Quoted from Saudi J Gastroenterol. 2009 Jul; 15(3): 201–207 publication :

Approximately 50% (over 3 billion) of the world populations are known to be infected with Helicobacter pylori, mainly in the developing countries. Among those, hundreds of millions of people develop peptic ulceration during their lifetime ....

I know that many people have H. pylori in their stomach, however, just a small percentage of them develop peptic ulceration. Does anyone know the role of this? Why don't more people develop any symptoms?

  • $\begingroup$ The answer is no, we don't know why some people are assymptomatic. Why? Because it's easier to prove causation than non-causation. But there is much more to H.pylori than ulcers. Chronic gastritis, lymphoma, gastric cancer, GERD, and other conditions (even bad breath) are associated with it. Given that H. pylori was only discovered 35 years ago (and taken seriously for far less than that), I'd say it's still early. $\endgroup$ – anongoodnurse Aug 26 '17 at 4:13
  • $\begingroup$ @anongoodnurse thank you for your reply. May be we should make a full genome sequencing of those H.Pylori on people with and without symptoms to see if there was a different type of H.Pylori that harmful and unharmful. $\endgroup$ – joe Aug 26 '17 at 7:29
  • $\begingroup$ @anongoodnurse i known it's weird but I was healthy before - until I make an eradication H.P on my stomach, I started develop inflammation and GERD when the H.P become negative. I was though there must be a relevant between the eradication of H.P and my symptoms. I'm trying to find an evidence that some type of H.P may protect the lining of duodenum and stomach from acid and bile. As it can produces urease to neutralize gastric acid and other mechanism to resist bile. $\endgroup$ – joe Aug 26 '17 at 7:50
  • $\begingroup$ No, to my knowledge, H. pylori is not protective at all. BUT our knowledge of all its effects is in its infancy. The present stance is if it's detected, it's treated (100% of the time), even though risks of treatment exist, and even if the patient is assymptomatic. I have some doubts about this approach, but as my mother died of gastric cancer and was discovered to have had H. pylori, I should be more open to this. I don't know. If I have time later today, I'll scrape up an answer. $\endgroup$ – anongoodnurse Aug 26 '17 at 15:22

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