What is Helicobacter pylori?
Helicobacter pylori is a bacteria that infects the stomach and affects about 50% of the world’s population. It is the leading cause of chronic gastritis, and it’s linked to conditions like peptic ulcers and, in some cases, helicobacter pylori may cause stomach cancer.
It’s usually acquired during childhood and can remain in the stomach for decades, often without symptoms. But in certain individuals, the infection may lead to serious long-term consequences.
How does Helicobacter pylori affect the stomach?
Once in the stomach, H. pylori releases substances that weaken the protective lining of the stomach, allowing acid to irritate and damage the tissue. This causes chronic inflammation, which can lead to atrophic gastritis, a condition where the stomach lining becomes thin and loses its function.
Over time, this damage may progress through a series of cellular changes that, in some cases, can end in gastric cancer.
Does having Helicobacter pylori mean I will get cancer?
Not necessarily. Having Helicobacter pylori does not mean you will develop cancer, but it does increase your risk.
The World Health Organization classifies it as a Group 1 carcinogen, placing it in the same category as tobacco and asbestos. This is due to its clear association with gastric adenocarcinoma (the most common form of stomach cancer) and gastric MALT lymphoma, a rare cancer of the stomach lining.
Still, the majority of people with this infection will never develop cancer—the risk depends on many factors.
What increases the cancer risk in Helicobacter pylori infection?
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Duration of infection – The longer the bacteria remains, the greater the risk.
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Family history – Especially first-degree relatives with gastric cancer.
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Type of gastritis – Conditions like atrophic gastritis or intestinal metaplasia indicate higher risk.
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Older age – Infections tend to be longer in older patients.
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Genetics and environment – Diets high in salt and processed foods, smoking, and alcohol also contribute.
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Gastric ulcers or persistent digestive symptoms.
What types of cancer are linked to Helicobacter pylori?
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Gastric adenocarcinoma – The most common type of stomach cancer. H. pylori can cause a sequence of changes in the stomach lining that can lead to malignancy.
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Gastric MALT lymphoma – A rare cancer of the lymphoid tissue in the stomach. In early stages, it can regress after H. pylori eradication.
How do I know if I have Helicobacter pylori?
Common diagnostic tests include:
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Urea breath test (13C) – Non-invasive and highly accurate.
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Stool antigen test – Useful for diagnosis and to confirm eradication.
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Upper endoscopy with biopsy – Required in cases with alarm symptoms or suspected gastric damage.
If you have ongoing symptoms like bloating, abdominal pain, nausea, fatigue, or unexplained anemia, it’s important to consult a digestive specialist.
Can Helicobacter pylori be cured?
Yes—and in most cases, it should be. Eradication treatment typically involves a combination of antibiotics and a proton pump inhibitor (such as omeprazole), taken for 10 to 14 days.
Treatment regimens may vary depending on antibiotic resistance and patient history.
Equally important is confirming eradication with a follow-up test (usually 4 weeks after completing treatment) to ensure the bacteria is gone.
Does treatment reduce the risk of cancer?
Yes. Multiple studies confirm that eradicating Helicobacter pylori significantly lowers the risk of developing gastric cancer—especially if done before precancerous changes like atrophic gastritis or intestinal metaplasia occur.
For high-risk individuals, regular endoscopic follow-up may also be recommended to monitor the condition of the stomach lining.
What if I’ve already been diagnosed with atrophic gastritis or metaplasia?
These are considered precancerous conditions, but not cancer themselves. If you have either:
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Make sure Helicobacter pylori has been eradicated.
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Schedule routine endoscopic monitoring to detect changes early.
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Eat a healthy diet rich in fruits and vegetables, and low in salty or processed foods.
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Avoid smoking and alcohol.
Can Helicobacter pylori be transmitted?
Yes. Though not highly contagious, H. pylori can spread—especially among people living together—via oral contact or contaminated food and water.
Sometimes, household members may be tested, especially if they have digestive symptoms.
What can I do to prevent cancer if I have Helicobacter pylori?
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Complete the treatment for eradication.
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Verify that the bacteria is gone with a follow-up test.
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Undergo regular endoscopies if there are precancerous changes.
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Improve your diet – Focus on fresh, unprocessed foods.
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Quit smoking and avoid alcohol.
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Talk to your gastroenterologist about your individual risk.
Conclusion
Having Helicobacter pylori doesn’t mean you’ll develop cancer—but it does increase the risk, especially if left untreated.
The good news is that early detection and treatment of the infection can dramatically reduce that risk. If you’ve been diagnosed with H. pylori, don’t panic—but take action. Consult a digestive specialist who can evaluate your case and help you manage your risk safely and effectively.
Dr. Pedro de María Pallarés
Digestive and Advanced Endoscopy Specialist
Hospital Universitario La Paz – Co-founder of INMEQ