Helicobacter: when to see a doctor?

You should see a doctor for Helicobacter pylori if you experience persistent upper abdominal pain, heartburn, nausea, bloating, or unexplained weight loss. Medical evaluation is also warranted if you have a diagnosed peptic ulcer, a family history of gastric cancer, or iron-deficiency anemia of unknown cause. Current guidelines (e.g., ACG, Maastricht VI) recommend testing for H. pylori in patients with dyspepsia, prior to long-term NSAID use, or with unexplained iron deficiency. Diagnosis is made via urea breath test, stool antigen test, or endoscopy with biopsy. Eradication therapy typically involves a proton pump inhibitor plus two antibiotics (e.g., clarithromycin and amoxicillin). Important: Many carriers remain asymptomatic; treatment is not mandatory for everyone but is strongly advised when risk factors are present. Evidence is based on clinical practice guidelines and large cohort studies. Caveat: Antibiotic resistance (especially to clarithromycin) varies by region, so susceptibility testing may be needed.