Gastric Juice is hostile for many bacteria, but it is home of helicobacter pylori, which is the main culprit behind gastritis and peptic ulcer disease.Helicobacter pylori are spiral-shaped gram-negative bacteria with long flagella. It's believed that... Gastric Juice is hostile for many bacteria, but it is home of helicobacter pylori, which is the main culprit behind gastritis and peptic ulcer disease.Helicobacter pylori are spiral-shaped gram-negative bacteria with long flagella. It's believed that the infection is acquired through faeco-oral or oral-oral routes. Since poor hygiene is a major risk factor, it's more common in developing countries.How does it survive the gastric acid?• The stomach has four parts: Cardia, fundus, body, and antrum. Body and fundus mainly secrete gastric acid. But the fundus secretes the gastrin hormone, and mucus which has a basic Ph value due to bicarbonate.• The mucosa of the antrum contains many gastric pits.• Helicobacter pylori colonize these pits by adhering to gastric epithelial cells. • It is protected from above by the mucus layer secreted by the antrum.• Additionally, helicobacter pylori have an enzyme called urease. It converts Urea into ammonia which neutralizes the acidity of gastric juice. • In short, Urease and the mucus secreted by the gastric antrum saves Helicobacter pylori from gastric acid.The bacteria release various enzymes and cytotoxic proteins which damage the gastric epithelium and cause inflammation. The inflammation of gastric mucosa is called gastritis. When the damage is so severe and breaks the entire mucosa, it’s called peptic ulcers. If untreated Helicobacter pylori can even cause gastric carcinoma.Peptic ulcers can be either in the stomach or in the duodenum. Although H.pylori lives in the gastric antrum, ulcers are more commonly seen in the duodenum. Peptic ulcers are characterized by recurrent burning type pain in the epigastric area of the abdomen. It may be associated with nausea, vomiting, loss of appetite and weight loss.Non-invasive tests like Urea breath test and Stool antigen tests are reliable with good sensitivity and specificity. The serum antibody levels test is another non-invasive test. But it’s weaker than the former two. Invasive tests are done with upper GI endoscopy. Biopsy samples from the stomach lining are taken and to carry out staining, culture, and biopsy urease tests or CLO test.Eradication with triple therapy is the treatment of choice for helicobacter pylori. It comprises two antibiotics with a proton pump inhibitor. They are given for a period of one to two weeks.