H Pylori: How to Identify the Signs and Get the Right Treatment

H. pylori infection: what is it?

H. pylori (Helicobacter pylori) infection is a bacterial infection affecting the stomach lining. This bacterium is commonly found in the digestive tract and is estimated to infect nearly half of the world’s population. The infection can cause various symptoms and sometimes lead to more severe conditions.

When should you suspect an H. pylori infection?

You should suspect H. pylori infection if you are experiencing symptoms such as:

  • Abdominal pain or discomfort, especially in the upper abdomen
  • Bloating
  • Nausea
  • Loss of appetite
  • Vomiting
  • Burping or acid reflux
  • Dark or black stools (a sign of bleeding in the digestive tract)

While the above are common symptoms of H. pylori infection, there are some less common symptoms as well, including:

  • Unexplained weight loss
  • Fatigue
  • Constipation or diarrhea
  • Unexplained iron-deficiency anemia
  • Dizziness or lightheadedness
  • Persistent bad breath
  • Persistent nausea or vomiting

In some cases, H. pylori infection can cause peptic ulcers or gastritis, leading to additional symptoms such as heartburn and indigestion.

How do you get H. pylori infections?

How H. pylori spread from person to person has yet to be fully understood. However, there are several potential modes of transmission, including:

Direct person-to-person contact: Through kissing or sharing utensils.
Contaminated food or water: H. pylori can also be spread through contaminated food or water.
Poor hygiene: Poor handwashing and sanitation practices can also increase your chances of contracting H. pylori.
Crowded living conditions: People living in overcrowded conditions, such as in developing countries, are more likely to become infected with H. pylori.
Family history: H. pylori infection can also run in families, which suggests that genetic factors may also play a role in its transmission.

It is also worth noting that while most people with H. pylori infections do not develop symptoms, the bacterium can still cause long-term damage to the digestive tract if left untreated.

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Can the H. pylori infection be cured?

Antibiotics and acid-reducing medications can be used to treat H. pylori infection. The treatment plan will differ depending on the severity of the disease and the individual patient’s needs and health history.

Treatment typically involves a combination of two antibiotics and an acid-reducing medication, such as a proton pump inhibitor, taken for 7–14 days. This combination of drugs effectively eradicates the H. pylori bacterium and reduces symptoms. However, in some cases, a longer course of treatment may be necessary.

While antibiotics are commonly used to treat H. pylori infections, their efficacy or success rate has been found to be only about 70%. This means that for every 100 people treated with antibiotics for H. pylori, about 70 will have their infection eradicated. At the same time, the other 30 may continue to experience symptoms or have the condition persist.

Various factors, including the strain of H. pylori, the type and duration of antibiotic treatment, and the presence of antibiotic resistance, can influence the effectiveness of antibiotics. In addition, the infection may reappear after treatment in some cases, requiring additional rounds of antibiotics or alternative treatment methods.

It’s important to note that while antibiotics may not be 100% effective in treating H. pylori, they remain the most commonly prescribed treatment for this condition. In addition, combination therapy, which involves taking two or more antibiotics simultaneously, has been shown to be more effective than using a single antibiotic.

It is essential to follow the treatment plan prescribed by your doctor and to complete the entire course of antibiotics, even if your symptoms have improved, to ensure that the H. pylori bacterium is entirely eradicated.

After treatment, your doctor may recommend a follow-up test to confirm that the infection has been successfully treated.

Diagnostic Tests for H. Pylori Explained

Blood Test

Blood tests are an indirect method used to diagnose H. pylori infections. These tests measure specific immune responses to the H. pylori bacteria, including H. pylori antibodies (IgA, IgG, and IgM) in the blood.

Suppose a person tests positive for IgA or IgM antibodies. In that case, it can indicate that they have an active H. pylori infection. This is because these antibodies are produced in response to a recent or current H. pylori infection.

On the other hand, a positive result for IgG antibodies may indicate a past H. pylori infection. Research has shown that test results in patients who test positive for IgG antibodies tend to decrease within six months of H. pylori removal. This suggests that these antibodies may persist in the blood even after the infection has been successfully treated.

