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What Every Bariatric Patient Should Know About H. Pylori

By Robert J. Kelly, Jr, MD


Anyone who is considering weight loss surgery or who is already a bariatric patient should consider being screened and treated for bacterium called Helicobacter pylori (H. pylori), This bacteria can be found in the human digestive tract and about 50% of the world’s population is a carrier of the germ. In some individuals, exposure to the germ may cause inflammation in the stomach known as gastritis. Symptoms associated with the development of gastritis include belching, bloating, nausea, vomiting, and abdominal pain. In certain cases the infection may lead to the development of ulcers within the stomach or small intestine. Symptoms associated with ulcer development include those listed above and the following: vomiting blood, passage of dark or tarry stools, fatigue, and anemia/low blood count. The bacteria may also contribute to the development of lymphoma within the stomach and treatment for this cancer requires eradication of the germ.


H. pylori is contagious and prevention can be difficult. Avoidance of the infection is best performed by hand washing with clean water. The organism may be detected by having a patient exhale into a bag and analyzing this air. This test is known as the Urea Breath Test. The bacteria may also be identified by a blood sample, stool study and an endoscopy. Endoscopy is a procedure where a tube with a camera is passed into the mouth and used to evaluate the esophagus, stomach and intestine. The procedure requires mild to moderate sedation and is usually performed in a hospital or endoscopic suite.


H. pylori infections are usually treated with antibiotics and acid-suppressing drugs. In order to minimize the risk of resistance to antibiotics, multiple antibiotics may be prescribed to help eradicate the organism. Physicians also prescribe medications to suppress acid production within the stomach in order to enhance tissue healing. Acid suppressing agents include histamine blockers and proton pump inhibitors. Treatment usually occurs for at least 10-14 days even if symptoms resolve prior to completion of the medication to ensure eradication of the germ.