is one of the most common bacterial infections in the world. About two-thirds of the global population is infected, and it’s more prevalent in developing countries.

This infection spreads from person to person via contaminated saliva, tooth plaque and fecal matter through kissing, unwashed/un-sanitized hands and contaminated water and food. “This bacteria is easily transmitted through the sharing of meals and drinks,” says Cindy M. Pabon, M.D., a gastrointestinal medical oncologist at Sylvester Comprehensive Cancer Center, part of University of Miami Miller School of Medicine and the University of Miami Health System. “Close family networks in which meals are often shared, such as in multi-generational households, face higher rates of infection.”

Many people catch H. pylori during childhood or while traveling to certain regions. “Immigrants from countries with high H. pylori prevalence often bring the bacteria with them,” she says.

“Due to Miami’s diverse population, including minorities and immigrants from countries with a lot of H. pylori infections, we tend to be at risk for this infection,” says Shria Kumar, M.D., MSCE, a gastroenterologist with Sylvester. Through Dr. Kumar’s community-based program in South Florida, populations at high risk of H. pylori can gain access to testing for this infection and others.

“The incidence rate of H. pylori in Miami-Dade County, Florida was highest in 2021 at 4.06 cases per 100,000 people, which was higher than the state average,” Dr. Pabon says.

“Studies show that U.S. Hispanic populations, especially those born outside the U.S., have significantly higher rates of infection compared to non-Hispanic populations,” she says. “Furthermore, many immigrant communities face limited access to health care, which can lead to delayed diagnosis, untreated infections and serious complications.”

What are the symptoms and complications of H. pylori infection?

While some people infected with H. pylori don’t have any symptoms (most commonly in children), others experience mild to severe GI distress that persists until the infection is cleared.

Symptoms of H. pylori infection include:

• dull or burning stomach pain (typically worsens after eating and at night)
• indigestion
• burping
• bloating
• nausea
• vomiting (can be bloody)
• unplanned weight loss
• loss of appetite
• dark stools

As H. pylori bacteria multiply in the stomach lining and part of the small intestine (called the duodenum), the bacteria secrete an enzyme that enables excess stomach acid. This can lead to gastritis,  gastric ulcers and/or gastric cancer. H. pylori causes more than 90% of duodenal ulcers and up to 80% of gastric ulcers.

“In some Hispanic cultures, abdominal discomfort is often seen as a sign of stress or life’s pressures manifesting through our body. While this may be partially true,” Dr. Pabon says, “it’s important not to overlook these symptoms, as they could indicate underlying gastrointestinal issues that may lead to more serious complications.”

Who should get tested for H. pylori?

Those with acid reflux

If you experience heartburn or other symptoms of gastroesophageal reflux disease (GERD), like upper belly pain, the first step is to identify and avoid possible lifestyle triggers. These include spicy, acidic and fried foods, caffeine, alcohol, cigarette smoking and stress.

To relieve these symptoms, you can also take over-the-counter medications including antacids, a histamine-2 blocker like famotidine, or a proton pump inhibitor (PPI) like lansoprazole or omeprazole that prevents the production of excess stomach acid.

Acid-reducing medications may relieve symptoms associated with H. pylori infection, but they cannot provide long-term relief because they can’t cure the bacterial infection. “If the symptoms do not get better, this may suggest potential underlying peptic ulcers or chronic gastritis, both of which can be related to H. pylori,” Dr. Pabon says.

Those with gastric ulcer symptoms

“Anyone with symptoms suggesting a gastric ulcer ¾ such as abdominal pain, black or tarry stools, nausea/vomiting, unexplained weight loss and anemia ¾  should get tested for H. pylori and have an endoscopy,” Dr. Pabon says.

Those with gastritis symptoms

“Symptoms suggesting gastritis such as abdominal pain, bloating and indigestion should also prompt someone to get tested for H. pylori,” she says.

Those who have had H. pylori before

“For those who have had H. pylori treated in the past and experience recurrent symptoms, it is possible to be re-infected, so testing should be repeated,” Dr. Pabon says.

Those in close contact with infected people

“If someone you live with tests positive for H. pylori, it’s worthwhile for all others in the home to get screened,” she says.

Dr. Pabon stresses the importance of communicating these symptoms to loved ones, especially those recently arriving to the country.

Testing and treatment for H. pylori

If you’re experiencing only heartburn and indigestion, your primary care doctor can perform a breath or stool test to determine if the H. pylori bacteria is present in your body.

If you’re having more serious symptoms like weight loss, nausea/vomiting, bloating, black stools or abdominal pain, an endoscopy is warranted. “This form of examination, performed by gastroenterologists, allows for H. pylori testing through biopsy while also examining for complications of this infection, such as gastric ulcers, gastrointestinal bleeding and gastric cancers,” Dr. Pabon says. “In some cases, if there is bleeding, the gastroenterologist can treat right away during the endoscopic procedure.”

H. pylori is effectively treated with a combination of antibiotics and antacids. “You will also need to confirm resolution of infection after completing this treatment,” she says, “because we have seen that some strains of H. pylori can be resistant and require further antibiotics and treatment to effectively cure.”

If you live in South Florida and are experiencing persistent GI symptoms, you can receive an accurate diagnosis and the most effective treatment at Sylvester.

Call to schedule an appointment: 1-844-324-HOPE (4673) or visit our website.

Dana Kantrowitz is a contributor for UHealth’s news service.

Tags: Dr. Cindy Pabon, Dr. Shria Kumar, H. pylori antibiotics, H. pylori prevention, H. pylori symptoms, Sylvester Comprehensive Cancer Center