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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes. A doctor can assess your symptoms by video and treat a positive breath or stool test; warning signs need an in-person check.
- What it is: a bacterium that lives in the stomach lining. Up to 2 in 5 people in the UK carry it, usually from childhood.
- Symptoms: most people have none. It can cause gastritis and stomach ulcers, with burning pain, indigestion, bloating and burping.
- Treatment: an acid-reducing medicine with two antibiotics, taken for 1 to 2 weeks.
- Emergency: call 112 for vomiting blood or material like coffee grounds, black tar-like poo, or sudden severe tummy pain.
Do not book a video appointment if you are vomiting blood or material that looks like coffee grounds, have black, sticky, tar-like poo, or have sudden, severe tummy pain or a tummy that is painful to touch. Call 112 or go to an emergency department. Weight loss without trying, difficulty swallowing, repeated vomiting or anaemia need an urgent in-person check.
Can an online doctor treat H. pylori?
Yes. H. pylori is found with a breath or stool test, and it is treated with tablets, so most of the care works by video. The doctor checks your symptoms and the warning signs, tells you how to prepare for the test so the result is reliable, prescribes treatment when the test is positive, and plans a second course or a retest when needed. The test itself is done in person, and warning signs such as weight loss, difficulty swallowing or bleeding need an endoscopy.
How an online consultation helps with H. pylori
- Testing done right: Which test to have, and which medicines to stop beforehand so it is not falsely negative.
- Treatment that suits you: A combination chosen around allergies and the antibiotics you have had before.
- Warning signs checked: Symptoms that need an endoscopy rather than a test and tablets.
- A plan if it comes back: When to retest, and what to do if the first course has not worked.
What the doctor checks in an online H. pylori consultation
The doctor checks for warning signs first. The doctor asks about:
- Warning signs: black poo, vomiting blood, weight loss without trying, difficulty or pain swallowing, repeated vomiting, or anaemia.
- Your symptoms: burning or gnawing pain in the upper tummy, indigestion, bloating, burping, and how long they have lasted.
- Your test: which test you had, the result, and whether you took acid-reducing medicines or antibiotics beforehand.
- Medicines: antibiotics in the past, anti-inflammatory painkillers such as ibuprofen, and any allergy to penicillin.
- Your family: a parent, brother, sister or child with stomach cancer or ulcers.
- Your health: pregnancy, breastfeeding, liver or kidney problems, and other medicines you take.
Before the call, have your test result to hand, and list any antibiotics you have taken in recent years.
What is H. pylori?
Helicobacter pylori (H. pylori) is a bacterium that lives in the lining of the stomach. Between half and two-thirds of people worldwide carry it, and up to 2 in 5 people in the UK, where it is becoming less common. For 8 or 9 in 10 people it causes no problems at all.
How do you get H. pylori? Is it contagious?
People almost always catch it in childhood, usually from their parents or within the family, probably through contact with saliva, vomit or poo. Catching it as an adult is very rare, and so is getting it again after it has been cured. It is more common where living conditions are crowded or clean water is not reliable.
How serious is H. pylori?
Usually not serious. About 10 to 15% of people with H. pylori develop a stomach or duodenal ulcer. After decades of untreated infection, a small number, estimated at 1 to 3 in 100, develop stomach cancer, and H. pylori can also cause a rare lymphoma of the stomach. Treating the infection lowers the risk of stomach cancer: in one large trial, it cut new cases by nearly half over 22 years.
What are the symptoms of H. pylori?
Most people with H. pylori have no symptoms. When it does cause them, it is usually through inflammation of the stomach lining (gastritis) or an ulcer:
- a burning or gnawing ache in the upper tummy, which may be worse on an empty stomach or at night
- indigestion, feeling sick, bloating and burping
- a poor appetite, and weight loss
What does H. pylori poo look like?
H. pylori itself does not change your poo. Black, sticky, tar-like poo is a sign of a bleeding ulcer and needs emergency care, and so does vomiting blood.
H. pylori, gastritis, ulcer or indigestion?
Swipe sideways to compare →
| Condition | What it is | Link with H. pylori |
|---|---|---|
| Gastritis | Inflammation of the stomach lining, often without symptoms | A common cause, alongside anti-inflammatory painkillers and alcohol |
| Stomach ulcer | An open sore in the stomach or duodenum, with burning pain | One of the two main causes, with anti-inflammatory painkillers |
| Indigestion | Pain or discomfort in the upper tummy, often from acid | Tested for when indigestion keeps coming back despite simple treatment |
| Stomach cancer | A rare cancer of the stomach lining | The main cause; treating the infection lowers the risk |
How is H. pylori tested?
