How to Treat a Helicobacter Pylori Infection

Medically reviewed by Mandolin S. Ziadie, MD

Last Updated: June 14, 2022 References Approved

It was once thought that spicy food and stress were the main causes of ulcers. But in truth, most ulcers are actually the result of a Helicobacter pylori infection. H. pylori is a bacteria found in the digestive tract of 30 percent of North Americans, and usually it doesn't develop into a problem.^{[1]
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Adriene Zables PharmD, I Simon MD, Emily Melton MD, Update on H pylori Treatment, American Family Physician 2007 Feb 1, 75(3) 351-358} The cause of this infection is still unknown. If you experience the symptoms of an ulcer, like stomach pain, nausea and vomiting, it's very possible that H. pylori is the culprit. This bacteria is also linked to stomach cancer. The most common treatment for infection is a combination of antibiotics and acid-suppressing drugs.

Part 1

Part 1 of 4:

Determining Whether You Are Infected

1
Look for the symptoms of an infection. An H. pylori infection has symptoms similar to an ulcer. Most people who have H. pylori will never experience symptoms. If you do experience ulcer-like symptoms, there's a good chance H. pylori is the problem. Here are the symptoms to look for:^{[2]
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- Pain in the abdomen with a burning, acidic quality
- Indigestion or "gnawing pain" in the stomach
- Acid reflux
- Nausea
- Bloody or black and tarry stools
- Blood in Vomit
- Sudden unconsciousness
- Rigidity of the stomach (peritonitis), in severe cases
2
Visit your doctor. Prolonged abdominal pain requires treatment, regardless of the cause. The infection won't go away on its own, so it's important to visit your doctor to find out whether H. pylori is the problem. This way, you can begin treatment right away to heal your stomach.
- Rarely, an H. pylori infection can lead to stomach cancer. That's why it's essential never to ignore abdominal pain, bloody stools, and other signs that you might have H. pylori.
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3
Get tested to confirm the diagnosis. Speak with your doctor about your concerns that the problem might be H. pylori. Doctors test for H. pylori in a variety of different ways. The doctor will choose the testing method that best suits your symptoms and condition. The following tests are most common:^{[3]
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Redeen,F. Petersson,E, Tornkrantz Reliability of Diagnostic Tests for Helicobacter pylori Infection, Gastroenterology Research and Practice Volume 2011 Article ID 940650 doi 10.1155/2011/940650}
- A urea breath test. The bacteria produces a urea compound. A urea breath test is the gold standard of diagnostic methods. It is the most accurate test for H. pylori.
- A stool test antigen, in which a sample is examined in a laboratory for signs of H. pylori. This is considered the second most effective.
- A blood test. This test reveals the presence of antibodies that fight H. pylori. It is 65 to 95% effective, making it the least reliable test.
- A biopsy. A tissue sample is removed from your stomach using a procedure called an endoscopy. A biopsy is usually only performed if an endoscopy is needed for other reasons such as treating an ulcer, bleeding, or making sure there is no cancer.^{[4]
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  MedlinePlus
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- Most doctors will order one of these tests if your symptoms match those of an H. pylori infection.
4
Have other household members tested. H pylori is thought to be spread through poor hygiene and unsanitary practices, so make sure to practice proper hygiene and hand washing. If you believe you have the bacteria, you should get other people who live in the same environment as you tested also.^{[5]
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Yazuz Selem Sari, Didem Can, Vahit Tundi et al. Helico Bacter: Treatment Just The Patient or For the Whole Family?. World Journal of Gastroenterology, Feb 28, 2008 14 (8) 1244-1247}
- This is important not only for the health of other household members, but also to prevent reinfection.
- This is especially important for spouses or other romantic partners. The bacteria may be transmitted through kissing with saliva.

Part 2

Part 2 of 4:

Receiving Treatment

1
Take a course of antibiotics, as prescribed. Since H. pylori is a bacteria, it may be successfully treated with a short course of antibiotics lasting from 10 to 14 days. Follow your doctor's instructions for how to take the antibiotic and make sure to take the full course, even if you start to feel better. Your doctor may prescribe:^{[6]
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- Amoxicillin
- Tetracycline (for adults and children over 12 years old)
- Metronidazole
- Clarithromycin
2
Take acid-protectors. While you're taking antibiotics, your doctor will also recommend that you take acid-protectors. These will not cure the bacterial infection on their own, but they may keep your ulcer from getting worse. They will also give your stomach lining time to heal.^{[7]
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- Your stomach naturally produces acid to aid in digestion, but when you have an ulcer the acid can cause further damage.
- Most often, doctors will prescribe Bismuth subsalicylate, or Pepto Bismol. It coats the stomach to protect it from acid. It also helps kill the bacteria. ^{[8]
  X
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  PubMed Central
  Journal archive from the U.S. National Institutes of Health
  Go to source} The amount and frequency will vary based on which antibiotics you are taking.
3
Take proton pump inhibitors (PPIs). Your doctor will also prescribe a PPI. These medications prevent acid production by inhibiting the "pumps" in stomach cells that activate gastric acid secretion.^{[9]
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American Academy of Family Physicians
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- In most cases, you'll receive a prescription for Lansoprazole. The amount and frequency of doses will depend on which antibiotics you are taking.
- Children may prescribed Omeprazole, 1 mg/kg divided twice daily (to a max of 20 mg twice daily) for 14 days.
4
Get tested again a month later. Your doctor should perform a second round of tests after four weeks to make sure that the H. pylori infection is gone. Be sure to follow your doctor's orders during your treatment and before your second testing session.
- Reinfection can occur and start the cycle over again if the entire household is not cured. This must be confirmed after four weeks of treatment.^{[10]
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  Yazuz Selem Sari, Didem Can, Vahit Tundi et al. Helico Bacter: Treatment Just The Patient or For the Whole Family?. World Journal of Gastroenterology, Feb 28, 2008 14 (8) 1244-1247}
- If you have severe symptoms during treatment, make an appointment with your doctor right away. Antibiotics do not always work, and your doctor may prescribe different treatment.

