Patient Care

Helicobactor Pylori

What is Helicobactor Pylori?

Helicobacter Pylori is a common chronic bacterial infection that is present in up to 31% of Singaporeans1. The majority of people infected with Helicobacter Pylori never experience any symptoms of complications. However, colonisation with Helicobacter Pylori is a major risk factor for peptic ulcer disease as well as gastric malignancy2.

Patients with dyspepsia (painful, difficult, or disturbed digestion) should be consider testing for a Helicobacter Pylori infection3. Helicobacter Pylori can be detected either through gastroscopy or through a carbon urea breath test.

Upon detection, a Helicobacter Pylori infection is treated with a course of antibiotics and confirmation of eradication is mandatory for all patients after treatment.

Helicobacter Pylori infection

1. Ang TL, Fock KM, Ang D, et al, The changing profile of Helicobacter pylori antibiotic resistance in Singapore: a 15 year study. Helicobacter. 2016; 21:261-5
2. Sueubaum S, Michetti P. Helicobacter pylori infection. N Engl J Med 2002; 2002; 347:1175-86
3. Chew ACZ, Lye TF, Ang D, et al, The diagnosis and management of H. pylori infection in Singapore. Singapore Med J 2017; 58(5):234-240
What are the signs & symptoms of Helicobactor Pylori?

Most individuals with chronic gastritis or duodenitis have no symptoms. On the other hand, some people develop more serious problems, including stomach or duodenal ulcers. Ulcers can cause a variety of symptoms or no symptoms at all. Common complaints include pain or discomfort (usually in the upper abdomen), bloating, feeling full after eating a small amount of food, lack of appetite, nausea, vomiting, and dark or tar-colored stools. Ulcers that bleed can cause a low blood count and fatigue.

Less commonly, chronic gastritis causes abnormal changes in the stomach lining, which can lead to certain forms of cancer. It is uncommon to develop cancer as a result of Helicobactor Pylori infection. Nevertheless, because so many people in the world are infected with Helicobactor Pylori, it is considered to be an important cause of stomach cancer.

In Singapore, the prevalence rate in the community (without any symptom) was estimated to increase with age from 3% in children below 5-year-old to 71% in adults above 65.

How is Helicobactor Pylori diagnosed?

There are several ways to diagnose Helicobactor Pylori.

  • Urea breath test is a procedure where a patient drinks a specialised solution containing a substance (13C [carbon] - or 14C-labeled urea) that is broken down by the Helicobactor Pylori bacterium. The breakdown products can be detected in a person's breath.

Urea breath test

  • Endoscopy of the upper gastrointestinal tract can confirm certain gastrointestinal conditions, such as peptic ulcers, as well as infection with Helicobactor Pylori. It is generally reserved for patients with symptoms.
  • Blood tests can be used to detect a Helicobactor Pylori specific antibody.

The following individuals should be tested:

  • Patients with symptoms indicated above.
  • Patients with higher risk of gastric cancer, e.g. family history of gastric cancer.
What are the treatment options for Helicobactor Pylori?

Treatment involves taking several medications for 7 to 14 days.

It generally consists of a gastric medication known as a proton pump inhibitor, and two antibiotics.

It is important to take your medication regularly as instructed to ensure complete eradication of Helicobactor Pylori. Failing which, the bacterial may recur, and even develop antibiotic resistance.

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