How To Treat H Pylori With Antibiotics

How Is H Pylori Diagnosed

Your healthcare provider will look at your past health and give you a physical exam. He or she may also use other tests, including:

• Blood tests. These check for infection-fighting cells that mean you have the bacteria.

• Stool culture. This looks for any abnormal bacteria in your digestive tract that may cause diarrhea and other problems. A small stool sample is collected and sent to a lab. In 2 or 3 days, the test will show if you have any abnormal bacteria.

• Breath tests. These can check if there is any carbon after you swallow a urea pill that has carbon molecules. If carbon is found that means that H. pylori has made the enzyme urease. This enzyme makes your stomach acids less acidic . It weakens your stomachs mucous lining.

• Upper endoscopy, also called EGD . This test looks at the lining of your food pipe , stomach, and duodenum . It uses a thin, lighted tube or endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes down into your esophagus, stomach, and duodenum. Your healthcare provider can see the inside of these organs. A small tissue sample is taken if needed. The tissue sample can show if you have the enzyme urease. It can also check the bacteria that is there.

If You Have Acid Reflux Which Of The Following Can Improve Symptoms

Gastroesophageal reflux disease happens when the stomach’s contents flow backward into the esophagus. If youâre overweight, dropping some pounds can relieve some of the pressure on your stomach. If you get acid reflux when you lie down at night, raise the head of your bed. Gravity can help keep stomach acid down. One study found that eating four to five small meals a day relieved symptoms better than three large ones. If these things don’t help, talk to your doctor about treatment options.

What Does It Mean If You Test Positive For H Pylori

A positive H. pylori stool antigen, breath test, or biopsy indicates that your signs and symptoms are likely caused by a peptic ulcer due to these bacteria. Treatment with a combination of antibiotics and other medications will be prescribed to kill the bacteria and stop the pain and the ulceration.

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What Is The Best Rescue Strategy

As previous treatment failure leads to the development of secondary bacterial resistance to both metronidazole and clarithromycin and the efficacy of retreatment is also significantly decreased by the number of previous treatments, it is understandable that the higher success rate with the first line treatment, the lower will be the treatment failure. Thus, choosing the best available first line treatment regimen should be considered to be the best approach to rescue treatment. In areas where the prevalence of metronidazole resistance in the general population is high, seven days triple therapy including a PPI at the recommended doses, clarithromycin 500 mg twice daily, and amoxicillin 1 g twice daily should be used if the bacterial sensitivity is not known. In the event of clarithromycin resistance, a seven day PPI based quadruple therapy or 14 day H2 receptor antagonist based quadruple therapy should be considered.The PPI and H2 receptor antagonist should be given at the recommended doses. Colloidal bismuth salicylate is given as 120 mg four times daily, metronidazole as 250 mg four times daily, and tetracycline as 500 mg four times daily. RBC 400 mg twice daily given with clarithromycin 500 mg twice daily and amoxicillin 1 g twice daily for seven days may also be considered as an alternative first line treatment regimen.

Advice On Taking Nsaids

If your stomach ulcer has been caused by taking NSAIDs, your GP will want to review your use of them.

You may be advised to use an alternative painkiller not associated with stomach ulcers, such as paracetamol.

Sometimes an alternative type of NSAID that’s less likely to cause stomach ulcers, called a COX-2 inhibitor, may be recommended.

If you’re taking low-dose aspirin to reduce your risk of embolism , your GP will tell you whether you need to continue taking it.

If you do need to keep taking it, long-term treatment with a PPI or H2-receptor antagonist may be prescribed alongside the aspirin to try to prevent further ulcers.

It’s important to understand the potential risks associated with continued NSAID use.

You’re more likely to develop another stomach ulcer and could experience a serious complication, such as internal bleeding.

