H pylori and indigestion: what should you know?

Indigestion may feel like burning, fullness, early satiety, belching, nausea or discomfort in the upper abdomen. H pylori is one possible contributor because it can inflame the stomach lining and is associated with peptic ulcer disease. Acid reflux, gastritis, gallstones and a hiatus hernia can cause similar symptoms. The pattern, duration, triggers and accompanying features help a clinician decide whether H pylori testing is useful.

Keep a brief record of meals, symptoms and medicines, especially pain relievers or acid-suppressing treatment. Eat slowly, use smaller portions if large meals worsen fullness, and avoid your known triggers. Do not stop prescribed treatment without advice. A clinician may recommend a breath or stool test and will explain how medicines may need to be paused before testing. Confirmed infection is treated with a prescribed medicine combination.

Book an assessment when indigestion is persistent, repeatedly returning, or interfering with eating or sleep. Seek urgent care for black stools, vomiting blood, severe or sudden abdominal pain, repeated vomiting, faintness, or trouble swallowing. Chest pressure, sweating or breathlessness should be treated as urgent because symptoms may not be coming from the stomach.

Could H pylori explain my symptom pattern? Should I be tested before changing acid treatment? What other causes should we consider? Which symptoms require urgent review? When should symptoms improve after treatment, and how is clearance checked?