Part 3

Part 3 of 4:

Using Natural Remedies to Help You Recover

1
Don't rely on natural remedies alone. Keep in mind that natural treatments have not been shown to cure the infection, so you will still need to seek medical treatment for the infection. However, they may help to keep the bacterial levels low, protect your gastrointestinal system, strengthen your immune system, and improve your health in general.^{[11]
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PubMed Central
Journal archive from the U.S. National Institutes of Health
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2
Eat broccoli. One small study suggested that eating broccoli helped to reduce H. pylori. Consuming broccoli regularly doesn't entirely kill off the H. pylori. But, it may possibly reduce the population.^{[12]
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Johns Hopkins Medicine
Official resource database of the world-leading Johns Hopkins Hospital
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- Eating a serving of broccoli several times per week may be beneficial.
3
Drink green tea. Studies in animals have shown that green tea brings about a significant reduction in the H. pylori for animals who consume it every day. It contains high levels of polyphenols, which inhibit H. pylori production. ^{[13]
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PubMed Central
Journal archive from the U.S. National Institutes of Health
Go to source}
- If you don't like the taste of green tea, green tea extract has the same beneficial effects.
- Red wine, which also has high levels of polyphenols, has similar benefits to green tea in animals.
4
Eat probiotics. Probiotics are beneficial bacteria that keep harmful bacteria populations from getting out of control. Studies show that regularly ingesting probiotics may be a good natural way to keep H. pylori at bay.^{[14]
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- Yogurt, kimchi, kombucha and other fermented products contain probiotics.

Part 4

Part 4 of 4:

Preventing an H. Pylori Infection

1
Wash your hands frequently. The primary factor in avoiding H. pylori infection is to practice proper hygiene and good hand washing. You should wash your hands, especially after using the restroom, or before handling food. Wash your hands in the following manner:^{[15]
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Allison, Aiello Phd, Rebecca Calhoun BS, Vanessa Perez Effective Hand Hygiene in Infectious Disease in the Community Setting: A Meta-analysis , Journal of Public Health 2008 August 98 (8) 1372-1381}
- Use warm water ( 120 degrees) and 3-5 cc (roughly a teaspoon) of liquid soap. The soap does not have to be antibacterial. Wash for a total of 15-30 seconds.
2
Eat a balanced diet. Eat a diet containing adequate proportions of carbohydrates, fats, proteins, vitamins, minerals and water. This will help you maintain good health. Having a strong immune system can reduce the risk of infection with many bacteria.^{[16]
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- Exact proportions vary based on weight,gender activity level, etc. But, caloric intake should be approximately 2000 calories per day, as a broad approximation. Get the majority of calories from fresh fruit and vegetables, legumes and grains, and low fat proteins.
- Even with a balanced diet, 67% of dieticians recommend dietary supplements. These supplements fill nutritional gaps that are not satisfied by food alone.^{[17]
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  Dieticians use and recommend dietary supplements: A Report of a survey, Nutrition Journal, 2012 11 14}
3
Take Vitamin C. Vitamin C is one factor of a healthy immune system. Many physicians recommend about 500 mg per day.^{[18]
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- Be aware that vitamin C is acidic and can irritate the stomach. It's a good idea to take a buffered form of the vitamin or try to get it through foods. Good choices include cantaloupe, cabbage, citrus fruits, and red pepper.^{[19]
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  National Health Service (UK)
  Public healthcare system of the UK
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- Because of its acidity, its a good idea to talk to your doctor about Vitamin C supplements you take if you are receiving treatment for H. pylori.
4
Avoid saliva contact. Studies suggest H. pylori may be transmitted via saliva.^{[20]
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Research source} If you know someone who has H. pylori, avoid saliva contact with them until it is confirmed that their treatment was successful.
- For example, if your spouse has H. pylori, avoid kissing him or her, and do not share a toothbrush.
5
Take precautions when traveling abroad. Especially when traveling to countries with poor sanitation, be careful about what you eat or drink.^{[21]
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Cleveland Clinic
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- Consider drinking bottled water when visiting countries with poor water sanitation.
- Refrain from eating at any questionable or roadside food trucks, etc. Eat only in restaurants with sanitation standards similar to an American standard of sanitation. Kitchen utensils should be washed in hot water (as warm as you can safely tolerate) with antibacterial soap.
- Using hand sanitizer can also be helpful in these types of situations. Washing your hands with unclean water can do more harm than good.