H. Pylori Infection

Last Updated: March 2, 2023

Helicobacter pylori is a type of bacteria that infects the stomach. It is the most common cause of gastritis and peptic ulcers. It can also cause stomach cancer. There are typically no symptoms with infection, but symptoms may include indigestion and pain in the upper abdomen.

H. Pylori Infection falls under theGut Healthcategory.

What is H. pylori?

Helicobacter pylori (H. pylori) is a pathogenic bacteria that colonizes the human stomach. About 50% of adults worldwide are infected with H. pylori, but not every infection causes symptoms. However, compared to uninfected individuals, those with an infection are three to six times more likely to develop gastric cancer. [1]

H. pylori is capable of reducing stomach acid, which leads to gastric microbial overgrowth and higher proportions of other potentially pathogenic microbes. It can also cause the formation of biofilm—a structured collection of microbes suspended in a protective matrix—which promotes abnormal bacterial colonization in the stomach.[2]

What are the main signs and symptoms of H. pylori infection?

H. pylori infection is usually asymptomatic, but it can erode the protective coating lining the stomach, causing inflammation that leads to gastritis or peptic ulcers.

Peptic ulcers can cause intermittent dull or burning abdominal pain that lasts minutes to hours, for days or weeks at a time. These ulcers can also cause nausea, bloating, and unintentional weight loss.[3]

How is H. pylori infection diagnosed?

H. pylori infections can be diagnosed with blood, breath, and stool tests.

Blood tests can reveal the presence of H. pylori-specific antibodies, which indicate an infection. Urea breath tests can diagnose an H. pylori infection based on abnormally-high carbon dioxide levels. Stool samples can be tested for H. pylori antigens or elevated levels of H. pylori, but the mere presence of H. pylori in the stool doesn’t confirm an active infection.

If these tests don’t provide enough information for a diagnosis, an endoscopy may also be performed to collect images and samples of the esophagus, stomach, and part of the small intestine to check for inflammation and ulcers.[4]

What are some of the main medical treatments for H. pylori infection?

H. pylori infections are commonly treated with a combination of antibiotics and proton pump inhibitors (PPI), which reduce the production of stomach acids. Bismuth (a non-antibiotic antimicrobial ingredient found in some medications for peptic ulcers) may also be included in the therapy. [5][6] These therapies are known as triple therapy or quadruple therapy, depending on how many antibiotics are included in the treatment.

Because H. pylori has developed resistance to many antibiotics, eradication is becoming more challenging, and often requires more than one round (or combination) of treatments.[6]

Have any supplements been studied for H. pylori infection?

There is some evidence that probiotics improve eradication rates when added to a conventional treatment regimen. Lactobacillus-containing probiotics combined with quadruple therapy (such as bismuth, antacid medication, and two antibiotics) may be the most effective combination.[7][8][9] However, another meta-analysis found that probiotics may not increase the eradication rate, but may decrease adverse effects of triple or quadruple therapy.[10]

Synbiotics (which contain both probiotic microbes and their preferred prebiotic nutrient) may also improve eradication rates while reducing adverse treatment side effects.[11]

High-dose vitamin C supplementation and antioxidant-rich cranberry juice improved the efficacy of conventional treatment in a small number of studies, but more research is needed.[12]

Supplemental vitamin E, N-acetylcysteine, and curcumin have also been studied, but they don’t appear to improve eradication rates when added to conventional treatment.[13][12]

How could diet affect H. pylori infection?

The link between H. pylori infection and diet is unclear, but some evidence suggests that higher salt intake could contribute to the development of H. pylori-associated gastric cancer, whereas fruit and vegetable intake are associated with a reduced risk of developing gastric cancer.[14][15]

Are there any other treatments for H. pylori infection?

Periodontal treatment — including professional dental cleaning and daily oral hygiene — greatly enhances the effects of traditional treatment. This is likely due to the removal of dental plaque, a biofilm which contains H. pylori that can cause reinfection when swallowed.[16]

What causes H. pylori infection?

