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Helicobacter Or Something Else? The Most Common Causes of Gastritis

Before the discovery of Helicobacter pylori, many cases of gastritis were considered chronic but relatively harmless conditions. For a long time, it was believed that gastritis was caused by an excess level of stomach acid, and treatment was aimed at reducing acidity. Other theories included the role of stress, improper diet, and an unhealthy lifestyle in the development of gastritis.

With the emergence of new data, it became clear that the presence of this bacterium in the stomach is not only associated with gastritis but can also increase the risk of more serious consequences, such as ulcers and stomach cancer. This discovery emphasized the importance of early detection and treatment of Helicobacter pylori infection to prevent more severe and dangerous outcomes.

Why can Helicobacter pylori survive in the stomach?

Helicobacter pylori, by surviving in the acidic environment of the stomach, penetrates the mucous layer of the stomach, causing damage to it. It produces urease, which breaks down urea into ammonia and carbon dioxide. This reaction leads to an increase in pH (decrease in acidity), creating a less hostile environment for H. pylori. However, the change in pH can have negative consequences.

The increase in pH not only facilitates the survival of H. pylori but also opens the door to other bacteria that are typically suppressed by the acidic conditions of the stomach. This can disrupt the balance of the stomach’s microflora and potentially cause additional health problems.

Furthermore, the increase in pH may hinder the absorption of essential nutrients and vitamins. The acidic environment of the stomach plays a crucial role in the breakdown of food and the absorption of nutrients, including important vitamins. When acidity decreases due to the ammonia production by H. pylori, the efficiency of these processes is compromised, leading to deficiencies in nutrients.

Gastric Diseases and H. pylori

The bacterium H. pylori plays a significant role in the development and progression of the following gastric diseases:

  • Gastritis: H. pylori is associated with the development of gastritis, which involves inflammation of the stomach lining. Gastritis can manifest with various symptoms, including pain in the epigastric region, nausea, and vomiting.
  • Peptic Ulcer Disease: H. pylori is also linked to the development of peptic ulcer disease, which can affect the mucous membrane of the stomach or the duodenum. Peptic ulcer disease can cause abdominal pain, vomiting, and bleeding.
  • Stomach Cancer: The presence of H. pylori may increase the risk of stomach cancer, especially in cases of prolonged infections and when the bacterium causes chronic inflammation.
  • Gastroesophageal Reflux Disease (GERD): Some studies suggest a connection between H. pylori and GERD, although the nature of this association remains a topic of discussion. GERD is characterized by the backflow of stomach contents into the esophagus, causing symptoms such as heartburn, acidity, and chest pain. The presence of H. pylori may influence acid secretion, which, in turn, can impact the development of GERD.

Symptoms of Helicobacter pylori

Helicobacter pylori (H. pylori) infection can be asymptomatic, and many people may not realize they are infected. Even when symptoms are present, they can vary and may be associated with various gastrointestinal problems. Some common symptoms that may occur with H. pylori infection include:

  • Dyspepsia: Discomfort, pain, or a feeling of fullness in the abdomen after eating.
  • Upper Abdominal Pain: Epigastric pain or discomfort.
  • Heartburn: A burning sensation in the chest, especially after meals.
  • Belching: The possibility of acid or a bitter taste in the mouth.
  • Flatulence and Abdominal Bloating: A sensation of increased gas volume in the abdomen.
  • Changes in Appetite: Decreased or increased appetite.
  • Bad Taste in the Mouth: A metallic or bitter taste.
  • Flatulence: Excessive gas formation.

It is important to note that digestive problems caused by gastric dysfunction can have a wide-ranging impact on the body. For instance, disruptions in digestion and nutrient absorption (vitamin B12 and iron, for example) can lead to low energy levels due to a lack of essential substances for effective metabolism. This can affect overall health, resulting in weakness, fatigue, and even neurological symptoms.

Additionally, issues with digesting proteins, crucial for neurotransmitter synthesis, can influence mental health. Insufficient components for neurotransmitter synthesis, such as serotonin and dopamine, may contribute to the development of depression and other neurological disorders. Furthermore, the compromised resistance of the body due to H. pylori infection can create conditions for the activation of other infections.

This underscores the importance of early detection and treatment of Helicobacter pylori, not only to prevent issues in the gastrointestinal tract but also to maintain overall health.

