H Pylori Eradication Techniques

H pylori bacteria living in the body is usually benign in most people. In some cases however, it is necessary to eradicate (kill) the bacteria because of infection-related complications and diseases. Eradication helps to heal ulcers, reduce the risk that more will form, and reduces the risk of cancer in the digestive system.

H pylori can cause all sorts of gastrointestinal symptoms and is the culprit in many cases of peptic ulcers and gastritis – conditions related to the inflammation of the stomach’s lining.

Eradicating H pylori symptoms can prove to be difficult in some cases because, as with any bacteria, there are several different strands of the germ and each strand is resistant to certain types of treatment. Determining the best course of treatment must be accomplished through properly testing for the bacteria and using the most recently available medical information as a guide.

The bacteria cause the body to produce antibodies, which are easily detected in blood tests. However, the presence of H pylori antibodies is only an indication that the bacteria have been present in the body. It does not provide conclusive information about the current state of the colonization of H pylori.

In other words, it does not help doctors to determine if H pylori are responsible for a certain symptom or condition. It is important to know for sure that H pylori are responsible for the treatment of certain conditions, especially peptic ulcers which can also be caused by NSAID medications. Ulcers are treated based on their cause.

Any person who has been diagnosed with peptic ulcer disease, an active stomach or duodenal ulcer, and those with a family history of stomach cancer should be treated if H pylori bacteria is discovered.

Once H pylori infection is confirmed however, the general course of treatment used to eradicate the bacteria remains the same – a strong antibiotic along with medications that make the stomach less hospitable for the bacteria.

Eradicating H Pylori with a Multi-Pronged Approach

It is commonly accepted in the medical community and has been proven through vast research on this particular type of bacteria that H pylori cannot be eradicated with antibiotics alone. Eradication depends heavily on reducing the number of bacterium in the body and making the stomach less appealing to the germs. Therefore, treatment usually includes an H2 blocker and proton pump inhibitor (PPI).


To accomplish eradication of the H pylori germs in the body, the first course of medicine is usually an antibiotic that is recommended by the most recent research in the field of bacteria. Antibiotics quickly accumulate in the mucosa (internal lining that secretes fluid like stomach acids) where the H pylori bacteria live.

Amoxicillin is the primary antibiotic used to start the eradication of H pylori. There is a relatively low rate of strands that are resistant to this type of antibiotic, so it can be widely used to kill off the infection. However, a large number of people are allergic to penicillin based medications so this antibiotic is not always an option.

Clarithromycin is another antibiotic option employed to eradicate H pylori. This type of antibiotic is resisted by a growing number of H pylori strands, however. Clarithromycin is most often used in combination with a PPI to help increase the amount of antibiotic in the stomach lining.

Other antibiotics that may be employed but have less influence on eradication include erythromycin, azithromycin, and metronidazole. Furazolidone may be helpful, but is known to cause problems with food and drug interactions.

Acid Reducing Medications

Antibiotics are more effective when the pH level of the stomach is higher, so medications that reduce acid are used in conjunction with the antibiotic. These medications also ease the symptoms of ulcers and allow them to heal faster by reducing the amount of acid to which they are exposed.

Since the bacteria prefer an acidic home, acid reducers can also help by increasing the pH level. These medications are known as “h2” blockers and they work by blocking the histamines that cause the acid to be secreted in the stomach lining.

PPIs, or proton pump inhibitors, are preferred when peptic ulcers are present because they help to control pain and pH better than H2 blockers. Additionally, PPIs help to eradicated H pylori in conjunction with a good antibiotic.

Most PPIs and H2 blockers work about the same in regard to eradicating H pylori bacteria levels, so a number of specific medications are appropriate.

Bismuth Subsalicylate

While there is no evidence that bismuth is overly effective on neutralizing acid during the eradication of H pylori, it does lend to the protection of the stomach lining from gastric acids by stimulating mucus production.

It also seems to cause the bacterium to release the lining, effectively putting it into a “free fall” of sorts. When this happens, side effects may occur that include darkened stool and mouth. Some bismuth compounds may also kill the bacteria, but aren’t effective on their own.

However, this medication may interfere with prescription treatments, so be sure to confirm with your doctor any over-the-counter medicines you may get.

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