Researchers aren’t sure how H. pylori is transmitted, but it could be spread through unclean water and food, or through contact with infected bodily fluids such as saliva. It’s also unclear why some people develop symptoms, while others don’t.[3]

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  1. ^Ford AC, Yuan Y, Forman D, Hunt R, Moayyedi PHelicobacter pylori eradication for the prevention of gastric neoplasia.Cochrane Database Syst Rev.(2020-07-06)
  2. ^Liu C, Ng SK, Ding Y, Lin Y, Liu W, Wong SH, Sung JJ, Yu JMeta-analysis of mucosal microbiota reveals universal microbial signatures and dysbiosis in gastric carcinogenesis.Oncogene.(2022-07)
  3. ^Helicobacter Pylori Infections
  4. ^Helicobacter Pylori (H. Pylori) Tests
  5. ^Ko SW, Kim YJ, Chung WC, Lee SJBismuth supplements as the first-line regimen for Helicobacter pylori eradication therapy: Systemic review and meta-analysis.Helicobacter.(2019-Apr)
  6. ^Yin Z, Li J, Huang W, Lei X, Xu D, Xu G, Li H, Zhang JHigh-Dose Dual Therapy Versus Bismuth-Containing Quadruple Therapy for the Treatment of Helicobacter pylori Infection: A Systematic Review with Meta-Analysis.Turk J Gastroenterol.(2022-06)
  7. ^Shi X, Zhang J, Mo L, Shi J, Qin M, Huang XEfficacy and safety of probiotics in eradicating Helicobacter pylori: A network meta-analysis.Medicine (Baltimore).(2019-Apr)
  8. ^Zhang M, Zhang C, Zhao J, Zhang H, Zhai Q, Chen WMeta-analysis of the efficacy of probiotic-supplemented therapy on the eradication of H. pylori and incidence of therapy-associated side effects.Microb Pathog.(2020-Oct)
  9. ^Viazis N, Argyriou K, Kotzampassi K, Christodoulou DK, Apostolopoulos P, Georgopoulos SD, Liatsos C, Giouleme O, Koustenis K, Veretanos C, Stogiannou D, Moutzoukis M, Poutakidis C, Mylonas II, Tseti I, Mantzaris GJA Four-Probiotics Regimen Combined with A Standard Helicobacter pylori-Eradication Treatment Reduces Side Effects and Increases Eradication Rates.Nutrients.(2022-Feb-01)
  10. ^Lu C, Sang J, He H, Wan X, Lin Y, Li L, Li Y, Yu CProbiotic supplementation does not improve eradication rate of Helicobacter pylori infection compared to placebo based on standard therapy: a meta-analysis.Sci Rep.(2016-Mar-21)
  11. ^Pourmasoumi M, Najafgholizadeh A, Hadi A, Mansour-Ghanaei F, Joukar FThe effect of synbiotics in improving Helicobacter pylori eradication: A systematic review and meta-analysis.Complement Ther Med.(2019-Apr)
  12. ^Yang-Ou YB, Hu Y, Zhu Y, Lu NHThe effect of antioxidants on Helicobacter pylori eradication: A systematic review with meta-analysis.Helicobacter.(2018-Dec)
  13. ^Caicedo Ochoa EY, Quintero Moreno CO, Méndez Fandiño YR, Sánchez Fonseca SC, Cortes Motta HF, Guio Guerra SAAssessment of the use of vitamin C and E supplements concomitantly to antibiotic treatment against Helicobacter pylori: A systematic review and meta-analysis.Med Clin (Barc).(2018-07-23)
  14. ^Morais S, Costa A, Albuquerque G, Araújo N, Pelucchi C, Rabkin CS, Liao LM, Sinha R, Zhang ZF, Hu J, Johnson KC, Palli D, Ferraroni M, Bonzi R, Yu GP, López-Carrillo L, Malekzadeh R, Tsugane S, Hidaka A, Hamada GS, Zaridze D, Maximovitch D, Vioque J, de la Hera MG, Moreno V, Vanaclocha-Espi M, Ward MH, Pakseresht M, Hernández-Ramirez RU, López-Cervantes M, Pourfarzi F, Mu L, Kurtz RC, Boccia S, Pastorino R, Lagiou A, Lagiou P, Boffetta P, Camargo MC, Curado MP, Negri E, La Vecchia C, Lunet NSalt intake and gastric cancer: a pooled analysis within the Stomach cancer Pooling (StoP) Project.Cancer Causes Control.(2022-May)
