Helicobacter pylori

Authored by Chris McDermott, APRN, practicing with autonomous authority in Florida | Intercoastal Health, Florida

What Is Helicobacter pylori?

H. pylori is a gram-negative, microaerophilic bacterium capable of surviving the highly acidic environment of the stomach. It produces urease, breaking down urea into ammonia and carbon dioxide, buffering stomach acid and enabling survival in the mucosal lining.
While up to 50% of the global population may harbor H. pylori, only a subset develop symptoms or complications. Risk factors include genetics, immune status, diet, co-infections, toxin exposure, and microbiome diversity.

Signs and Symptoms

Most infections are asymptomatic. Symptomatic individuals may experience:

• Epigastric pain (especially on an empty stomach)
  
• Bloating and belching
  
• Nausea or vomiting
  
• Loss of appetite
  
• Frequent burping
  
• Peptic ulcers (burning pain relieved by food or antacids)
  
• Weight loss, vomiting blood, or black stools (suggesting gastrointestinal bleeding)

Diagnostic Evaluation

1. Urea Breath Test

• Highly sensitive; detects labeled carbon after ingestion of urea.
  

2. Stool Antigen Test

• Identifies H. pylori proteins; useful for initial diagnosis and follow-up.
  

3. Blood Serology

• Detects antibodies but cannot distinguish active from past infections.
  

4. Endoscopy with Biopsy

• Recommended in cases of ulcers, bleeding, or red flag symptoms.

Functional Medicine Treatment Principles at Intercoastal Health

1. Targeted Eradication Protocol

• Botanical antimicrobials: berberine, mastic gum, oregano oil, bismuth, zinc carnosine
  
• Tailored herbal regimens may reduce microbiome disruption compared to conventional triple therapy.
  

2. Mucosal Healing and Acid Restoration

• Demulcent herbs (e.g., licorice root, aloe vera)
  
• Digestive enzymes or betaine HCl for post-eradication support
  
• L-glutamine and zinc carnosine for mucosal healing
  

3. Microbiome Support

• High-potency probiotics (e.g., Lactobacillus rhamnosus GG, Saccharomyces boulardii)
  
• Fermented foods and prebiotics
  

4. Anti-inflammatory and Antioxidant Nutrients

• Vitamin C, E, selenium, curcumin, resveratrol, green tea extract
  

5. Lifestyle and Diet Optimization

• Eliminate ulcer-promoting foods: caffeine, alcohol, sugars
  
• Emphasize polyphenol- and antioxidant-rich foods
  
• Address emotional stress and tobacco use

Monitoring and Follow-Up

• Follow-up with stool antigen or urea breath test 4–6 weeks post-treatment.
  
• Discontinue PPIs and antibiotics at least 2 weeks before testing for accuracy.
  
• Address treatment-resistant infections with expanded antimicrobial protocols if needed.