H. Pylori Infection

    Written by:
    Gabrielle Fundaro

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    by:

    Shyam Jayaraman, Nick Milazzo
    Last Updated: October 13, 2024

    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 the Gut Health category.

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    14,939 participants in 5 trials and 2 meta-analyses

    What is H. pylori?

    Helicobacter pylori (H. pylori) is a pathogenic bacterum that colonizes the human stomach. Around 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]

    Examine Database: H. Pylori Infection

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    Frequently asked questions

    What is H. pylori?

    Helicobacter pylori (H. pylori) is a pathogenic bacterum that colonizes the human stomach. Around 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]

    Other FAQs
    How does H. pylori infection affect the gastric microbiome?

    H. pylori infection is associated with less diverse gastric (stomach) microbiota, higher relative proportions of opportunistic pathogens (microbes that can cause disease with the right conditions), and lower proportions of beneficial microbes.[17][2]

    It’s also linked to some functional changes, including a reduction in microbial interactions and higher levels of gastric biofilm formation (which makes it harder to treat by reducing the impact of antibiotics).[2]

    Some or all of these changes may explain the relationship between H. pylori infection and gastric cancer.[17][2]

    What role might H. pylori infection play in other diseases?

    People with H. pylori infections are more likely to have or develop hypertension, non-alcoholic fatty liver disease, and subclinical atherosclerosis. H. pylori infection may also increase the risk of developing irritable bowel syndrome (IBS), but more research is needed to confirm this association.[18][19][20][21][22]

    H. pylori treatment may help to reduce IBS symptoms and is also associated with a reduced risk of gastric cancer. Some research shows that eradication therapy could increase the risk of developing gastroesophageal reflux disease, but other research suggests it has no effect.[22][23]

    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. Helicobacter Pylori Infection Signs - Tanashat M, Abuelazm M, Abouzid M, Al-Ajlouni YA, Ramadan A, Alsalah S, Sharaf A, Ayman D, Elharti H, Zhana S, Altobaishat O, Abdelazeem B, Jaber FEfficacy of probiotics regimens for Helicobacter pylori eradication: A systematic review, pairwise, and network meta-analysis of randomized controlled trials.Clin Nutr ESPEN.(2025 Dec 3)
    7. 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)