The preferred tests are a breath test or a stool test, which are equally accurate:
- Urea breath test: you have a drink, and breath samples are taken before and after it.
- Stool antigen test: a small sample of poo is checked for H. pylori proteins.
- Endoscopy: a camera on a thin tube, with a small sample taken, for people with warning signs.
- Blood test: used less often, because guidelines prefer the breath or stool test.
How to prepare for the test
Acid-reducing medicines and antibiotics can make the breath and stool tests falsely negative. Do not have the test within 2 weeks of taking a proton pump inhibitor, or within 4 weeks of a course of antibiotics. Ask the doctor before stopping a medicine you take every day.
Who should be tested?
- people with indigestion that keeps coming back despite simple treatment, without warning signs
- people with a stomach or duodenal ulcer
- the parents, brothers, sisters and children of people with stomach cancer
Under the European Maastricht VI/Florence consensus, everyone found to have H. pylori should be offered treatment.
Which H. pylori treatment might the doctor recommend?
Treatment depends on the test result, your allergies and the antibiotics you have had before. This is the framework the doctors use, in line with UK test-and-treat guidance and the Maastricht VI/Florence consensus:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Indigestion that keeps coming back, no warning signs | A breath or stool test, or a trial of an acid-reducing medicine first | Yes | For the test sample |
| A positive breath or stool test | An acid-reducing medicine with two antibiotics | Yes | Not usually needed |
| A positive test and a penicillin allergy | A combination without amoxicillin | Yes | Not usually needed |
| Still positive after a first course | A second course with different antibiotics | Yes | Specialist advice if it keeps failing |
| A parent, brother, sister or child with stomach cancer | A test for H. pylori | Yes | For the test sample |
| Weight loss, difficulty swallowing, repeated vomiting or anaemia | An urgent endoscopy | Partly | For the endoscopy |
| Vomiting blood, black poo or sudden severe tummy pain | Emergency care | No | Call 112 now |
Tested positive for H. pylori? A doctor can review your result and plan treatment in one consultation.
See available times →Treatment options for H. pylori
What you can do yourself
- Take every dose of the course, exactly as prescribed, even when you feel better.
- Avoid alcohol while you take metronidazole.
- Avoid anti-inflammatory painkillers such as ibuprofen, which can cause ulcers too.
- For indigestion, eat smaller meals, cut down on tea, coffee, cola and alcohol, and have your evening meal 3 to 4 hours before bed.
- Do not smoke: smoking raises the risk of ulcers.
Prescription treatment
A prescription is never issued without a consultation. If the test is positive, the doctor may prescribe a proton pump inhibitor with two antibiotics, usually amoxicillin with clarithromycin or metronidazole, for 7 to 14 days. People allergic to penicillin are given a combination without amoxicillin, and a bismuth-based combination is another option. The doctor asks which antibiotics you have taken before, because resistance to clarithromycin is common in much of Europe. Side effects can include a strange taste, feeling sick and headache. If the doctor prescribes, use the prescription at a pharmacy near you.
Has the treatment worked?
Treatment is usually very successful. A breath or stool test at least 4 weeks after finishing treatment shows whether it has worked; UK guidance advises one after an ulcer, for MALT lymphoma of the stomach, or with a family history of stomach cancer. If the test is still positive, a second course with different antibiotics usually follows. Relief of indigestion can take up to 12 months.
What does not help
Diet changes alone: they ease indigestion but do not clear the infection. Stopping the course early. Testing too soon after acid-reducing medicines or antibiotics, which can give a falsely negative result.
Special situations
Your partner or a family member has H. pylori
Adults rarely catch H. pylori from each other: it is usually caught in childhood. You only need a test if you have symptoms such as indigestion that keeps coming back, or a close relative with stomach cancer.
Antibiotic resistance across Europe
Resistance to clarithromycin, one of the main antibiotics used, has been reported above 20% in western, central and southern Europe and below 10% in northern Europe. Each course of clarithromycin or metronidazole you take raises the chance of resistance, which is why the doctor asks about earlier courses, wherever you live.
Pregnancy and breastfeeding
Tell the doctor if you are pregnant or breastfeeding, because it changes which medicines are suitable.
Long-term anti-inflammatory painkillers
Regular use of medicines such as ibuprofen is the other main cause of stomach ulcers. Tell the doctor if you take them, because it changes the plan.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When H. pylori is treated online, and when you need in-person care
Treated online: indigestion and ulcer symptoms without warning signs, preparing for the test, treatment after a positive test, second courses, and planning a retest.
In-person care: the breath or stool test sample, endoscopy for warning signs, a bleeding ulcer, and specialist care when treatment keeps failing.
