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Expert Q&A

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Where did my H. pylori infection come from?

Asked by James, Tucson, Arizona

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I am a 31-year-old male. A few months ago, I was diagnosed with H. pylori. I live a healthy life and maintain a relatively clean house. How would a person spontaneously contract the bacterium? Others in my household have tested negative for H. pylori. Could it be something that I picked up in a public place? I do not travel, let alone to developing countries or third-world nations. I went to urgent care in April and was admitted to the ER because I could not keep down liquids, solids or medications. They diagnosed me with gastroenteritis. I have two sick pets: They have both been diagnosed with IBD, though one has been controlled with a diet change. Could H. pylori be transmitted from animal to human? Any information would be helpful.

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Conditions Expert Dr. Otis Brawley Chief Medical Officer,
American Cancer Society

Expert answer

Dear James:

Helicobacter pylori is the most common chronic bacterial infection in humans. Although most people who have the infection have no symptoms or problems with it, it can cause chronic gastritis, most peptic ulcers, and gastric adenocarcinoma and gastric lymphoma.

It is believed that half of the world's population has this infection. In developing countries, infection is common in children and affects more than 80 percent before age 50. In developed countries, such as the United States, infection in children is rare. In the United States, about 10 percent of those between 18 and 30 years of age and half of people over age 60 are infected.

The route by which H. pylori infection occurs remains unknown. Person-to-person transmission of H. pylori through either fecal/oral or oral/oral exposure seems most likely. Although the bacterium appears to be primarily a human pathogen, it has been found in primates, sheep and domestic cats. It is unclear how these animals acquired H. pylori. Though we do not really know how it is spread, fecal/oral transmission of the H. pylori bacterium is likely.

Swimming in or drinking contaminated water in developing countries also likely serves as a source of bacteria. Infected individuals are more likely to have infected spouses and children than uninfected individuals. This suggests person-to-person transmission. The organism has been found in dental plaque, suggesting that oral/oral transmission can occur.

When diagnosed, it is treated with a proton pump inhibitor (a drug to decrease acid secretion) and a series of antibiotics. Reinfection with H. pylori after successful treatment is unusual. Recurrence usually means a relapse of the original infection, meaning it was never cleared. This occurs in less than 2 percent of adults.

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