Page last reviewed: 14 January 2022 Next review due: 14 January 2025

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H Pylori As An Infectious Disease

Not until the late 1980s was H pylori recognized as the cause of peptic ulcer disease, which until then accounted for hundreds of thousands of hospitalizations and more than 100,000 surgical procedures each year. Now, peptic ulcer disease is routinely treated by eradicating H pylori. In addition, the World Health Organization has recommended considering H pylori eradication to reduce the risk of gastric cancer, which causes 738,000 deaths worldwide per year.

The problems of how to diagnose and treat H pylori infection were taken on by gastroenterologists, and not by specialists in infectious disease. Even now, almost all the major reviews and consensus statements on H pylori come from gastroenterologists and are published in gastroenterology journals.,,

But infectious diseases differ from most gastrointestinal diseases. In gastrointestinal problems such as constipation or inflammatory bowel disease, the causes are generally unknown, and there is a large placebo response to therapy. In contrast, in infectious diseases, the cause is generally known, there is no placebo response, and treatment success depends on susceptibility of the organism. Failure of proven regimens is generally due to resistant organisms, poor adherence, or, in the case of H pylori, poorly designed regimens in terms of doses, frequency of administration, or duration of therapy.

Current H pylori recommendations may also contribute to the global increase in antimicrobal resistance.

Search Strategy For Identification Of Studies

Trials were identified by searching the Cochrane Controlled Trials Register, PubMed , Embase , andthe Science Citation Index . A search strategy wasconstructed using a combination of the following words: Helicobacterpylori or H. pylori and moxifloxacin or avelox.Only articles published in English were included. Reference lists from thetrials selected by electronic searching were manually searched to identifyfurther relevant trials. We also conducted a manual search of abstracts from1995 to 2012 from the following congresses: International Workshop ofthe European Helicobacter Study Group, American Digestive Disease Week, andUnited European Gastroenterology Week. Abstracts of the articles selected ineach of these multiple searches were reviewed, and those meeting the inclusioncriteria were recorded. References of reviews on H. pyloritreatment with moxifloxacin and from the articles selected for the study werealso examined for articles meeting the inclusion criteria. Authors of someidentified trials were asked whether they knew of additional studies, includingunpublished randomized ones. In the case of duplicate reports, or studiesobviously reporting results from the same study population, only the latestpublished results were used.

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Finding A High Quality Probiotic

Look for a quality probiotic brand that contains a high CFU count and multiple strains of bacteria.

Also, make sure that the probiotic contains some form of protective technology that allows the bacteria to survive the journey through the gastrointestinal tract!

Most probiotic brands use vegetable capsules that deliver only around 4% of their bacteria safely to the gut. Thatâs because the veggie capsules are quickly broken down in your stomach, and the live bacteria are then exposed to your stomach acid.

Probiotic bacteria are sensitive to this highly acidic environment and most of them are killed before passing through to your intestines.

To solve this problem, we compress our bacteria into special time-release tablets using a technology named BIO-tract. When these come into contact with moisture, they form a protective gel coating that keeps the bacteria safe in your stomach. Then, when the tablet passes through to your intestines, the bacteria are slowly released over 8-10 hours.

Tests using simulated stomach acid have shown that this method safely delivers at least 15 times more bacteria, when compared to regular vegetable capsules.

Our probiotic also has 12 strains chosen for their impact on digestion and immunity, and a total of 15 billion CFUs of bacteria.

Here are a few key benefits of our probiotic:

Helicobacter Pylori: Current Treatment Options And Challenges

Supplements and Featured Publications

A Q& A With Colin W. Howden, MD

The American Journal of Managed Care® : What treatment options or regimens for Helicobacter pylori exist that are not reflected in the 2017 American College of Gastroenterology guidelines?

HOWDEN: The most important one thats not present in the 2017 ACG guideline is the triple combination of rifabutin, amoxicillin, and omeprazole, which was approved by the FDA in late 2019. It wasnt included in the 2017 guideline because we didnt have data about its efficacy at that time. Also of note is a clinical trial using the potassium-competitive acid blocker vonoprazan, which is not currently approved in the United States, with either amoxicillin alone or with the combination of amoxicillin and clarithromycin. Top-level results from that should be available shortly. No other established treatments have become available since 2017.

