Helicobacter pylori

Acid blockers have to be stopped two weeks and antibiotics four weeks beforehand — otherwise the test comes back falsely negative and everything starts again. That is the commonest mistake of all.

Two antibiotics plus an acid blocker over ten to fourteen days. Anyone who leaves one out or stops early breeds resistance — and the second attempt is markedly harder.

With a breath or stool test, at the earliest four weeks after the end and without acid blockers in the last two weeks. Without this check nobody knows whether it was enough.

With stomach cancer in close family, testing and treatment are done even without complaints — that measurably lowers one’s own risk. Partners in the same household are examined too with repeated reinfection.

Established main cause; eradication cures most ulcers for good.

Classed a Group 1 carcinogen by IARC — the leading avoidable cause.

Treatment is for symptoms, ulcers or risk — not reflexively on every positive test.

About a third to a half of people worldwide carry Helicobacter, fewer in Switzerland, more with age. Most never develop symptoms. After successful eradication, over ninety percent of those who had an ulcer stay free of it.

The course combines three to four drugs at once over ten to fourteen days — a single antibiotic cannot manage it, because the organism sits under the mucus in an acid setting. The acid blocker belongs to it, because the antibiotics only work at a higher pH. Success is checked at the earliest four weeks after the end, otherwise the test reads falsely negative. After a successful course, catching it again is rare in our part of the world.

The majority of those colonised notice nothing. So the search is targeted — with complaints, with an ulcer in the history, with stomach cancer in the family and before a longer treatment with anti-inflammatory painkillers.

A gnawing or burning that with a stomach ulcer comes during or shortly after eating, and with a duodenal ulcer rather on an empty stomach and at night — where eating briefly helps.

An early feeling of fullness, frequent belching, bloating and nausea in the morning. These signs are unspecific — only the test turns them into an answer.

Anaemia without a recognisable source of bleeding and an iron deficiency that does not rise on tablets are among the less known signs — treating the germ sometimes solves both.

Chronic H. pylori gastritis can cause unexplained iron deficiency.

Impaired acid or intrinsic factor can lower B12 absorption.

With H. pylori-related iron deficiency, treat the cause too.

Correct a proven deficiency.

As an add-on to eradication they can reduce side effects and slightly improve success.

Small studies suggest reduction — no substitute for eradication.

Antimicrobial in tradition and in the lab; on H. pylori there are few studies.

Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.

Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.

The bacterium changes the acid production — up or down depending on where in the stomach it sits. This is why it can cause both duodenal ulcers and a weakened stomach lining.

The stomach makes the hunger hormone. After eradicating the bacterium ghrelin rises again for many, and some gain a few kilos — that is expected and no sign of a problem.

In children with stubborn iron deficiency and unexplained delayed growth, Helicobacter belongs on the list — it hinders iron uptake in the stomach.

Promoted as supportive — actual treatment remains eradication.

Studied alongside antibiotic therapy: they reduce side effects and slightly raise the success rate in reviews. Alone they do not clear the germ.

Manuka honey is promoted against Helicobacter. In the test tube it inhibits the germ; in the stomach it does not reach the lining in an effective amount. Eradication needs antibiotics.

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