So, you have been diagnosed with H. pylori.  What is it, what problems can it cause and how do I treat it?  These are issues we deal with a lot and I’m am hopeful this will give you the information you need.

Helicobacter pylori (H. pylori) is a spiral shaped bacteria that infects your stomach causing chronic inflammation. H. pylori infection is very common and estimated to affect 50% of the world’s population, mainly in areas of inadequate sanitation. The main health conditions we associate with H. pylori are gastritis (inflammation of the stomach lining), ulcers, anemia and a certain type of gastric cancer. 

H. pylori causes more than 90% of duodenal and up to 80% of gastric ulcers. Since ulcers, and H. pylori, are common conditions I see in my San Antonio gastroenterology practice, I wanted to provide an overview of this infection along with how a GI doctor diagnoses the infection and available treatment options.


The majority of people infected with H. pylori show no symptoms related to the infection. The bacterial infection is typically detected during routine testing for other issues.  Although its usually asymptomatic, there are many symptoms people do have that are felt to be associated with this infection.

Common symptoms that can be attributed to H. pylori infection are:

When to see a Doctor for H. pylori Infection

If you have been diagnosed with H.pylori from blood work or by other method, make sure you follow up with your primary care physician or your gastroenterologist as there are many treatment options available for this infection, and if left untreated can cause an ulcer and the symptoms above.

Causes & Risk Factors

Soon after the discovery of H. pylori in 1982, it was commonly thought that this infection was caused by spicy food, acid and lifestyle. We have since learned otherwise.

H. pylori Causes

The exact mode of transmitting this infection is unclear. However, it is common to develop an H. pylori infection by these methods:

  • Oral-Oral (passed through saliva)
  • Fecal-Oral (not washing hands or eating/drinking something contaminated with infected fecal material)
  • Inadequate Sanitation
  • Contaminated Water Sources

H. pylori Risk Factors

Prominent factors affecting the likelihood of becoming infected are:

  • Ethnicity – People of African-American or Hispanic decent have a higher risk of infection
  • Age – Older adults have a higher incidence of H. pylori infection
  • Living in unsanitary conditions (typically seen in developing countries)
  • Poor hygiene

H. pylori Infection Diagnosis

There are several methods currently available to test for this bacteria.  The most common is a blood test for antibody production against H. pylori.  More often then not when I first meet someone for H. pylori treatment, this is how it was found. The main limitation with the blood test is that it doesn’t test for the actual infection – it tests for antibodies against the infection. So, if your blood test is positive it means you had H.pylori at some point in your life – but not necessarily an active infection at this time.  Also, if you have H. pylori and get treated, the blood test will remain positive even if the infection is gone (again, it is just testing for the antibody production, not the bacteria.  Therefore, I rarely use this test.  The most common and accurate ways to test for active infection are as follows:

The methods used to diagnose active H. pylori are:

  • Stool study (poop in a cup and send to the lab)
  • Endoscopy (EGD with biopsy to look for the actual bacteria)
  • Breath test (drink a solution in the office and blow in a tube)

H. pylori Infection Treatments

The best way to prevent an infection is through good hygiene. There is some evidence that good nutritional status, especially consumption of fruits, vegetables and Vitamin C appears to help as well.

For active infections, treatment is traditionally done with a combination of 2 or 3 different antibiotics at the same time along with a strong acid blocker medication. The bacteria are very difficult to kill and have a high rate of resistance to antibiotics – so we have treat it more aggressively to make it go away. Then, 4-6 weeks after finishing treatment, you should get a confirmatory breath test to make sure it has been killed.

Given the expense of medications and the fact that some patients prefer other (non-antibiotic) options, there are natural remedies used to try and treat H. pylori infection. Although success rates for eradication with these treatments are small, they are generally safe, and some people do give them a try. Popular natural treatment options are:

  • Manuka honey and Monolaurin – Shown to have antibacterial activity against H. pylori in small trials. However, they have not been shown to be able to kill the bacteria by themselves when in a person’s stomach.
  • Mastic Gum – Has been shown to have some success in treating bacterial infection, but the eradication rate is very low.
  • Quebracho & Mediterranean Diet – We have had success using a natural product called Atrantil along with a Mediterranean diet to reduce the symptoms of bloating and abdominal discomfort associated with this bacteria.

Remember, once treatment is complete you should be tested again (but not with a blood test, as it will remain positive even when bacteria is gone) to make sure your infection was eradicated. I hope this was helpful.  If I can be of assistance with this infection for you, please call us at 210-615-8308 or schedule an appointment online.