Breath Test

The H. pylori breath test is a diagnostic tool used to detect the presence of bacteria in the stomach. The test measures carbon dioxide (CO2) levels in the breath, a by-product of the bacteria’s urease and nitrogen.

During the test, the patient drinks a solution containing a special substance and then breathes into a bag at regular intervals. The special substance in the breath will change if H. pylori are present. The increase in CO2 levels in the breath can indicate the presence of the bacteria.

It is important to note that H. pylori breath tests tend only to show acute infections, which are the most accurate in detecting recent, active infections. However, suppose an individual has had a long-standing H. pylori infection. In that case, the breath test results may need to be more accurate.

Stool Test

A stool test is a diagnostic tool used to detect the presence of H. pylori antigens in a person’s stool sample. This test is non-invasive and involves collecting a small sample of stool to be sent to a laboratory for analysis.

The stool test looks for specific antigens produced by the H. pylori bacteria in the stool sample. If antigens are present, it is an indication that the individual is infected with H. pylori.

The stool test is a highly accurate method for diagnosing H. pylori infections. It is also less invasive than other tests, such as endoscopy or biopsy, which may be necessary in some cases.


This test involves inserting a small, flexible tube with a camera into the digestive tract to visualize the stomach and small intestine directly. In addition, a biopsy may be taken during the endoscopy to test for H. pylori.

During the endoscopy, a biopsy may also be taken to test for the presence of H. pylori. A biopsy is a small sample of tissue removed from the lining of the stomach or small intestine and sent to a laboratory for analysis.

Endoscopy and biopsy are considered the most accurate methods for diagnosing H. pylori infections. This is because they allow the doctor to visualize the inside of the digestive tract and obtain a tissue sample for analysis.

However, it is essential to note that endoscopy may not always be the most reliable test for H. pylori, especially if the individual has no overt symptoms. Other tests, such as blood or stool tests, may be more appropriate in these cases.

It is also essential to consider that endoscopy is an invasive procedure with some risks, such as bleeding or infection. Therefore, for most individuals, endoscopy is unnecessary and is only recommended for high-risk patients or in cases where other tests have not been able to confirm the diagnosis.

Urea Breath Test

The urea breath test is a non-invasive diagnostic test used to detect the presence of H. pylori in the digestive tract. The test measures the amount of carbon dioxide in the breath after drinking a solution containing a special substance called urea.

During the test, the individual drinks a solution containing a specific dose of urea labeled with a harmless isotope, such as carbon-13 or carbon-14. Suppose H. pylori are present in the digestive tract. In that case, it will produce an enzyme called urease, which breaks down the urea into carbon dioxide and ammonia.

The amount of carbon dioxide produced is then measured in the breath using a specialized machine. An increased amount of carbon dioxide in the breath indicates the presence of H. pylori.

The urea breath test is a quick and non-invasive method for diagnosing H. pylori infections and is often used in combination with other tests, such as a blood test or stool test, to confirm the diagnosis.

It is crucial to remember that a diagnosis of H. pylori infection should not be based on a single test alone. Instead, your doctor may recommend additional testing or a combination of tests to confirm the diagnosis.

How to treat H. pylori infection naturally?

While antibiotics and acid-reducing medications are the most effective ways to treat H. pylori infection, some natural remedies may help reduce symptoms and promote healing. However, it is essential to remember that these remedies do not replace medical treatment. Therefore, speaking with your doctor before trying any natural remedies would be best.

Some natural remedies that may help with H. pylori infection include:

Probiotics: Probiotics can help restore the balance of good bacteria within the gut, which can help in symptom reduction and healing.
Garlic: Garlic has antibacterial properties and may help fight H. pylori.
Ginger: Ginger has anti-inflammatory properties and may help reduce symptoms of H. pylori-related gastritis.
Manuka honey: Manuka honey has antibacterial properties and may help reduce H. pylori.
Aloe vera: Aloe vera may help soothe the digestive tract and reduce symptoms of H. pylori-related gastritis.
Dietary changes: Making nutritional changes, such as avoiding spicy or acidic foods and reducing stress, may help reduce symptoms and promote healing.

