Helicobacter pylori, a common bacterium, can infect the stomach lining and cause serious problems like ulcers and even cancer. It’s estimated that half the world’s population carries this bacteria. H. pylori spreads through person-to-person contact, often within families. If you’re diagnosed with H. pylori, it’s recommended that your close family members get tested and treated too.

H. pylori infection can cause a variety of digestive symptoms, such as bloating, nausea, vomiting, indigestion, burping, and loss of appetite. You may also experience more severe symptoms like dull or burning pain in the stomach, unplanned weight loss, and dark stools. It's important to note that these symptoms can vary in severity and may not always be present. If you experience any of these symptoms, it's recommended to consult a healthcare professional for diagnosis and treatment.

A significant medical advancement recognized that a specific bacteria, Helicobacter pylori, was responsible for a majority of duodenal ulcers and approximately two-thirds of gastric ulcers. This breakthrough earned a Nobel Prize. Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin are known to cause most other peptic ulcers. When combined, H. pylori and NSAIDs can increase the risk of ulcers and bleeding. Eliminating H. pylori before starting long-term NSAID treatment can help reduce this risk.

H. pylori infection is estimated to increase an individual's lifetime risk of developing gastric cancer by 1.5 to 2%. However, early eradication of this bacteria, before the development of precancerous changes, has been shown to effectively prevent gastric cancer. This preventive measure is the foundation for widespread screening and treatment programs targeting young adults in regions with high rates of H. pylori infection and sufficient resources to implement such initiatives.

Indications for H. pylori Eradication:

1. History of ulcers: Duodenal or gastric ulcers, with or without complications

2. MALT lymphoma: A type of lymphoma associated with the stomach

3. Gastric mucosal abnormalities: Atrophy or intestinal metaplasia

4. Post-gastric cancer surgery: To reduce the risk of recurrence

5. Family history: First-degree relatives with gastric cancer

6. Patient preference: Based on consultation with their physician

7. Functional dyspepsia: Indigestion without a clear cause

8. NSAIDs: To prevent ulcers and bleeding in those not taking NSAIDs

9. Aspirin: To reduce the risk of ulcers and bleeding before or during long-term aspirin therapy

10. GERD: To support proton-pump inhibitor treatment

11. Cancer prevention: In areas with high gastric cancer rates

12. Blood disorders: Unexplained iron-deficiency anemia or idiopathic thrombocytopenic purpura

Note: This list provides a general overview of indications for H. pylori eradication. Specific recommendations may vary based on individual circumstances and healthcare guidelines.

The urea breath test (UBT) is the most widely studied and recommended non-invasive method for diagnosing H. pylori infection as part of a 'test-and-treat' approach. Monoclonal stool antigen tests (SAT) can also be used effectively. Serological tests, while viable, require careful validation. It's important to avoid using rapid, on-site serological tests with whole blood for H. pylori diagnosis.