Helicobacter pylori (H. pylori) is a spiral-shaped bacterium that lives in the gastrointestinal systems of nearly half the world’s population.1Ali A, AlHussaini KL. Helicobacter pylori: a contemporary perspective on pathogenesis, diagnosis and treatment strategies. Microorganisms. 2024;12(1). https://doi.org/10.3390/microorganisms12010222,2Parikh NS, Ahlawat R. Helicobacter pylori. StatPearls. Aug 8. https://www.ncbi.nlm.nih.gov/books/NBK534233 One of the most common contributors to digestive disease,3Sun Q, Yuan C, Zhou S, et al. Helicobacter pylori infection: a dynamic process from diagnosis to treatment. Front Cell Infect Microbiol. 2023;13. https://doi.org/10.3389/fcimb.2023.1257817 some 20% of people with H. pylori will develop an ulcer, and approximately 80% of stomach cancers are attributable to the bacteria.4Aldhaleei WA, Wallace MB, Harris DM, Bi Y. Helicobacter pylori: a concise review of the latest treatments against an old foe. Cleve Clin J Med. 2024;91(8):481-487. https://www.ccjm.org/content/91/8/481 However, many people who test positive for H. pylori experience no complications.
“[H. pylori] has been a part of the human microbiome longer than written history,” says GI specialist Mark Davis, ND. “Even today, [most] people have H. pylori in their gastric microbiome, and the majority of them will not develop a peptic ulcer.”
Emerging evidence suggests that H. pylori may even be beneficial. The bacteria’s immune-modulatory effects could reduce the risk of asthma, inflammatory bowel disease, and other autoimmune disorders. Preliminary research also shows that H. pylori can influence satiety (fullness) hormones, such as leptin and ghrelin, which might help with weight control.5Schulert JP, Rayner CK, Costello SP, et al. Helicobacter pylori: have potential benefits been overlooked? JGH Open. 2022;6(11):735-737. https://doi.org/10.1002/jgh3.12842
Common symptoms and diagnosis
Many people with H. pylori infection are unaware of it. That’s because there are typically no symptoms until related issues, like ulcers or gastritis, begin causing abdominal pain, nausea, vomiting, or indigestion.2Parikh NS, Ahlawat R. Helicobacter pylori. StatPearls. Aug 8. https://www.ncbi.nlm.nih.gov/books/NBK534233 Patients often describe a feeling of “fullness” or a gnawing, burning sensation in the stomach.6Vakil N. Helicobacter pylori infection. Merck Manual Consumer Version. 2025;Jan. https://www.merckmanuals.com/home/digestive-disorders/gastritis-and-peptic-ulcer-disease/helicobacter-pylori-infection
H. pylori colonizes the stomach lining in nearly everyone who develops gastritis. Bacterial infection of the gastric mucosa can eventually lead to ulcers,5Schulert JP, Rayner CK, Costello SP, et al. Helicobacter pylori: have potential benefits been overlooked? JGH Open. 2022;6(11):735-737. https://doi.org/10.1002/jgh3.12842 and stomach cancer is a risk with long-term cases. Symptoms are similar but may also include bloating after meals, difficulty swallowing, unexplained weight loss, and fatigue.7Menon G, El-Nakeep S, Babiker HM. Gastric cancer. StatPearls. 2024;Oct 28. https://www.ncbi.nlm.nih.gov/books/NBK459142/?report=reader#_NBK459142_pubdet_
Noninvasive tests of stool, blood, or breath can detect H. pylori, as can more invasive methods, such as endoscopic biopsy, culture, and molecular sampling of gastric tissue.4Aldhaleei WA, Wallace MB, Harris DM, Bi Y. Helicobacter pylori: a concise review of the latest treatments against an old foe. Cleve Clin J Med. 2024;91(8):481-487. https://www.ccjm.org/content/91/8/481 However, many people who test positive for H. pylori experience no complications.
But these tests reveal only part of the picture. “If there is evidence of H. pylori in a stool or blood test,” says Dr. Davis, “I will encourage patients to do a breath test, to not only find out if it’s truly there, but also if it is genuinely overgrown.”
To treat or not to treat
Treatment philosophies for H. pylori tend to differ between natural medicine practitioners and conventional physicians. Many naturopathic doctors question whether eliminating the bacteria is truly necessary. Standard treatment often includes a combination of antibiotics, proton pump inhibitors, and, in some cases, prescription bismuth.6Vakil N. Helicobacter pylori infection. Merck Manual Consumer Version. 2025;Jan. https://www.merckmanuals.com/home/digestive-disorders/gastritis-and-peptic-ulcer-disease/helicobacter-pylori-infection
“The triple or quadruple therapy is designed for rapid eradication and has high reported success,” notes Laurence Freitas, ND, LAc, a clinician based in Coronado, California. “But [it] is limited by growing antibiotic resistance and [the] risk of side effects, including GI upset and altered microbiota.” Research indicates that antibiotic resistance is a leading factor in treatment failure.
If triple therapy is unsuccessful or antibiotic resistance prevents complete eradication of H. pylori, conventional treatment may add a two-week course of a bismuth-based antibiotic.8Chey WD, Howden CW, Moss ST, et al. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2024;119(9):1730-1753. https://doi.org/10.14309/ajg.0000000000002968
“If the patient is under 30,” says Dr. Davis, “I usually suggest that we don’t eradicate H. pylori, unless they have a first-degree family member with peptic ulcers, stomach cancer, or a MALT lymphoma. If the patient is over 40, I often suggest eradication, unless the patient or a first-degree family member has esophageal cancer, gastroesophageal reflux disease, or is overweight or obese.”
