H. pylori infection
H. pylori is a bacterium carried by a large share of Nigerian adults. Most never know. In others it causes ulcers, chronic gastritis and years of unexplained stomach pain.
Also known as: Helicobacter pylori · Stomach bacteria · H pylori
Understanding h. pylori infection
What H. pylori is
Helicobacter pylori is a spiral-shaped bacterium uniquely adapted to survive in the stomach, one of the most hostile environments in the body. It burrows into the protective mucus layer and neutralises acid immediately around itself.
It is one of the most common chronic bacterial infections in the world, and prevalence in Nigeria is high, with a large proportion of adults carrying it.
Understanding h. pylori infection
How you get it
Most people acquire H. pylori in childhood. It spreads through contaminated food and water, and through close contact within households, which is why infection often clusters in families.
Crowded living conditions and limited access to clean water increase transmission, which explains the higher prevalence across much of West Africa.
Understanding h. pylori infection
What it does
Carrying H. pylori is not the same as being ill from it. The majority of carriers never develop symptoms.
In others it causes persistent inflammation of the stomach lining, called chronic gastritis, and wears down the protective barrier so that acid injures the wall beneath, producing peptic ulcers.
Long-standing infection is also the single most important risk factor for stomach cancer, and is associated with a rare lymphoma of the stomach called MALT lymphoma, which can regress when the bacterium is cleared. This is why we do not dismiss it as harmless in people who have symptoms.
Understanding h. pylori infection
Symptoms
When it does cause trouble, the pattern is that of an irritated stomach or an ulcer:
- Burning or gnawing pain in the upper middle abdomen, often worse when hungry
- Bloating and frequent belching
- Feeling full after only a small amount of food
- Nausea, or loss of appetite
- Unintended weight loss in more established cases
Understanding h. pylori infection
How we test for it
There are three practical routes, and the right one depends on your age and symptoms.
A urea breath test and a stool antigen test are both accurate and non-invasive, and are reasonable first choices in younger patients without alarm features. Both require stopping acid-reducing medication and antibiotics beforehand, or the result can be falsely negative.
A gastroscopy with biopsy is the most informative option. It confirms the infection and at the same time shows whether an ulcer, significant gastritis or anything more serious is present. We recommend it for anyone over 45 with new symptoms, and for anyone with alarm features at any age.
Understanding h. pylori infection
Treatment
Clearing H. pylori requires a combination, never a single antibiotic. Standard treatment pairs two antibiotics with a proton pump inhibitor, taken together for one to two weeks. Where local resistance is a concern, a four-drug regimen including bismuth may be used.
The single most common reason treatment fails is stopping early because the pain has gone. The bacterium survives, and is often harder to clear the second time. Take the whole course exactly as prescribed.
A follow-up test at least four weeks after finishing, and off acid-reducing medication for two weeks, confirms the infection has genuinely cleared. Skipping that confirmation is how people end up back where they started.
Understanding h. pylori infection
After treatment
Once cleared, reinfection in adults is uncommon. Ulcers caused by the infection heal and, importantly, tend not to recur, which is a genuine cure rather than ongoing management.
If symptoms persist after confirmed eradication, the cause is something else and deserves investigating rather than another course of antibiotics.
Common questions
How common is H. pylori in Nigeria?
Very common. A large proportion of Nigerian adults carry it, usually acquired in childhood, though many never develop symptoms.
Can H. pylori be cured?
Yes. A complete course of combination therapy clears it in most people, and a follow-up test confirms success.
Is H. pylori contagious?
It spreads through contaminated food and water and close household contact, which is why it often runs in families. Routine testing of family members is not usually needed unless they have symptoms.
Do I need testing if I have no symptoms?
Routine screening of people without symptoms is not standard. Testing is advised for those with ulcer symptoms, a history of ulcers, or a family history of stomach cancer.
Acid reflux and GERD
Occasional heartburn is normal. Reflux that returns the moment you stop medication, or has run for years, is worth examining rather than medicating indefinitely.
Peptic ulcers
Stress and pepper get the blame for ulcers in Nigeria. The real causes are H. pylori infection and anti-inflammatory painkillers, and both are treatable once identified.
Gastritis
Gastritis means inflammation of the stomach lining. It is one of the most over-diagnosed and under-investigated labels in Nigerian medicine, and the cause matters more than the name.
Talk to the unit
This page is general information, not a diagnosis. If it describes you, a short consultation decides what, if anything, you need. Call +234 707 056 6272 or message +234 707 056 6272 on WhatsApp.