H. Pylori Symptoms, Causes and Treatments in Singapore
by: Dr. Paul Chang, General Practitioner, Regis Medical
Last updated: December 5, 2025
What You Need to Know About This Common Stomach Infection
H. pylori (Helicobacter pylori) is one of the most common bacterial infections worldwide, and it is frequently seen in Singapore as well. Many people may carry the bacteria without symptoms, while others may experience persistent gastric discomfort that affects daily life.
Early detection and proper treatment are important because untreated H. pylori can increase the risk of stomach ulcers and, in the long term, even stomach cancer. Here is a complete guide to understanding H. pylori symptoms, causes, diagnosis and treatment options available in Singapore.
What Is H. Pylori?
H. pylori is a type of bacteria that lives in the stomach lining. It can weaken the stomach’s protective mucus layer and create inflammation (gastritis). Over time, this may lead to ulcers in the stomach or small intestine.
While the infection is typically acquired during childhood, symptoms may only appear much later in life.
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Symptoms of H. Pylori Infection
Many people with H. pylori have no symptoms at all, but when symptoms are present, they tend to fall into several clusters:
1. Gastric Discomfort & Pain
These symptoms come from inflammation of the stomach lining (gastritis) or ulcers:
- Burning or gnawing stomach pain, usually in the upper abdomen
- Pain that worsens when the stomach is empty (common a few hours after meals or at night)
- Pain relieved temporarily after eating or taking antacids
- Recurrent or persistent indigestion
2. Bloating & Digestive Disturbances
H. pylori affects stomach acid production and digestion:
- Feeling full quickly, even after small meals
- Abdominal bloating or tightness
- Excessive belching
- Sour taste or mild reflux due to disrupted gastric function
3. Nausea & Appetite Changes
Inflammation may affect the stomach’s ability to empty:
- Nausea, often worse in the morning
- Loss of appetite
- Occasional vomiting
4. Ulcer-Related Symptoms (More Serious)
If H. pylori leads to ulcers, symptoms may escalate:
- Sharp or persistent upper abdominal pain
- Dark, tarry stools (suggestive of bleeding)
- Vomiting blood or coffee-ground-like material
- Persistent fatigue (from slow internal bleeding)
These symptoms require urgent medical attention.
5. Non-Specific Symptoms
While less common, they can occur:
- Unexplained weight loss
- Chronic burping or acidity
- Bad breath not related to oral hygiene
Causes of H. Pylori Infection
H. pylori spreads mainly through oral transmission and thrives in environments with close human contact. In Singapore and globally, people commonly acquire it in childhood.
1. Person-to-Person Transmission
The bacteria is found in saliva and gastric fluids:
- Sharing utensils
- Sharing food from common plates
- Close contact with someone infected
- Kissing (low but possible transmission route)
H. pylori is not highly infectious, but repeated exposure increases risk.
2. Contaminated Food or Water
Though Singapore has safe water standards, infection can still occur:
- Consumption of contaminated raw/undercooked food
- Exposure during overseas travel to countries with higher infection rates
- Food handled by someone carrying H. pylori
3. Family or Household Exposure
H. pylori tends to “cluster” within households:
- If one family member has it, others have a higher chance of infection
- Crowded living conditions increase transmission risk
- Children are more susceptible
4. Ethnic & Genetic Factors (Relevant in SG)
Local studies show H. pylori prevalence varies across ethnic groups:
- Higher rates recorded among certain Asian populations
- Strong link between H. pylori and gastric cancer in East Asian ethnic groups
5. Lifestyle Factors That Worsen Effects (Not direct causes)
While these do not cause H. pylori, they can worsen its impact:
- Frequent NSAID use (e.g., ibuprofen)
- High-stress lifestyles
- Smoking (slows ulcer healing)
- High-sodium or highly processed diet
These factors make symptoms more severe or increase ulcer risk.
How H. Pylori Is Diagnosed in Singapore
Singapore GP Clinics commonly use three accurate diagnostic tools:
1. Urea Breath Test (UBT), Gold Standard, Non-Invasive
Urea Breath Test is the gold standard to test for H.Pylori infection. The test is done by drinking a urea solution. If H. pylori is present, the bacteria break it down and produce detectable carbon dioxide in the breath.
Benefits:
- Highly accurate
- Non-invasive
- Suitable for initial diagnosis and post-treatment confirmation
2. Stool Antigen Test
Detects H. pylori proteins in a stool sample.
Benefits:
- Good for children and adults
- Reliable for initial screening
3. Gastroscopy (Endoscopy)
A thin tube with a camera is inserted into the stomach to visualise inflammation or ulcers. Tissue samples (biopsies) can confirm H. pylori.
Recommended for:
- Severe or long-standing symptoms
- Suspected ulcers
- Family history of stomach cancer
H. Pylori Treatments in Singapore
H. pylori is treatable and curable with standard medical therapy known as eradication therapy.
1. Triple Therapy (First-Line Treatment)
Usually prescribed for 10–14 days:
- 2 antibiotics (e.g., clarithromycin + amoxicillin or metronidazole)
- 1 stomach acid–reducing medication (PPI)
2. Quadruple Therapy
Used when:
- The patient is allergic to certain antibiotics
- First-line treatment fails
- Antibiotic resistance is suspected
Includes:
- 2 antibiotics
- Bismuth
- PPI
3. Follow-Up Testing
A repeat urea breath test is typically done 4–8 weeks after treatment to ensure the infection has been fully cleared.
Possible Complications if Left Untreated
Even though many people carry H. pylori without symptoms, untreated infection may lead to:
1. Peptic Ulcers
Breaks in the stomach or intestinal lining caused by chronic inflammation.
2. Chronic Gastritis
Long-term irritation of the stomach lining.
3. Iron Deficiency or Vitamin B12 Deficiency
Due to impaired absorption.
4. Higher Risk of Stomach Cancer
H. pylori is a known risk factor for gastric cancer, particularly relevant in East Asian countries, including Singapore.
Who Should Get Tested in Singapore?
You should consider testing if you have:
- Chronic or recurrent gastric pain
- A history of stomach ulcers
- Unexplained bloating or nausea
- Family history of stomach cancer
- Previously treated H. pylori but symptoms returned
- Anaemia without clear cause
Testing is especially recommended for adults over 30, a group more likely to experience H. pylori related gastric issues.
How to Prevent H. Pylori Infection
While complete prevention isn't always possible, these steps help reduce risk:
- Practice good hand hygiene
- Ensure food is cooked thoroughly
- Drink clean, safe water
- Avoid sharing utensils, cups, or toothbrushes
- Use disposable utensils when dining at less hygienic places
- Treat infected household members early
When to see a Doctor
Seek medical attention if you experience:
- Persistent upper abdominal pain
- Gastric discomfort lasting more than 2 weeks
- Severe bloating, nausea, or early satiety
- Unexplained weight loss
- Symptoms suggesting ulcers
Early diagnosis ensures faster relief and prevents long-term complications.
Get Tested and Treated Early
H. pylori is common in Singapore, but with proper diagnosis and treatment, it can be fully eradicated. If you have ongoing gastric symptoms, it’s best not to ignore them, a simple breath test may identify the cause.
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