When to get in-person care
Call 112 or go to an emergency department now for:
- vomiting bright red blood, or vomit that looks like ground coffee
- black, sticky, very smelly poo, or blood in your poo
- sudden, severe tummy pain, or a tummy that is painful to touch
- chest pain that started suddenly
Get medical advice the same day for:
- difficulty or pain swallowing
- repeated vomiting
- weight loss without trying
- unusual tiredness, dizziness or fainting
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your stomach: describe your symptoms, share your test result if you have one, and list the antibiotics and stomach medicines you have taken.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s H. pylori? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Stomach ulcers can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about H. pylori
What is H. pylori?
Helicobacter pylori is a bacterium that lives in the stomach lining. Up to 2 in 5 people in the UK carry it, usually from childhood, and most never have symptoms, but it can cause gastritis and stomach ulcers.
What are the signs of H. pylori infection?
Most people with H. pylori have none. When it causes symptoms, they include a burning or gnawing ache in the upper tummy, indigestion, bloating, burping, feeling sick and a poor appetite.
How serious is an H. pylori infection?
Usually not serious. About 10 to 15% of people with H. pylori develop an ulcer, and after decades without treatment a small number develop stomach cancer. Treatment lowers that risk.
Can you get rid of H. pylori?
Yes. A course of an acid-reducing medicine with two antibiotics usually clears H. pylori. If a test afterwards is still positive, a second course with different antibiotics is used.
How long does H. pylori treatment take, and what is the outlook?
H. pylori treatment lasts 1 to 2 weeks, 14 days in most current European guidance, and clears the infection in about 8 to 9 in 10 people at the first attempt; symptoms from gastritis usually ease within a few weeks of a cure, and an ulcer heals over 4 to 8 weeks with the acid reducer continued. Once cured, reinfection is rare, the ulcer risk falls back to normal, and the long-term stomach cancer risk drops.
What causes H. pylori infection, and is it contagious?
H. pylori is usually caught in childhood, within families, probably through saliva, vomit or poo. Catching it as an adult is very rare, and so is getting it again after treatment.
My partner has H. pylori. Should I get tested?
Not unless you have symptoms such as indigestion that keeps coming back, or a close relative with stomach cancer. Adults rarely catch H. pylori from each other.
What does H. pylori poo look like?
H. pylori does not change the look of your poo, and there is no way to see the bacterium; what a stool test detects is H. pylori antigen in an ordinary sample. Black, sticky, tar-like poo is different: it means digested blood from a bleeding ulcer higher up and needs emergency care, and bright red blood comes from piles or lower in the bowel, not from H. pylori.
How do you test for H. pylori?
H. pylori is tested with a breath test or a stool test, which are equally accurate. Avoid acid-reducing medicines for 2 weeks and antibiotics for 4 weeks before the test, or the result can be falsely negative.
What foods should I avoid with H. pylori?
No food clears H. pylori, and no special diet is needed. Avoid alcohol while taking metronidazole, and for indigestion cut down on tea, coffee, cola and alcohol.
What can I do at home with H. pylori?
Take the full course exactly as prescribed, because missed doses are the main reason H. pylori survives; expect a metallic taste, nausea or loose stools for the 1 to 2 weeks and keep going; avoid alcohol with metronidazole; eat regular meals and limit the foods that worsen your indigestion; stop smoking, which makes treatment less likely to work; avoid ibuprofen and aspirin unless a doctor agrees; and have the follow-up test at least 4 weeks after finishing. Home remedies do not clear H. pylori.
Can H. pylori come back?
Getting H. pylori again after a cure is very unusual. A test at least 4 weeks after treatment shows whether the first course worked, and a second course with different antibiotics follows if it did not.
Can an online doctor treat H. pylori?
Yes. A doctor can assess your H. pylori symptoms by video, explain how to prepare for the test, and prescribe treatment for a positive result. Warning signs such as weight loss or bleeding need an in-person check.
- Stomach ulcer, NHS, National Health Service (UK), reviewed 12 August 2025.
- Helicobacter pylori in dyspepsia: test and treat (quick reference guide), UK Health Security Agency, GOV.UK, page updated 22 May 2025.
- Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report, Malfertheiner P et al., European Helicobacter and Microbiota Study Group, Gut, 2022.
- Helicobacter pylori (H. pylori), Guts UK, leaflet November 2025.
- Helicobacter pylori (H. pylori) infection: symptoms and causes, Mayo Clinic, updated 16 December 2025.
- Helicobacter pylori (H. pylori) and cancer, National Cancer Institute (US), reviewed 12 April 2023.
- Indigestion, NHS, National Health Service (UK), reviewed 5 May 2023.
- Symptoms and causes of gastritis and gastropathy, NIDDK, US National Institutes of Health, reviewed August 2019.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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