  15. ^Fang X, Wei J, He X, An P, Wang H, Jiang L, Shao D, Liang H, Li Y, Wang F, Min JLandscape of dietary factors associated with risk of gastric cancer: A systematic review and dose-response meta-analysis of prospective cohort studies.Eur J Cancer.(2015-Dec)
  16. ^Ozturk APeriodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical Trials.Int Dent J.(2021-Jun)
  17. ^Guo Y, Cao XS, Guo GY, Zhou MG, Yu BEffect of Eradication on Human Gastric Microbiota: A Systematic Review and Meta-Analysis.Front Cell Infect Microbiol.(2022)
  18. ^Fang Y, Xie H, Fan CAssociation of hypertension with helicobacter pylori: A systematic review and meta‑analysis.PLoS One.(2022)
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  20. ^Wang X, He Q, Jin D, Ma B, Yao K, Zou XAssociation between helicobacter pylori infection and subclinical atherosclerosis: A systematic review and meta-analysis.Medicine (Baltimore).(2021-Nov-19)
  21. ^Chenyu Li, Yujun Shuai, Xiaodong Zhou, Hongxia ChenAssociation between Helicobacter pylori infection and irritable bowel syndrome: A systematic review and meta-analysisMedicine (Baltimore).(2020 Dec 11)
  22. ^Xiong Y, Liu L, Zhou X, Wen Y, Wang RAnti-Helicobacter pylori treatment can effectively improve the clinical remission rates of irritable bowel syndrome: a controlled clinical trial meta-analysis.Clinics (Sao Paulo).(2020)
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Examine Database References
  1. Helicobacter Pylori Infection Signs - McNulty CA, Wilson MP, Havinga W, Johnston B, O'Gara EA, Maslin DJA pilot study to determine the effectiveness of garlic oil capsules in the treatment of dyspeptic patients with Helicobacter pyloriHelicobacter.(2001 Sep)
  2. Helicobacter Pylori Infection Signs - Graham DY, Anderson SY, Lang TGarlic or jalapeño peppers for treatment of Helicobacter pylori infectionAm J Gastroenterol.(1999 May)
  3. Helicobacter Pylori Infection Signs - Heidrun Mehling, Andreas BusjahnNon-viable Lactobacillus reuteri DSMZ 17648 (Pylopass™) as a new approach to Helicobacter pylori control in humansNutrients.(2013 Aug 2)
  4. Helicobacter Pylori Infection Signs - Francavilla R, Lionetti E, Castellaneta SP, Magistà AM, Maurogiovanni G, Bucci N, De Canio A, Indrio F, Cavallo L, Ierardi E, Miniello VLInhibition of Helicobacter pylori infection in humans by Lactobacillus reuteri ATCC 55730 and effect on eradication therapy: a pilot studyHelicobacter.(2008 Apr)
  5. Helicobacter Pylori Infection Signs - Biswas DP, Tk DSThe efficacy of adjuvant N acetyl cysteine for the eradication of H pylori infections: A systematic review and meta-analysis of randomized clinical trials.Clin Res Hepatol Gastroenterol.(2022-Mar)
  6. Leptin - Celinski K, Konturek PC, Konturek SJ, Slomka M, Cichoz-Lach H, Brzozowski T, Bielanski WEffects of melatonin and tryptophan on healing of gastric and duodenal ulcers with Helicobacter pylori infection in humansJ Physiol Pharmacol.(2011 Oct)