Helicobacter pylori is a bacteria known for causing stomach problems such as peptic ulcers. H. pylori is a common spiral-shaped gram-negative bacterium commonly found in the mucous layer of the stomach. This organism is very common in developing countries with as many as 80% of persons showing evidence of infection. In the United States infection seemed rare before the age of 10 but by age 60, 60% of persons have evidence of exposure to the bacterium. This qualifies Helicobacter pylori as being the most common chronic bacterial infection in humans. However, most people with the bacterium never have any symptoms. The transmission of this bacterium from person to person remains unexplained. It is presumed that hand to mouth transmission and fecal to oral transmission is most likely mode. Reinfection with this bacterium following a successful treatment regimen seems unusual. In adults, less than 2% recurrence has been documented per year. Eradication of the bacterium is not always associated with cessation of symptoms.
Current recommendations for testing include; persons with peptic ulcer disease, MALT lymphoma, or typical stomach burning/discomfort. If treatment is not planned testing typically is avoided. Current methods for testing include endoscopic biopsy, urea breath test, antibody testing by blood sample and stool testing. Confirmation of eradication should be considered in patients to have undergone previous surgery for early gastric cancer, patients with certain types of gastric lymphoma, patients whose symptoms have not resolved with blind treatment, and patients with Helicobacter pylori associated ulcers.