Symptomatic or Asymptomatic Infection with Helicobacter pylori:

The symptomatic or asymptomatic nature of Helicobacter pylori infection is associated with various factors, including:

  • Genetic Factors: Some individuals may be more predisposed to developing symptoms in response to Helicobacter pylori due to their genetic characteristics.
  • Immune Response: The immune system’s reaction to the bacterium can vary among individuals. Some may develop a strong inflammatory response leading to symptoms, while others may maintain the infection in a “dormant” state without pronounced manifestations.
  • Bacterial Strain: Different strains of Helicobacter pylori exist, and some may be more aggressive, causing severe symptoms, while others may be less pathogenic.
  • Mucous Membrane Health: The health of the stomach’s mucous membrane also plays a role. If the mucous membrane is resilient and less prone to inflammation, symptoms may be less pronounced.
  • Other Diseases: There are associations between Helicobacter pylori and certain other diseases. For example, patients with Helicobacter pylori may have gastritis for other reasons, which can exacerbate symptoms.
  • Personal Lifestyle Circumstances: Lifestyle factors, such as diet, stress, and activity level, can also influence the manifestation of symptoms.

These factors collectively determine why some people experience symptomatic infection while others go through it without noticeable symptoms.

Research and Discovery of Helicobacter pylori

Now, let’s recall the history of this remarkable discovery. In 1984, Barry Marshall and Robin Warren conducted an experiment in which they intentionally infected themselves with Helicobacter pylori to demonstrate the connection of this bacterium with the development of gastritis and stomach ulcers. Marshall’s experiment was a pivotal step in proving that Helicobacter pylori can cause stomach infections and gastritis. The results of this study confirmed the link between this bacterium and ulcerative conditions, opening new perspectives in the treatment of these conditions.

Barry Marshall ingested a culture of H. pylori and developed symptoms of gastritis within a few days. Later, when an endoscopy of his stomach was performed, it was discovered that he had developed a gastritic infection. This experiment was one of the key steps in establishing the cause-and-effect relationship between H. pylori and stomach ulcers.

Their work initially faced skepticism and resistance from the medical community as it had long been believed that gastric ulcers were primarily caused by stress or excessive acid consumption. However, the discovery by Marshall and Warren, supported by subsequent research, led to a reconsideration of medical concepts and a change in approaches to the treatment of gastric ulcers.

For these groundbreaking studies, Barry Marshall and Robin Warren were awarded the Nobel Prize in Physiology or Medicine in 2005. Their discovery significantly altered the approach to treating gastric ulcers and contributed to the development of new treatment methods, including antibiotic therapy to eradicate H. pylori.

Diagnosis of Helicobacter pylori

It is crucial to accurately and timely diagnose this bacterium. I want to emphasize once again: no one treats asymptomatic Helicobacter pylori infection now. If someone in your family is found to have H. pylori, it is necessary to check the entire family, specifically those who have symptoms. However, it is not advisable for the entire family to take antibiotics without symptoms. Now, about diagnostics:

Breath Test:

  • Principle: Measurement of carbon dioxide levels in exhaled air.
  • Comment: The patient ingests labelled carbon, which the bacterium metabolizes, releasing carbon dioxide.

Stool antigen test:

  • Principle: Detection of antigens or DNA of Helicobacter pylori in stool samples.
  • Comment: Non-invasive method that allows assessment of infection activity.

Blood Tests:

  • Principle: Measurement of antibody levels to Helicobacter pylori in the blood.
  • Comment: A positive result may indicate a current or past infection.

Gastrofibroscopy (in some cases):

  • Principle: Taking tissue samples from the inner wall of the stomach during endoscopy.
  • Comment: Allows assessment of the degree of mucous membrane damage and biopsy for further studies.

Helicobacter pylori: Enemy or Friend?

In the early days of Helicobacter pylori research, the medical community focused on its association with gastritis and ulcers, and treatment of the bacterium was considered necessary even if a person had no pronounced symptoms. However, over time and with deeper research, it became clear that not everyone infected with H. pylori develops serious diseases.

Many infections turned out to be asymptomatic, and treating them without specific indications could have negative consequences. In particular, some studies have shown that excessive treatment of H. pylori in individuals without symptoms may increase the risk of developing colorectal cancer and inflammatory bowel diseases (IBD). It turned out that H. pylori could be part of the normal microbiome, and the bacterium might have a protective function. There is also a hypothesis that it may play a protective role against food allergies.

Today, the approach to H. pylori treatment has become more individualized. Doctors decide whether to prescribe treatment based on the specific symptoms of the patient, test results, and overall health. If the bacterium manifests symptoms, testing is conducted, and if detected, it undergoes treatment. Otherwise, searching for the bacterium is considered impractical, as it is considered part of normal flora.

Treatment of H. pylori:

Traditional treatment regimens include combinations of antibiotics such as amoxicillin, clarithromycin, metronidazole, and others. However, issues arise due to antibiotic resistance, requiring careful selection of the treatment scheme and results monitoring.

