Helicobacter pylori as a Cause of Iron Deficiency in a Menstruating Woman in a Primary Care Setting

Helicobacter pylori (H. pylori) bacterial infections are moderately common clinical entities. They infect the mucosa lining of the antrum and cause pain and inflammation. The exact transmission of H. pylori remains unclear, though fecal-oral and oral-oral routes via contaminated food or water are considered common. Research over the past three decades has linked H. pylori infection to gastric cancer, micronutrient malabsorption, and malnutrition. Iron deficiency anemia is also often linked to H. pylori infection, where absorption is inadequate, or losses exceed absorption, eventually depleting iron stores and leading to anemia. Although the literature has widely studied this condition, diagnosing it upon clinical presentation may be challenging due to the various factors, causes, and tests required for an accurate diagnosis. We present the case of a 43-year-old female who initially presented to the clinic with nausea and fatigue, which turned out to be iron deficiency caused by H. pylori. An H. pylori breath test confirmed the infection and led to the prescription of a proton-pump inhibitor and a two-week course of an antibiotic called Prevpac. A repeat breath test one month later showed effective eradication of the bacterial infection and improvement in serum iron levels. This report highlights the diagnostic process and clinical considerations involved in identifying and managing the H. pylori infection.