H. pylori: symptoms, causes and diagnosis
Most people have experienced some form of stomach discomfort at some point: pain, heartburn, indigestion and bloating. And often, the explanation seems simple: stress, a poor diet or ‘a bout of gastritis’.
But what if there’s more to it than that?
The bacterium Helicobacter pylori (H. pylori) is one of the most common causes of gastric problems — and also one of the most insidious.
In this article, we explain what Helicobacter pylori is, how it affects the body, and when it is worth getting it checked out.
What is H. pylori?
H. pylori is a bacterium capable of colonising the stomach lining and possesses a rare ability: it survives in a highly acidic environment.
To do this, it produces an enzyme called urease, which neutralises the acid around it and creates an area where it can live and multiply.
This mechanism enables it to remain in the body for years, often without being detected.
And this is precisely where the problem begins.
An infection that is more common than it seems
Before we look at symptoms or consequences, it is worth understanding the scope of the issue.
- According to international epidemiological studies, around 50 per cent of the world’s population is infected (Hooi et al., Gastroenterology, 2017);
- In Portugal, the prevalence may exceed 60 per cent (Sociedade Portuguesa de Gastrenterologia);
- The infection is often contracted during childhood (Instituto Nacional de Saúde Dr. Ricardo Jorge).
In other words, we are dealing with an extremely common infection, but one that is still rarely discussed in everyday life.
And that helps to explain why so many people live with it without realising it.
What happens in the stomach?
When the H. pylori bacterium takes hold, it does not simply ‘reside’ there. It directly disrupts the stomach’s balance.
By producing the enzyme urease and other substances in order to survive, the bacterium:
- Alter the acidic environment of the stomach;
- Causes inflammation of the mucous membrane;
- Weakens the stomach’s protective barrier.
Over time, this process can develop slowly and gradually. And that is why the symptoms do not always appear straight away.
Symptoms: not always obvious
t is estimated that up to 80% of cases are asymptomatic.
When signs or symptoms are present, they are often vague.
These symptoms are easily mistaken for common digestive problems. And that is why many infections go undetected for years.
- Heartburn or stomach pain;
- A feeling of fullness;
- Early satiety;
- Abdominal bloating;
- Nausea;
- Belching (burping).
As the infection progresses
Although many infections are asymptomatic, the prolonged presence of the bacteria can have an impact, as, over time, ongoing inflammation can lead to various conditions.
- Chronic gastritis – Persistent inflammation of the stomach lining is the most common consequence.
- Gastric and/or duodenal ulcers – H. pylori weakens the stomach’s natural defences, making it easier for lesions to develop.
- Gastric cancer – The World Health Organisation classifies H. pylori as a Group 1 carcinogen, meaning there is strong scientific evidence that it is associated with the development of gastric cancer.
Nevertheless, it is important to clarify that not all infections lead to serious illness. The risk depends on various factors, such as the duration of the infection, the characteristics of the bacterium and individual factors. However, these findings underline the importance of timely diagnosis.
Why is it difficult to realise that something isn’t right?
Once we have understood the potential impacts, an important question arises: why are so many people unaware that they have H. pylori?
The answer lies in a combination of three factors:
- Non-specific symptoms;
- Slow progress;
- Links to ‘common’ causes (stress, diet, etc.)
In other words, the problem is often dismissed as normal and not investigated.
When should you consider launching an investigation?
Not all digestive discomfort is cause for concern, but there are situations where it makes sense to investigate, such as:
- In adults under the age of 55 who have symptoms, but no obvious or diagnosed reflux disease and no ‘warning signs’. (adapted from DGS)
- A history of gastritis or ulcers;
- Digestive discomfort with no clear cause;
- Family history of HP-related gastric disease.
- Chronic, long-term use of proton pump inhibitors (omeprazole, pantoprazole, etc.), without a diagnosis of conditions justifying their use.
