What Is H. pylori? Symptoms, Testing and Treatment in the UK (NHS-Aligned Guide)
Quick answer: H pylori (Helicobacter pylori) is a common bacterium that can live in the lining of the stomach. Most people who have it never get symptoms, but it can cause indigestion, gastritis and stomach ulcers. In the UK, a GP can arrange a breath or stool test and, if it is positive, prescribe a short course of treatment.
- Common and often silent. One NHS trust estimates around 40% of people in the UK have it; most never notice.
- Symptoms overlap with other problems, such as indigestion, bloating and upper tummy pain.
- Two main tests: a breath test or a stool antigen test, usually arranged by your GP.
- Treatment is prescribed: typically 7 days of an acid-lowering medicine plus two antibiotics.
- Know the red flags: vomiting blood, black poo, weight loss or difficulty swallowing need urgent help.
01What is H pylori?
Helicobacter pylori is a type of bacteria that can infect the lining of the stomach and the duodenum, the first part of the small intestine.
The NHS lists H pylori infection as one of the main causes of stomach ulcers, alongside regular use of anti-inflammatory painkillers such as ibuprofen. It is also a cause of gastritis, where the stomach lining becomes irritated.
| What it is | A bacterium that can live in the lining of the stomach and duodenum |
|---|---|
| How common | Around 40% of people in the UK, according to one NHS trust; most have no symptoms |
| Main UK tests | Carbon-13 urea breath test or stool antigen test (NICE) |
| Before a test | Usually no proton pump inhibitor (PPI) for 2 weeks and no antibiotics for 4 weeks |
| Usual first treatment | A 7-day, twice-daily course of a PPI plus two antibiotics, prescribed by a doctor |
| If left untreated | Can lead to ulcers and bleeding, and raises the risk of stomach cancer (NHS) |
02How common is it, and how does it spread?
A Chelsea and Westminster Hospital NHS Foundation Trust leaflet estimates that around 40% of people in the UK have H pylori, and only around 1 in 10 of them will have symptoms or complications.
How it spreads isn’t fully understood. It is thought to pass from person to person, usually in childhood, through close contact with family.
03What are the symptoms of H pylori?
When H pylori does cause problems, the symptoms usually come from gastritis or a stomach ulcer. NHS pages list:
- Tummy pain: usually in the upper part of the tummy, sometimes burning, and often worse at night.
- Indigestion: heartburn, burping, or feeling full and bloated after eating.
- Feeling or being sick, and not feeling as hungry as usual.
These symptoms are common and have many other causes, including acid reflux, some medicines, smoking and stress.
You can’t tell whether you have H pylori from symptoms alone. A test is the only way to know.
04When to see your GP
05How is H pylori tested for in the UK?
If your GP thinks H pylori could be behind your symptoms, they may arrange a test. NICE recommends a carbon-13 urea breath test or a stool antigen test. A laboratory blood test can be used where its performance has been checked locally.
| Urea breath test | You have a special drink or tablet, then breathe into a tube. Shows a current infection; NICE also uses it for re-testing after treatment. |
|---|---|
| Stool antigen test | A small poo sample is tested for traces of the bacteria. Shows a current infection. |
| Blood antibody test | Shows whether you have ever had H pylori, not whether you have it now. NICE advises against rapid “office-based” blood tests. |
| Gastroscopy | A thin camera is passed into the stomach and a tissue sample can be tested. Used in some cases, after a referral. |
Preparing for a breath or stool test
Some medicines can cause a false negative result. NICE advises a 2-week gap after a proton pump inhibitor (PPI), such as omeprazole, and UK guidance advises waiting 4 weeks after antibiotics.
Don’t stop a prescribed medicine on your own. Ask your GP or pharmacist how to prepare, and mention any supplements you take.
Testing outside the GP route
Some pharmacies and private clinics sell breath or stool tests. If you use one, share the result with your GP, because a positive result needs a prescription.
06How is H pylori treated?
If you test positive, your GP (or a specialist) will prescribe treatment. NICE recommends a 7-day, twice-daily course of three medicines:
- A PPI to lower the amount of acid your stomach makes.
- Amoxicillin, an antibiotic.
- Clarithromycin or metronidazole, a second antibiotic.
Other combinations, some including bismuth, are used for people allergic to penicillin or who have had certain antibiotics before. Take every dose exactly as prescribed and finish the course. Side effects can include feeling sick, diarrhoea and headaches; tell your GP or pharmacist if they are a problem.
