When is it necessary to get tested for H. pylori?

I've had bloating and fatigue for almost a month now, sometimes fainting, and black stools. Do I need to get tested for H. pylori? (Minh Hieu, 47 years old, Bac Ninh )

Reply:

Helicobacter pylori (HP) is a gram-negative bacterium that thrives in the stomach. People with chronic gastritis or duodenitis caused by HP often have no symptoms. If symptoms do occur, they may include epigastric pain, often when hungry, nausea, bloating, indigestion, and feeling full quickly after eating.

People infected with H. pylori have a 10-20% risk of peptic ulcers and a 1-2% risk of stomach cancer. H. pylori attacks the protective lining of the stomach, damaging the tissue in the stomach and the first part of the small intestine (duodenum). The bacteria produce an enzyme called urease, which reduces stomach acid, leading to a weakening of the stomach lining. As a result, stomach cells are highly vulnerable to damage from acid and pepsin, strong digestive fluids, leading to peptic ulcers.

Helicobacter pylori infection also causes chronic inflammation of the gastric mucosa. Long-term chronic inflammation leads to atrophic gastritis and intestinal metaplasia. Severe atrophic gastritis and intestinal metaplasia are high-risk factors for gastric cancer.

Frequent bloating, fatigue, occasional fainting, nausea, and black stools could be symptoms of peptic ulcer disease caused by H. pylori bacteria or other gastrointestinal diseases. You need to see a specialist for appropriate diagnosis and effective treatment.

You should get tested for and treated for H. pylori if you have stomach or duodenal ulcers, a history of stomach or duodenal ulcers that have never been diagnosed or treated for H. pylori, or H. pylori-related indigestion. If you have a family history of stomach cancer (parents, siblings), you should also get tested for this bacteria.

This test is also necessary for people with precancerous lesions, treated stomach cancer, and those using non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin for extended periods.

Helicobacter pylori (H. pylori) testing via C13-14 breath test at Tam Anh General Hospital. Photo: Provided by the hospital.

Currently, there are many ways to test for and diagnose H. pylori. Some common tests include the C13 and C14 breath tests; stool tests (tests to detect H. pylori in stool); and the rapid urease test performed through gastroscopy.

Practice healthy habits such as washing hands with soap and water before eating and after using the toilet, eating cooked food and drinking boiled water, and ensuring safe and clean drinking water to prevent diseases caused by H. pylori bacteria.

Doctor Hoang Nam
Department of Gastroenterology, Tam Anh General Hospital , Hanoi

Readers can ask questions about digestive diseases here for doctors to answer.

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