If symptoms recur, the focus should be on identifying the cause, rather than simply relieving the symptoms.
Diagnostic
For many years, the diagnosis of H. pylori was associated with invasive tests, such as endoscopy.
Today, this has changed significantly.
Nowadays, there are simpler, quicker and more comfortable methods that enable the bacteria to be detected with a high degree of accuracy, which facilitates an earlier and more accessible approach.
Breath test: the gold standard in a clinical setting
Of the available methods, the breath test (exhaled air) is often regarded as one of the most widely used in a clinical setting.
It is based on the ingestion of a substance containing urea, which, in the presence of the bacteria, is broken down by the enzyme urease, releasing carbon dioxide that can be detected in exhaled air. It therefore makes it possible to identify active bacterial activity.
However, despite its reliability, this method has some practical limitations:
- Booking required;
- Ingestion of a specific substance;
- Preparatory measures (fasting and discontinuation of certain medicines, such as proton pump inhibitors and antibiotics);
- Dependence on specific equipment and logistics.
In other words, it is not always the most practical option for an initial assessment.
Other diagnostic methods
As well as the breath test, there are other options:
- Stool analysis — detects bacterial antigens;
- Blood test — detects antibodies against H. pylori;
- Endoscopy with biopsy — used in more specific clinical situations.
Each method has its own indications, depending on the objective: initial diagnosis, confirmation or further assessment.
Test available at Correia Rosa pharmacies
At Correia Rosa Pharmacies, we offer serological blood tests for the detection of H. pylori.
These tests involve a small finger prick and enable the detection of IgG antibodies against the bacterium. They are therefore a practical solution for an initial assessment (screening).
Advantages of hair testing
This type of test offers a number of advantages in everyday life:
- Quick — results in just a few minutes;
- Simple — done straight away, no appointment needed;
- Convenient — no preparation required;
- No ingestion of substances;
- No need to fast;
- Without interference from medicines such as antibiotics or proton pump inhibitors;
- Less invasive and more comfortable than other methods;
- It avoids the need to collect faeces, which can be a source of discomfort for many people.
It is, therefore, an excellent option for anyone who wants to get to the bottom of their symptoms quickly and affordably.
What does a positive result mean?
It is important to understand the purpose of this test.
Serological tests detect the body’s response to the bacterium — rather than its activity directly.
This means that:
- A positive result indicates exposure to H. pylori;
- It may indicate a current or past infection.
For this reason, they do not, on their own, confirm an active infection or allow an assessment of whether the bacteria have been eliminated following treatment.
And after the test?
At Correia Rosa Pharmacies, the test is just the starting point.
In the event of a positive result, the following applies:
- Career guidance;
- Structured referrals for medical assessment, where necessary.
The aim is to help you decide on the next steps in an informed and safe manner.
The ability to carry out an initial assessment quickly and affordably represents a significant step forward in the way we approach digestive health.
It allows:
- To investigate persistent symptoms;
- Identify situations that warrant investigation;
- Take action at an earlier stage.
At Correia Rosa Pharmacies, you can have your test carried out with close support and personalised guidance..
What you can do in your day-to-day life
Although it is not possible to completely prevent H. pylori infection, there are certain behaviours that can help reduce the risk of transmission and protect digestive health.
Rather than one-off measures, it is about small, consistent habits that make a difference over time.
Step up hygiene measures
The transmission of H. pylori is often linked to oral contact and hygiene conditions.
Therefore:
- Wash your hands thoroughly before meals and after using the toilet;
- Avoid putting other people’s (especially children’s) cutlery in your mouth;
- Pay attention to hygiene in shared spaces.
These precautions are particularly important in a family setting.
Avoid sharing utensils (in high-risk situations)
Although it is not always necessary to avoid sharing items in everyday life, in cases of active infection or suspected symptoms, it is advisable to:
- Do not share glasses, cutlery or bottles;
- Avoid tasting food using the same utensils.
