Originally it was probably the result of a childhood infection causing a bout of nausea and vomiting. It probably then lay dormant, reproducing slowly and then erupting to cause the vast majority of peptic ulcers or a sudden spell of chronic gastritis - erupting over many years to produce sporadic episodes of stomach irritation and nausea, which is made worse by eating or drinking. Gastritis damages the control of stomach acid secretion, resulting in an increase in the amount of acid produced which can adversely affect the production of mucus cells and leave the stomach wall open to attack. Estimates suggest that up to 40% of the population of developed countries could be harbouring the bug, often with no symptoms, while it is estimated that only 20% of those who harbour the bug actually develop a stomach ulcer.

Diagnosis could be unpleasant for some emetophobes since, unless a finger prick blood test or breath/saliva test is offered, it could involve an endoscopic examination of the stomach. The back of the throat will be anaesthetised to avoid gagging and retching as the instrument is passed down and brought up again, while the patient mildly sedated with a drug such as midazolam (sedation is strongly advised). A small sample of stomach tissue is taken for examination and, if Helicobacter Pylori is found then it can be eradicated with a cocktail of antibiotics which should permanently kill the bug within 4 weeks and prevent any future peptic ulcers recurring. The best option from these, for emetophobes would probably be Clarithromycin (Claricid) which has the lowest incidence of nausea/vomiting (and is suitable for the penicillin-allergic) together with Omeprazole.  (A recent UK user of HELICLEAR, which includes these drugs, experienced mild diarhoea as the only side effect and this was on the third day of treatment.)