In the experiment where Barry Marshall infected himself with Helicobacter pylori, he used the antibiotic metronidazole. After developing gastritis symptoms from consuming the H. pylori culture, he initiated treatment. Marshall used metronidazole initially and later completed the course with other antibiotics such as amoxicillin and tetracycline. Do not attempt this on your own; consult a doctor if you have symptoms, undergo testing, and if the test shows a positive result, you will be given a complex of 4 or 5 medications with instructions on how to take them.

Alternative approaches to treatment are considered, such as the use of probiotics, dietary changes, and herbal remedies. Monitoring after completing treatment is also essential to confirm complete eradication of the bacterium. However, this should not be done immediately after the antibiotic course but after 4-6 weeks.

If Not H. pylori, Then What Else?

For some patients, there may be gastritis symptoms, but tests do not show the presence of Helicobacter pylori. This may be due to other reasons. Here are a few other problems that can lead to gastritis:

  • Autoimmune Gastritis: This is a condition where the immune system attacks the body’s own stomach cells, including those that produce stomach acid, leading to inflammation of the stomach lining.
  • Use of Certain Medications: Prolonged use of certain medications, such as NSAIDs (including aspirin and ibuprofen), can irritate the stomach lining and lead to gastritis.
  • Hiatal Hernia: A hiatal hernia occurs when the upper part of the stomach protrudes through the opening in the diaphragm (hiatal opening) into the chest cavity. This can lead to various problems, including acid reflux from the stomach into the esophagus (gastroesophageal reflux disease, GERD).
  • Infections Other Than H. pylori: Other infections, such as viruses (EBV, CMV, etc.), bacteria (Bartonella, H.Heilmani, Streptococci, Staphylococci, Enterobacteria, Clostridium, E.coli, Tuberculosis, Syphili), fungi (C.albicans, Histoplasmosis), or parasites (Anisakiasis), can also cause inflammation of the gastrointestinal tract.
  • Excessive Alcohol Consumption: Alcohol can irritate the stomach lining, leading to inflammation.
  • Stomach Injury: Trauma, surgical procedures, or other types of stomach damage can cause gastritis.
  • Irritable Bowel Syndrome (IBS): IBS can cause abdominal pain, changes in stool, bloating, and discomfort, resembling symptoms of gastrointestinal infections.
  • Crohn’s Disease, Ulcerative Colitis (IBD): These chronic inflammatory conditions of the intestines can induce symptoms similar to those exhibited in H. pylori, including abdominal pain and changes in stool.
  • Stress: While stress itself is not considered a cause of simple gastritis, it can exacerbate an existing condition and contribute to inflammation.

As you can see, there are many problems that can cause similar symptoms. Why do people talk only about Helicobacter? Because before the discovery of this bacterium, no one believed that anything could survive in such an acidic environment. That’s why this discovery received the Nobel Prize. And then the problems started to unfold one after another, but by then, it no longer surprised anyone. But still, Helicobacter remains the main cause, with autoimmune gastritis being the second most common cause. All the rest are less common. When there are many reasons, finding them becomes more challenging, and often specialists don’t have time to investigate them all. Although, these infections can also cause a lot of trouble if not treated.

What does the thyroid gland have to do with it?

There is some association between Helicobacter pylori (H. pylori) infection and autoimmune thyroid diseases such as chronic thyroiditis (Hashimoto’s) and Graves’ disease. Chronic thyroiditis (or Hashimoto’s) and Graves’ disease are the two main types of autoimmune diseases affecting the thyroid gland. In the case of Hashimoto’s, the immune system attacks the tissues of the thyroid gland, leading to inflammation and gradual destruction. Graves’ disease, on the other hand, is characterized by the excessive production of hormones by the thyroid gland, caused by an autoimmune process. Several studies have shown that people with H. pylori infection may have an increased risk of developing autoimmune thyroid diseases. This may be related to the fact that H. pylori can trigger immune reactions in the body that affect not only bacteria but also the body’s own cells. The mechanism of this connection is not fully understood yet, and research in this area is ongoing.


The article on Helicobacter pylori provides a comprehensive overview of the role of this bacterium in gastrointestinal diseases. Research highlights the connection between H. pylori and gastritis and ulcers, while also emphasizing potential positive aspects of the bacterium’s interaction with the body.

The association between H. pylori infection and autoimmune diseases of the thyroid gland, such as chronic thyroiditis (Hashimoto’s) and Graves’ disease, adds complexity to our understanding, and further studies are necessary to unravel the mechanisms of this relationship. Determining the need for H. pylori treatment requires additional research.

Caution in treatment, especially in the absence of symptoms, is underscored, urging an individualized approach to patient care. It’s important to note that symptoms can be diverse, so it’s always advisable to discuss your condition with a doctor to understand whether your symptoms may be related to H. pylori.