AJMC®: Which treatment regimens are currently used most often to treat H pylori?

AJMC®: What type of information about H pylori would be helpful to improving treatment outcomes?

AJMC®: How challenging would it be to adopt and implement antibiotic stewardship principles to H pylori treatment? Do you think that clinicians would support a movement toward treating H pylori based upon these principles?

AJMC®: Given the challenges of antibiotic resistance that exist and the limited access to antimicrobial sensitivity testing, what treatments are most effective?

REFERENCE

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Can H Pylori Make You Tired

Two-thirds of the world’s populationover 4.5 billion peoplehave bad bacteria known as H. Pylori living in their stomach. This harmful bacteria can be a major source of fatigue. Your stomach’s inner lining produces acid to digest food, while simultaneously creating protective mucus to guard from this acid.

H Pylori: What It Is + 9 Natural Treatments

By Annie Price, CHHC

Do you know whats been called the most successful pathogen in human history? Its a type of bacteria known as Helicobacter pylori and its been around for at least two hundred thousand years. And, its actually not uncommon for a person to have this bacteria living inside of them for an entire lifetime and not even know it!

According to the CDC, about 66 percent of the worlds human population is infected with Helicobacter pylori. In developing countries, the numbers are even worse, with up to 80 percent of adults and 10 percent of children likely having a H. pylori infection. If you have this infection, youre actually most likely not to have any symptoms. But, having this bacteria living in your body can make your risk of developing gastric cancer up to six times higher. Plus, H. pylori bacteria is often at the root of other major digestive problems, like peptic ulcers and gastritis. So, not only can H. pylori cause stomach ulcers, it can also cause ulcers in your esophagus or small intestine.

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Digestion Happens Mostly In The Stomach

Digestion begins in the mouth. Chewing and exposure to saliva is the first step in breaking down food. Food and drinks mix with gastric juices. This creates a mixture called chyme. Thatâs dumped into the small intestine, where most of the digestion takes place. From there, food is dissolved, nutrients are absorbed into the body, and waste is sent to the colon.

Conventional H Pylori Treatment

In order to diagnose a Helicobacter pylori infection, your doctor will have you take an H. pylori breath test, stool test or blood test.

Treatment for H. pylori usually includes several medications with at least two of them being antibiotics to hopefully kill the bacteria. The other medication are usually acid reducers. Why multiple antibiotics? Conventional wisdom says a single antibiotic may not kill the bacteria, so they typically use at least two at the same time.

Conventional H. pylori treatment also typically includes acid reducers like esomeprazole, lansoprazole, omeprazole or pantoprazole, especially if the patient has symptoms of an ulcer or heartburn. Bismuth subsalicylate is also commonly recommended. In addition, your doctor may also recommend histamine blocking medications to reduce stomach acid.

So, all together, were talking about possibly consuming 14 or more medications every day for weeks. Around a week or two after finishing your treatment regimen, your doctor will likely retest you to see if the treatment successfully eradicated the H. pylori bacteria.

Sometimes, the bacteria is still there and patients are instructed to take another two weeks of medications. Its approximated that as much as 20 percent of H. pylori sufferers will have a reoccurring infection.

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How Long Does It Take Food To Reach Your Stomach

When you swallow food, it enters your esophagus. Thatâs a stretchy tube about 10 inches long that connects the back of the throat to the stomach. Itâs narrow, but the muscles in its walls slowly squeeze food down and through. This is called peristalsis. It normally takes just a couple of seconds for each bite.