Addressing inflammation, digestive health
An integrative treatment plan incorporates conventional treatments and natural remedies, emphasizing nutrition and dietary supplements.
“The naturopathic approach takes a wider view,” says Dr. Freitas, “and also focuses on reducing inflammation, supporting gut health, repairing tissue, and minimizing medication side effects [when] antibiotics are used.”
Research supports use of various antimicrobial herbs, essential oils, and propolis for the treatment of H. pylori.9Reddy K, Sree N, Ranjit P, et al. Essential oils, herbal extracts, and propolis for alleviating Helicobacter pylori infections: a critical view. S Afr J Bot. 2023;157:138-150. https://doi.org/10.1016/j.sajb.2023.03.056 A 2024 analysis of 534 randomized clinical trials found that multi-strain probiotics significantly improved eradication rates and reduced the risk of adverse effects compared with standard therapy alone.10Yang Z, Zhou Y, Han Z, et al. The effects of probiotics supplementation on Helicobacter pylori standard therapy: an umbrella review of systematic reviews with meta-analyses. Sci Rep. 2024;14. https://www.nature.com/articles/s41598-024-59399-4
“If eradication is the goal,” says Dr. Davis, “I include quadruple therapy and enhance the safety and efficacy with probiotics, lactoferrin, and zinc carnosine between meals. Depending on the individual patient, I may also add herbs like Panax ginseng (Chinese or Korean ginseng) or Glycyrrhiza glabra (licorice), or I might add N–acetylcysteine or Saccharomyces boulardii.”
Some of Dr. Freitas’s go-to supplements include natural antimicrobials such as mastic gum, black cumin seed, berberine, oregano/thyme oils, deglycyrrhizinated licorice (DGL), sulforaphane, and probiotics.
Dr. Freitas also encourages an anti-inflammatory diet that avoids processed or fried food, alcohol, gluten, dairy, and sugar.11Xiong Y, Du L, Diao Y, et al. Association of dietary inflammatory index with Helicobacter pylori infection and mortality among the US population. J Transl Med. 2023;21. https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04398-8,12Sreeja S, Le T, Eom B, et al. Association between the dietary inflammatory index and gastric disease risk: findings from a Korean population-based cohort study. Nutrients. 2022;14(13). https://doi.org/10.3390/nu14132662 “I recommend small, cooked meals, and increasing foods with antimicrobial and gut-healing properties, such as green tea, honey, cabbage juice, garlic, ginger, and aloe juice,” he says.
Ultimately, the naturopathic approach to H. pylori centers on restoring balance in the digestive system rather than completely wiping out the bacteria. Through lifestyle changes, dietary choices, and natural options that promote microbial balance, many people can strengthen their overall gut health. A personalized assessment that considers individual physiology and health history will inform the most appropriate treatment path.
Footnotes
- 1Ali A, AlHussaini KL. Helicobacter pylori: a contemporary perspective on pathogenesis, diagnosis and treatment strategies. Microorganisms. 2024;12(1). https://doi.org/10.3390/microorganisms12010222
- 2Parikh NS, Ahlawat R. Helicobacter pylori. StatPearls. Aug 8. https://www.ncbi.nlm.nih.gov/books/NBK534233
- 3Sun Q, Yuan C, Zhou S, et al. Helicobacter pylori infection: a dynamic process from diagnosis to treatment. Front Cell Infect Microbiol. 2023;13. https://doi.org/10.3389/fcimb.2023.1257817
- 4Aldhaleei WA, Wallace MB, Harris DM, Bi Y. Helicobacter pylori: a concise review of the latest treatments against an old foe. Cleve Clin J Med. 2024;91(8):481-487. https://www.ccjm.org/content/91/8/481
- 5Schulert JP, Rayner CK, Costello SP, et al. Helicobacter pylori: have potential benefits been overlooked? JGH Open. 2022;6(11):735-737. https://doi.org/10.1002/jgh3.12842
- 6Vakil N. Helicobacter pylori infection. Merck Manual Consumer Version. 2025;Jan. https://www.merckmanuals.com/home/digestive-disorders/gastritis-and-peptic-ulcer-disease/helicobacter-pylori-infection
- 7Menon G, El-Nakeep S, Babiker HM. Gastric cancer. StatPearls. 2024;Oct 28. https://www.ncbi.nlm.nih.gov/books/NBK459142/?report=reader#_NBK459142_pubdet_
- 8Chey WD, Howden CW, Moss ST, et al. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2024;119(9):1730-1753. https://doi.org/10.14309/ajg.0000000000002968
- 9Reddy K, Sree N, Ranjit P, et al. Essential oils, herbal extracts, and propolis for alleviating Helicobacter pylori infections: a critical view. S Afr J Bot. 2023;157:138-150. https://doi.org/10.1016/j.sajb.2023.03.056
- 10Yang Z, Zhou Y, Han Z, et al. The effects of probiotics supplementation on Helicobacter pylori standard therapy: an umbrella review of systematic reviews with meta-analyses. Sci Rep. 2024;14. https://www.nature.com/articles/s41598-024-59399-4
- 11Xiong Y, Du L, Diao Y, et al. Association of dietary inflammatory index with Helicobacter pylori infection and mortality among the US population. J Transl Med. 2023;21. https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04398-8
- 12Sreeja S, Le T, Eom B, et al. Association between the dietary inflammatory index and gastric disease risk: findings from a Korean population-based cohort study. Nutrients. 2022;14(13). https://doi.org/10.3390/nu14132662
