Understanding H. pylori and Ulcers

Cross section of stomach showing ulcers in stomach and duodenum.
An ulcer can form in two areas of the digestive tract; the stomach and the duodenum (where the stomach meets the small intestine).
Traditionally, ulcers, or sores in the lining of your digestive tract, were thought to be caused by too much spicy food, stress, or an anxious personality. We now know that most ulcers are probably due to infection with bacteria known as Helicobacter pylori (H. pylori).

Common ulcer symptoms

These include the following:

  • Burning, cramping, or hungerlike pain in the stomach area, often 1 to 3 hours after a meal or in the middle of the night

  • Pain that gets better or worse with eating

  • Nausea or vomiting

  • Black, tarry, or bloody stools (which means the ulcer is bleeding)

Or you may have no symptoms.

Your evaluation

An evaluation by your healthcare provider can show if you have an ulcer and determine whether it was caused by H. pylori. Your healthcare provider may ask you questions, examine you, and possibly do some tests. These may include:

  • A special X-ray called an upper gastrointestinal series, to help locate an ulcer. Before the test, you drink a chalky liquid, called barium. This liquid helps the ulcer show up on the X-ray.

  • An endoscopic exam, done with a long tube with a camera on the end. The tube is passed through your mouth into your stomach, and allows the healthcare provider to get a closer look at your ulcer. You will be lightly sedated for this procedure. Your healthcare provider can also take a tissue sample to test for H. pylori.

  • Blood, stool, and breath tests are also available to show whether you have H. pylori in your digestive tract.

Your treatment

To kill H. pylori so your ulcer can heal, your healthcare provider will probably prescribe antibiotics. Other ulcer medicines that help reduce stomach acid may also be prescribed as well. Testing after treatment may be recommended to be sure the H. pylori infection is gone. Usually, killing H. pylori helps keep the ulcer from returning. However, you can develop ulcers more than once in your lifetime. 

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