Antacids Are Not The Solution

If youre taking PPIs or acid-blocking drugs, listen up! Reflux is a very common side effect of H pylori infection for the reasons mentioned above: it causes low stomach acid. This prevents food from breaking down properly, so the food ferments, and the gases travel up the esophageal tract, causing burning. This is treated with acid-blocking drugs, which further reduce stomach acid and allow H pylori to proliferate. Thats right: reflux and heartburn are often caused by stomach acid that is too alkaline, NOT too acidic! Thats why H pylori and reflux/heartburn go hand in hand. And those with low stomach acid production are at risk of SIBO and vitamin deficiencies from malabsorption.

Certain strains of H pylori that produce cytotoxins cause worse inflammation and damage to the stomach lining and intestinal cells and are more closely related to ulcers, gastritis, and cancer.

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What Are The Signs & Symptoms Of H Pylori Infections

Many people who get an H. pylori infection dont realize it. Often, these infections dont cause symptoms.

When the bacteria do cause symptoms, they’re usually either symptoms of gastritis or peptic ulcer disease.

In kids, symptoms of gastritis may include:

In older kids and adults, the most common symptom of peptic ulcers is a lasting or burning belly pain, usually in the area below the ribs and above the navel. This pain often gets worse on an empty stomach and gets better as soon as the person eats food, drinks milk, or takes antacid medicine.

Peptic ulcers that bleed can cause:

• hematemesis : bloody vomit or vomit that looks like coffee grounds
• melena : stool that’s black, bloody, or looks like tar

What Are Helicobacter Pylori

Helicobacter pylori are a type of bacteria. These germs are a common cause of digestive illnesses, including:

• gastritis: the irritation and inflammation of the stomach lining
• peptic ulcers : sores in the lining of the stomach, small intestine, or esophagus
• later in life, stomach cancer

Kids can get stomachaches for many reasons, like indigestion, viruses, stress and worry, and appendicitis. Most stomachaches are not caused by Helicobacter pylori bacteria.

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How Are H Pylori Infections Treated

If you have an H. pylori infection that isnt causing you any problems and you arent at increased risk of stomach cancer, treatment may not offer any benefits.

Stomach cancer, along with duodenal and stomach ulcers, is associated with H. pylori infection. If you have close relatives with stomach cancer or a problem like a stomach or duodenal ulcer, a healthcare professional may recommend treating an H. pylori infection.

Treatment can cure an ulcer, and it may reduce your risk of developing stomach cancer.

How Are H Pylori Infections Diagnosed

If you have symptoms of a digestive condition, you may need to get tested for H. pylori. There are several ways to diagnose an H. pylori infection, including:

• Blood test: A healthcare professional may draw a sample of blood from a persons arm or hand. The blood sample can then be sent to a laboratory to check for antibodies to H. pylori.
• Stool test: For this test, youll use a container from a healthcare professional to collect a sample of your feces. It can then be sent to a lab for either a stool antigen test or a stool culture test.
• Breath test: A urea breath test can check for abnormal carbon dioxide levels, which can be a sign of an H. pylori infection. The test involves breathing into a collection bag twice. In between providing breath samples, youll consume a pill or liquid with a harmless radioactive material. A healthcare professional can then compare the two samples to see if you may have H. pylori.

A healthcare professional may recommend getting an endoscopy if the results of the other tests are inconclusive. It allows a healthcare professional to look at your esophagus, stomach lining, and a portion of your small intestine.

During the procedure, a healthcare professional will insert a long, thin tube called an endoscope into your mouth and down into your stomach and duodenum.

An attached camera will send back images on a monitor for a healthcare professional to see. The test may also involve removing a small tissue sample to be analyzed after the procedure.

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Can H Pylori Spread From Person To Person

Yes, H. pylori can spread from person to person. H. pylori are found in saliva, plaque on teeth and poop. Infection can be spread through kissing and by transferring the bacteria from the hands of those who have not thoroughly washed them after a bowel movement.

Scientists think H. pylori also might be spread through H. pylori-contaminated water and food.