Remember that these natural remedies may only be effective for some. The best treatment for H. pylori infection will depend on the patient’s needs and health history. If you have any of the symptoms mentioned in this article, click here to schedule a complimentary consult.

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What Causes H. Pylori Infection…The Most Insidious Infection Around?

By Dr. Justin Marchegiani

What causes H. pylori infection? Did you know that over 50% of the population has an H. pylori infection (1)? Dr. Marshall, the scientist who discovered H. pylori, won the Nobel Prize in medicine in 2005 for his discovery. His initial research was done on himself, as he infected himself to prove the bacteria’s causal connection with gastritis (inflammation of the stomach).

H. pylori is an opportunistic infection that spreads more rapidly in people that have a compromised immune system. This is why there are higher rates of all parasite infections in Third World countries. In the United States, we are seeing an increase in chronic stress and poor eating habits, which compromises our immune function and makes us open for an attack.

How Do You Get an H. pylori Infection?

H. pylori, unlike other parasitic infections, can be spread very easily via saliva and doesn’t require sexual intimacy per se. This is why it’s very common to see an entire family test positive for an H. pylori infection. Things like sharing a drink or silverware can be enough to spread the infection in a compromised individual.

What does H. pylori do to our body?

One of the biggest problems with H. pylori is its production of a specific enzyme called urease, which essentially neutralizes hydrochloric acid due to its increased production of ammonia. Hydrochloric acid is needed to help digest protein, ionize minerals, and create an acidic environment in the guts to stimulate bile release from the gallbladder, which aids in fat digestion in the small intestine.


h. pylori infection

If we can’t ionize our minerals properly, this will lead to a whole host of issues, including osteoporosis, immune problems, thyroid problems, and anemia. Lack of hydrochloric acid will also lead to indigestion, malabsorption, gas, bloating, and a catabolic physiology (your body breaking down faster than it can build up).

A large percentage of H. pylori infected patients will not present with any symptoms, so it’s possible you could be feeling great and still have an infection. This is also why my recommendation for anyone with an H. pylori infection is to supplement with hydrochloric acid and enzymes to ensure optimal digestion, even if no digestive symptoms are present.

It’s important to note that the enzymes and hydrochloric acid by themselves will not be enough to eradicate the infection. A proper assessment should be made by your functional-medicine doctor regarding your primary physical, chemical, and emotional stressors to ensure long-term eradication of the infection.

Click here to eradicate your H pylori infection!

h pylori and inflammation

H. pylori also irritates the stomach lining, hence its connections with gastric ulcers. This essentially creates silent inflammation, and now your adrenal glands have to come to the rescue to put out the smoldering fire in your gut. Your body uses cortisol from the adrenal glands to help put out the fire. But as your adrenals become more fatigued, cortisol will lose its capability of keeping the fire under control. This is the point where you will start to see the exacerbation of your symptoms. Many people can have this infection for a long period of time and not necessarily have any symptoms until their adrenals drop into stage III adrenal fatigue.

What Makes H. pylori Different?

H. pylori is a gram-negative bacteria. What this means is that H. pylori has two cell walls while most bacteria (gram positive) only have one cell wall (see picture below). When there are two cell walls, it makes it harder for antimicrobial medicines and herbs to eradicate the infection. This is analogous to a castle with stone walls for protection also being surrounded by a moat, which makes it more difficult for any intruders to invade.

Efflux Pumps and Antibiotics

In between the first and second cell wall, there is something known as efflux pumps. These pumps have the ability to disperse the antibiotic medicines that were given to the patient back outside into the gastrointestinal tract. These efflux pumps are believed to significantly contribute to antibiotic resistance, which is so prolific today (2).

When the antibiotics are pumped back into the gastrointestinal tract, patients can experience more die-off reactions. These reactions can include fatigue, nausea, bloating, flu-like symptoms, and diarrhea. H. pylori has obviously adapted in a way that has made it more resistant to antibiotics. This is one of the main reasons why I’m such a fan of herbal medicines, as they can be used for longer periods of time and don’t seem to have the same side effects as antibiotics.

