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University Medicine Cluster

Common Conditions:




High Blood Pressure


High Cholesterol

Chronic Obstructive Pulmonary Disease

Lung Cancer


Obsessive Compulsive Disorder



Helicobactor pylori


Helicobacter pylori (H. pylori) is a spiral shaped bacterium that lives in the stomach and duodenum (section of intestine just below stomach).


It is now known to be associated with gastric and duodenal ulcers, and stomach cancers.





Most individuals with chronic gastritis or duodenitis have no symptoms. On the other hand, some people develop more serious problems, including stomach or duodenal ulcers. Ulcers can cause a variety of symptoms or no symptoms at all. Common complaints include pain or discomfort (usually in the upper abdomen), bloating, feeling full after eating a small amount of food, lack of appetite, nausea, vomiting, and dark or tar-colored stools. Ulcers that bleed can cause a low blood count and fatigue.


Less commonly, chronic gastritis causes abnormal changes in the stomach lining, which can lead to certain forms of cancer. It is uncommon to develop cancer as a result of H. pylori infection. Nevertheless, because so many people in the world are infected with H. pylori, it is considered to be an important cause of stomach cancer.



Is this infection common?

In Singapore, the prevalence rate in the community (without any symptom) was estimated to increase with age from 3% in children below 5-year-old to 71% in adults above 65.



How does the doctor make a diagnosis of H pylori infection?

There are several ways to diagnose H. pylori.


Urea breath test - patient drinks a specialised solution containing a substance (13C [carbon] - or 14C-labeled urea) that is broken down by the H. pylori bacterium. The breakdown products can be detected in a person's breath.




Endoscopy of the upper gastrointestinal tract can confirm certain gastrointestinal conditions, such as peptic ulcer, as well as infection with H. pylori. It is generally reserved for patients with symptoms.


Blood tests – for H. pylori-specific antibody.



Who should be tested?

  1. Patients with symptoms indicated above.
  2. Patients with higher risk of gastric cancer, e.g. family history of gastric cancer.




Treatment involves taking several medications for seven to 14 days.


It generally consists of a gastric medication known as proton pump inhibitors, and two antibiotics.


It is important to take your medication regularly as instructed to ensure complete eradication of H. pylori. Failing which, the bacterial may recur, and even develop antibiotic resistance.



Post-treatment test

In some patients, the H. pylori may not be eradicated with the standard course of three-drug regimen. The doctor will arrange for repeat H. pylori test, usually a urea breath test to document successful therapy.


If the bacteria are not eradicated in the first round, the patient may need to go on a two-week regimen comprising four drugs.



Doctors Listing

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Appointment and Enquiry

University Digestive Centre

Kent Ridge Wing Level 4

National University Hospital


Appointment Lines:
(65) 6772 2505 / (65) 6773 3380
Fax : (65) 6774 1075


Opening Hours: 8.30am - 5.00pm
Closed on Sat, Sun & Public Holiday