Helicobacter pylori: The Ulcer-Causing Stomach Invader
H. pylori infects roughly half the world's population, with prevalence significantly higher in South Africa and sub-Saharan Africa. It causes 80 to 90% of peptic ulcers and is classified as a WHO Group 1 carcinogen (definite cause of stomach cancer). It is curable once detected.
Why Is H. Pylori Dangerous?
80 to 90% of peptic ulcers
The primary cause of stomach and duodenal ulcers worldwide
WHO Group 1 carcinogen
Classified alongside asbestos and tobacco as a definite cause of cancer
50% global prevalence
Higher in South Africa and sub-Saharan Africa due to water quality and crowding
Often silent for years
Many carriers are asymptomatic while chronic inflammation progresses
How H. Pylori Causes Harm
Survives stomach acid. H. pylori produces an enzyme (urease) that neutralises surrounding acid, creating a protective alkaline pocket. This allows it to colonise the stomach lining where no other bacteria can survive.
Damages the stomach lining. It burrows into the mucus layer and triggers chronic inflammation (gastritis). Over years, this can progress to ulcers (10 to 15% of infected individuals) and precancerous changes.
Carcinogenic pathway. Chronic inflammation leads to atrophic gastritis, intestinal metaplasia, dysplasia and eventually gastric adenocarcinoma in 1 to 3% of infected individuals. Eradication at any earlier stage interrupts this progression.
Evades immune clearance. H. pylori modifies its surface proteins to avoid immune detection. The immune system's inflammatory response causes tissue damage but fails to clear the infection, creating a cycle of chronic inflammation.
Symptoms of H. Pylori Infection
Gut Symptoms
Burning stomach pain
Worse on an empty stomach, often wakes you at night
Bloating and early fullness
Feeling uncomfortably full after small meals
Nausea
Especially in the morning, sometimes with vomiting
Loss of appetite
Unintentional weight loss over weeks or months
Acid reflux and heartburn
Persistent reflux that does not respond to dietary changes
Dark or tarry stools
Sign of a bleeding ulcer: seek medical attention promptly
Whole-Body Effects
H. pylori's damage extends beyond the stomach. Chronic infection triggers systemic inflammation, iron deficiency and vitamin B12 malabsorption.
Fatigue
From iron deficiency or B12 malabsorption caused by chronic gastritis
Unexplained anaemia
H. pylori impairs iron absorption even without visible bleeding
Anxiety around eating
Pain association with food leads to meal avoidance
Disease Associations
Peptic ulcers: H. pylori causes 80 to 90% of duodenal ulcers and 60 to 80% of gastric ulcers. Gastric cancer: WHO Group 1 carcinogen; 1 to 3% of infected individuals develop stomach cancer. MALT lymphoma: a rare stomach lymphoma that often resolves with H. pylori eradication. Chronic gastritis: ongoing stomach lining inflammation in most infected individuals. Iron deficiency anaemia: impairs iron absorption. Vitamin B12 deficiency: chronic gastritis reduces B12 absorption.
How H. Pylori Infection Progresses
Infection acquired (often in childhood)
Usually through contaminated water or close contact. In South Africa, acquisition rates are higher in communities with untreated water sources. Most people do not notice the initial infection.
Chronic gastritis develops
The immune response causes chronic inflammation of the stomach lining. Most people have no symptoms at this stage but damage is accumulating. This phase can last years or decades.
Ulcers or symptoms appear
In 10 to 15% of infected individuals, chronic inflammation leads to peptic ulcers. Burning pain, bloating and nausea prompt medical attention. Many are diagnosed only at this stage.
Atrophic changes begin
Years of inflammation cause atrophic gastritis and intestinal metaplasia: precancerous changes in the stomach lining. Still reversible with eradication.
Cancer risk materialises
In 1 to 3% of infected individuals, progression reaches gastric adenocarcinoma. Eradication at any earlier stage interrupts this pathway.
The good news: H. pylori is curable. Standard eradication therapy clears the infection in 80 to 90% of cases. Early detection is key. The earlier you test and treat, the better the outcome. Epicentre detects H. pylori by PCR stool test: no blood draw, no breath test, no endoscopy.
Prevention and Protection
Get tested
If you have symptoms, family history or risk factors, a PCR stool test detects H. pylori accurately
Complete any treatment course
Stopping early promotes resistance. Finish the full course as directed by your doctor
Anti-inflammatory diet
Fruits, vegetables, sulforaphane (broccoli sprouts) and vitamin C support gut healing
Safe water and hygiene
Boil or filter water from untreated sources. Hand hygiene reduces transmission
Test for H. Pylori at Epicentre
H. pylori is included in all three gut panels: the Gut Essentials Test, the Complete Gut Profile and the Gut Deep Dive. Stool sample with home collection kit or branch pickup. No doctor's referral.
Gut Essentials Test
Complete Gut Profile
Gut Deep Dive and Disease Association
All packages: Payflex available (4 interest-free instalments). 10% student discount. 10% pensioner discount. Results in 5 to 7 working days. All prices include VAT.
Frequently Asked Questions
Which Epicentre test detects H. pylori?
How is H. pylori transmitted?
Can H. pylori be cured?
Should I test if I have no symptoms?
Do I need a doctor's referral?
Can diet help with H. pylori?
Find Out If H. Pylori Is in Your Gut
PCR stool test. Home kit or walk-in. No doctor's referral. Results in 5 to 7 days.
Walk-in labs: Observatory (Cape Town), Hillcrest (Durban), Parktown North (Johannesburg). Mon to Fri, 08:30 to 16:00. Practice #1117394.
Epicentre Walk-In Labs does not provide medical diagnoses or treatment. For diagnoses and advice, consult your healthcare practitioner.