Ensure food safety
Consuming contaminated water or food can lead to infection.
Some precautions to take are:
- Wash fruit and vegetables thoroughly,
- Ensure that food is cooked thoroughly;
- Avoid drinking untreated water in high-risk situations.
Indeed, the quality of our diet remains a key pillar of digestive health.
Avoid prolonged self-medication
It is common to take medication to relieve symptoms such as a heartburn or a stomach ache. However, prolonged use without a diagnosis may:
- Masking important symptoms;
- Delaying the identification of the cause of these same symptoms;
- Allowing an infection to progress because it was not treated at the outset.
If your symptoms persist, the most important thing is not to relieve them,. CYou can count on Correia Rosa Pharmacies to explain this to you.
Paying attention to your digestive health
Although they do not directly cause the infection, certain factors can exacerbate the symptoms and gastric inflammation, such as:
- Excessive coffee consumption;
- Alcohol;
- Foods that are very fatty or spicy;
- Prolonged stress.
Reducing these factors can therefore help to improve digestive comfort, particularly for those who are already experiencing symptoms.
Don’t ignore persistent signs
This is perhaps the most important point. Occasional symptoms are common, but when they become frequent or persistent, they are no longer ‘normal’.
Recurrent pain or a burning sensation in the ‘pit of the stomach’, a feeling of fullness after a light meal or shortly after starting a meal, difficulty digesting food, and abdominal bloating are symptoms that should be investigated.
Nowadays, there are simple ways to clear up any doubts, and taking prompt action can prevent more complex problems in the future.
Nowadays, it’s possible to get answers to your questions quickly and conveniently.
At Correia Rosa Pharmacies are available H. pylori screening tests using capillary serology which allow:
- To assess the presence of H. pylori antibodies and thereby detect signs of exposure to the bacterium;
- To investigate digestive symptoms;
- To support informed decisions about your health.
FAQs –
H. pylori (Helicobacter pylori) is a bacterium that can colonise and live in the stomach and is able to survive in the acidic environment. It is associated with conditions such as gastritis, ulcers and, in some cases, more serious illnesses.
Symptoms do not always occur. When they do, the most common include stomach pain or a burning sensation, feeling full quickly, bloating, frequent burping, nausea and a feeling of indigestion.
The only way to confirm this is through a diagnostic test. The symptoms may provide clues, but they are not enough to identify the infection with certainty.
No. Many people who are infected do not show any symptoms, which makes the infection difficult to detect without specific tests.
Yes. The treatment is usually effective and combines antibiotics with medicines that reduce stomach acidity.
There are several tests available, each with a different purpose.
Hair-based serological tests, such as those carried out at Correia Rosa Pharmacies, are a quick and simple option for an initial assessment, enabling the detection of antibodies against the bacterium.
Yes. It is a safe, quick and minimally invasive test, carried out by means of a small prick on the finger, with results available in a few minutes.
Não necessariamente.
This test detects antibodies, which indicate exposure to the bacterium, but it does not distinguish between current and past infection.
Therefore, medical supervision may be required for further assessment.
Pessoas com sintomas digestivos persistentes, histórico de gastrite, úlceras ou desconforto recorrente, histórico familiar de doenças gástricas, utilização crónica de IBP sem de patologia clínica que o justifique, devem considerar fazer uma avaliação.
The infection can persist for years and increase the risk of chronic gastritis, ulcers and other complications over time.
No. Many people carry the bacteria without developing the disease. However, the risk increases if it is not monitored.
It is not common. In most cases, the infection persists if left untreated.
Yes. It can be transmitted via saliva, or by sharing contaminated utensils or food.
It is possible, although it is not common. Reinfection can occur if there is exposure to risk factors.
Diet does not eliminate the bacteria, but it can either worsen or alleviate associated digestive symptoms.
You can have an initial assessment via a hair serology test at Correia Rosa Pharmacies, with professional advice and guidance on the next steps, if necessary.