The other major issue with gram-negative bacteria is that the outside of the bacteria is toxic. This toxin is known as lipopolysaccharide (LPS), or endotoxin, which is actually toxic to the liver. The more H. pylori becomes eradicated from your body, the more your detoxification pathways become stressed from the toxic debris! This is why I find removing the infection over a longer period of time and using additional herbs to help with drainage and detoxification can be beneficial in reducing those die-off reactions.


gram negative bacteria

The most common or conventional symptoms of H. pylori infection:

  • Abdominal pain
  • Bloating and fullness
  • Dyspepsia or indigestion
  • Feeling very hungry one to three hours after eating
  • Mild nausea (may be relieved by vomiting)

Less common symptoms of H. pylori infection:

  • Neurological pain
  • Anemia (B12 or iron)
  • Leaky gut (gastrointestinal permeability)
  • Depression and anxiety: All of the neurotransmitters in our body are made from proteins and amino acids.
  • Constipation and diarrhea: Inflammation can disrupt motility in the GI tract.
  • Crohn’s, ulcerative colitis, or any other digestive disorder
  • Explainable weight gain.
  • Fatigue or thyroid disorder: H. pylori is linked to autoimmune thyroid disease (6).

gut healthExams and Tests for H. pylori

  1. Blood tests: These tests are indirect and assess the specific immune responses to the H. pylori infection. The immune responses that are measured are H. pylori and IgA, IgG, and IgM antibodies. If you test positive for IgA or IgM, you can be confident that you have an active H. pylori infection. Research has shown that test results in patients that are positive for IgG antibodies tend to drop within six months of H. pylori removal (5).
  2. H. pylori breath test: This test measures increased levels of CO2, which is the by-product of urease and nitrogen. H. pylori breath tests tend to only show acute infections.
  3. Stool testH. pylori stool tests are the gold standard and are the only tests that look for the actual particles of the H. pylori bacteria.
  4. Endoscopy: This test is the most invasive and tends to be the least reliable, especially if you have no overt symptoms. This test can be good at assessing cancer as well as damage to the stomach, duodenum, and esophagus. For most individuals this test is unnecessary and is only recommended for high-risk patients.

Conventional Treatment Options and the Prevpac

Patients who have H. pylori and also have an ulcer are most likely to benefit from being treated. The treatment does not work in all patients.

Treatment must be taken for 10 to 14 days. Medications may include the Prevpac, which is a combination of three antibiotics.

  1. Clarithromycin (Biaxin)
  2. Amoxicillin, tetracycline, or metronidazole (Flagyl)
  3. Proton-pump inhibitors, such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium)
  4. Optional: Bismuth subsalicylate (Pepto-Bismol), in some cases

Natural Treatment Options

  1. Mastica (3)
  2. Burberines (4)
  3. Oil of oregano
  4. Wormwood
  5. Neem
  6. Olive leaf
  7. Black walnut hulls
  8. Burdock
  9. Probiotics (4)
  10. Vitamin C (4)

It’s very important the right combination of herbs as well as the right dosage of herbs are used. I strongly recommend a customized program by a functional-medicine doctor specific to your needs. This will give you the best chance of removing the infection the first time without terrible die-off reactions. If you have any of the symptoms mentioned in this article, click here to schedule a complimentary consult.


1. Yale J Biol Med. 1998, Helicobacter pylori: the Middle East scenario.

2. Biochemical Pharmacology 2000, Antibiotic Efflux Pumps Francoise Van Bambeke et al.  

3. Phytomedicine. 2010, The effect of mastic gum on Helicobacter pylori: a randomized pilot study.

4. Alernative medicine review 2001, Alan Gaby M.D, Helicobacter pylori Eradication: Are there alternative to antibiotics?

5.  J Clin Microbiol. 2001, Short-Term Follow-Up by Serology of Patients Given Antibiotic Treatment for Helicobacter pylori Infection.

6. Acta Med Iran. 2013 May, The association of Helicobacter pylori infection with Hashimoto’s thyroiditis.


The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.