07What happens after treatment?
If your symptoms settle, you usually won’t need another test. NICE does not routinely recommend re-testing after treatment for indigestion.
If you had a stomach ulcer, NICE recommends a breath test 6 to 8 weeks after starting treatment. If symptoms come back, see your GP, who can offer a different combination of medicines or specialist advice.
08Diet and everyday habits
No food or supplement replaces NHS testing and prescribed care. Once you have seen a GP, the NHS suggests some everyday habits for stomach discomfort:
- Eat smaller meals, and have your evening meal 3 to 4 hours before going to bed.
- Notice your triggers. Fatty or spicy foods, coffee, chocolate and alcohol bother some people.
- Don’t smoke, and don’t take anti-inflammatory painkillers such as ibuprofen without speaking to a doctor first.
Our guide to gut health and diet covers fibre, fluids and meal timing. We also publish plain-English ingredient explainers, such as what NAC (N-acetyl cysteine) is and Pylopass™ explained.
09Frequently asked questions
What is H pylori?
H pylori (Helicobacter pylori) is a type of bacteria that can live in the lining of the stomach and the first part of the small intestine. Many people carry it without symptoms, but in some it causes gastritis or stomach ulcers.
What are the symptoms of H pylori?
Most people have no symptoms. When it causes problems, symptoms can include burning upper tummy pain, indigestion, bloating and feeling sick. These have many other causes, so a test is the only way to know.
How do I get tested for H pylori in the UK?
Speak to your GP. NICE recommends a carbon-13 urea breath test or a stool antigen test. Some pharmacies and private clinics also sell these tests; if you use one, share the result with your GP.
Do I need to stop any medicines before an H pylori test?
Possibly. NICE advises a 2-week gap after a proton pump inhibitor such as omeprazole, and UK guidance advises 4 weeks after antibiotics, as both can cause false negative results. Never stop a prescribed medicine without asking your GP or pharmacist.
How is H pylori treated in the UK?
Treatment is prescribed by a GP or specialist. NICE recommends a 7-day, twice-daily course of a proton pump inhibitor plus two antibiotics, usually amoxicillin with clarithromycin or metronidazole. Take every dose and finish the course.
Can H pylori come back after treatment?
An NHS hospital leaflet says the chance of reinfection after successful treatment is very low. If symptoms come back, see your GP. People who had a stomach ulcer are offered a breath test 6 to 8 weeks after starting treatment.
10About London Health Star
London Health Star is a UK company that makes food supplements. A food supplement is not a medicine and does not replace GP testing or prescribed care.
Explore StarBiome Pylori, a food supplement with Pylopass™, NAC, chamomile and vitamin B12. Each daily dose of 2 vegan capsules contains:
- Pylopass™ (Lactobacillus reuteri DSM 17648, inactivated)200 mg
- N-acetyl cysteine (NAC)600 mg
- Chamomile extract37.5 mg
- Vitamin B12 (as methylcobalamin)25 µg (1000% NRV)
Vitamin B12 contributes to the reduction of tiredness and fatigue and to normal energy-yielding metabolism.
11Sources
Disclaimer: this guide is for general information only and does not replace advice from your GP, pharmacist or another healthcare professional. Always follow the advice you are given about testing and treatment.
- NHS. Stomach ulcer. https://www.nhs.uk/conditions/stomach-ulcer/
- NHS. Gastritis. https://www.nhs.uk/conditions/gastritis/
- NHS. Indigestion. https://www.nhs.uk/conditions/indigestion/
- NICE. Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management (CG184), Recommendations. https://www.nice.org.uk/guidance/cg184/chapter/1-Recommendations
- NICE Clinical Knowledge Summaries. Dyspepsia: unidentified cause. https://cks.nice.org.uk/topics/dyspepsia-unidentified-cause/
- BNF (via NICE). Helicobacter pylori infection: treatment summary. https://bnf.nice.org.uk/treatment-summaries/helicobacter-pylori-infection/
- UK Health Security Agency (GOV.UK). Helicobacter pylori in dyspepsia: test and treat. https://www.gov.uk/government/publications/helicobacter-pylori-diagnosis-and-treatment
- Chelsea and Westminster Hospital NHS Foundation Trust. Helicobacter pylori (patient leaflet). https://www.chelwest.nhs.uk/your-visit/patient-leaflets/helicobacter-pylori
