According to the Mayo Clinic, Helicobacter pylori--more commonly known as H. pylori--is a bacterium that infects the stomach or first section of the small intestine. H. pylori infection is the cause of most ulcers, as well as many cases of gastritis (stomach inflammation). Most patients with H. pylori infection have no symptoms. Symptoms can include an ache or burning pain in your abdomen, nausea, vomiting, frequent burping, bloating or weight loss.
The Centers for Disease Control and Prevention reports that treatment is indicated only when the patient has developed an ulcer or cancer from the H. pylori infection. Several categories of medications are available to treat H. pylori infection by reducing acid, killing the bacteria coating the stomach lining. Drugs are always used in combination, never as solo therapies.
Antibiotics
The American Academy of Family Physicians reports that effective antibiotics include amoxicillin, a semi-synthetic penicillin; clarithromycin; and metronidazole. Antibiotic-resistant strains of H. pylori are emerging. Amoxicillin-resistant strains are found less frequently than strains resistant to the other antibiotics used to treat H. pylori infection. Health care providers often prescribe the medications in combination with other medications.
Acid Reducers
H. pylori prefers an acidic environment, so medications that reduce the acid in the stomach may improve the effectiveness of antibiotics, the Mayo Clinic says. These medications may also promote healing and alleviate symptoms. Histamine blockers, including ranitidine, famotidine, cimetidine and nizatidine, reduce the amount of acid released into the digestive tract. Proton pump inhibitors, including omeprazole and esomeprazole, suppress the pumps that produce acids. According to the American Academy of Family Physicians, proton pump inhibitors are more effective in patients with ulcers caused by H. pylori because they provide faster pain relief and better control of the level of acid.
Bismuth Salts
The American Academy of Family Physicians reports that bismuth salts are effective in helping to destroy the bacterium, as well as in forming a barrier against acids accumulating in the crater of an ulcer. Bismuth salts are not effective in neutralizing acids. Bismuth salts are never prescribed as the only therapy for H. pylori. They are used in combination with other medications.
Combination Treatment Regimens
H. pylori infection is difficult to treat because the stomach lining helps protect the bacteria from antibiotics. Therefore, health care providers prescribe various combinations of two, three or four medications. According to the National Institute for Diabetes and Digestive and Kidney Diseases, the most effective treatment is a 2-week course of treatment called triple therapy--two antibiotics plus either an acid suppressor or a stomach-lining medication. This regimen reduces ulcer symptoms, kills the bacteria, and prevents ulcer recurrence in more than 90 percent of patients.
References
- American Academy of Otolaryngology: Management of Helicobacter Pylori Infection
- Centers for Disease Control and Prevention: Helicobacter Pylori
- National Institutes of Health: Helicobacter Pylori
- Centers for Disease Control and Prevention: Helicobacter Pylori and Peptic Ulcer Disease
- National Institute of Diabetes and Digestive and Kidney Diseases: H. Pylori and Peptic Ulcer Disease
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