H. pylori (Helicobacter pylori) is a bacterium commonly found in the stomachs of about half the world's population. H. pylori infection does not cause problems most of the time, but for some people, H. pylori infection can result in digestive problems, including ulcers and, less commonly, stomach cancer.
Treatment for H. pylori infection usually involves taking two antibiotics along with a proton pump inhibitor (PPI) to reduce the risk of treatment failure and antibiotic resistance for 14 days.
After H. pylori treatment is completed, repeat testing with a breath or stool test is recommended between four to six weeks to ensure the infection is gone.
What Are Symptoms of H. pylori?
H. pylori (Helicobacter pylori) infection usually does not cause symptoms in most people. For those who develop ulcers due to H. pylori infection, early symptoms of ulcers include:
- Pain or discomfort in the upper abdomen
- Nausea
- Vomiting
- Belching (burping)
- Feeling full after eating a small amount of food
- Gas
- Bloating
- Loss of appetite
Later symptoms of stomach ulcers include:
- Severe abdominal pain
- Ulcers that bleed can cause a low blood count (anemia)
- Fatigue
- Dark or black-colored stools
- Unusual weight loss
- Shortness of breath
How Is H. pylori Diagnosed?
H. pylori (Helicobacter pylori) infection is diagnosed with a patient history and physical examination, and tests such as:
- Breath tests (urea breath tests)
- Stool tests
- Blood tests
- Biopsy of tissue from the lining of the stomach
- Endoscopy
What Is the Treatment for H. pylori?
H. pylori (Helicobacter pylori) infection is typically treated with a few different medications taken for two weeks.
- Proton pump inhibitors (PPIs) are used to decrease the stomach acid production
- Dexlansoprazole (Dexilant)
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Omeprazole (Prilosec)
- Pantoprazole (Protonix)
- Rabeprazole (aciphex)
- Two antibiotics are usually recommended along with a PPI to reduce the risk of treatment failure and antibiotic resistance
- Bismuth quadruple therapy: bismuth subsalicylate, metronidazole, tetracycline, and a PPI given for 14 days
- Clarithromycin triple therapy: clarithromycin, amoxicillin, and a PPI, all given twice daily for 14 days
- Concomitant therapy: clarithromycin, amoxicillin, nitroimidazole (tinidazole or metronidazole), and a PPI administered together for 10 to 14 days
- Hybrid therapy: amoxicillin and a PPI for seven days followed by amoxicillin, clarithromycin, a nitroimidazole, and a PPI for seven days
- Levofloxacin triple therapy: levofloxacin, amoxicillin, and a PPI for 10 to 14 days
- Levofloxacin sequential therapy: amoxicillin and a PPI for five to seven days followed by levofloxacin, amoxicillin, nitroimidazole and a PPI for five to seven days
- Levofloxacin quadruple therapy: levofloxacin, omeprazole, nitazoxanide, and doxycycline (LOAD) for 7 or 10 days (additional studies are needed to confirm the efficacy of this regimen and its cost-effectiveness)
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https://www.uptodate.com/contents/h-pylori-infection-the-basics?search=H.%20pylori&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.medscape.com/answers/176938-44719/what-are-possible-complications-of-helicobacter-pylori-h-pylori-infection
https://www.uptodate.com/contents/bacteriology-and-epidemiology-of-helicobacter-pylori-infection?search=H.%20pylori&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4#H5
https://www.uptodate.com/contents/helicobacter-pylori-infection-and-treatment-beyond-the-basics#H15
https://pubmed.ncbi.nlm.nih.gov/9795468/