H. pylori Infection

What is H. pylori Infection?

H. pylori (Helicobacter pylori) infection is a bacterial infection of the stomach lining. It is a common, long-lasting infection that causes chronic gastritis and increases the risk of peptic ulcers and stomach cancer.^{[1, 2]} A pooled analysis estimated that about 43 percent of people worldwide were infected in 2011 to 2022, down from about 58 percent in 1980 to 1990.^[3]

Common symptoms

Most infections cause no symptoms, so many people do not know they are infected.^[4] When symptoms occur, they include upper abdominal pain or discomfort, bloating, nausea and indigestion, and the infection can cause peptic ulcers.^[5]

Causes and risk factors

The infection is usually acquired in childhood and can last for decades if it is not treated.^[2] Infection is less common in high-income countries and in younger people, and it is more common in some racial and ethnic groups and immigrant communities in the United States.^{[3, 4]}

How it is diagnosed and treated conventionally

H. pylori is diagnosed with breath or stool tests, or with a stomach biopsy taken during endoscopy.^[6] Treatment is a prescribed combination of antibiotics and acid-reducing medicine. In North America, a 14-day bismuth quadruple regimen is the preferred first treatment when antibiotic sensitivity is unknown, and the ACG guideline advises a test after treatment to confirm the infection is gone.^[5]

Treatment is getting harder because resistance to commonly used antibiotics has reached high levels worldwide.^[7] Clearing the infection matters because treatment was associated with about half the odds of later stomach cancer in a long-term randomized trial in a high-risk region of China.^[8]

Why H. pylori Infection calls for a whole-person approach

The infection itself is a medical problem that needs medical treatment. Around it, though, are other factors that can affect how a person feels, such as inflammation of the lining, the effects of antibiotic courses on the gut, and stress. Supportive care can address some of these, and cannot replace the treatment.

Chronic inflammation of the stomach lining

H. pylori colonizes the stomach for many years and drives continuing inflammation. In some people this slowly progresses to atrophy of the lining, which is the main step toward stomach cancer.^{[2, 6]} This is why follow-up with a physician matters, even when symptoms are mild.

Side effects of eradication therapy

Antibiotic regimens often cause diarrhea, nausea and a bad taste. A meta-analysis of 19 trials found that adding probiotics to bismuth quadruple therapy lowered side effects, especially diarrhea and nausea, and also improved the eradication rate.^[9] Whether anything outside medicine can ease these effects is worth discussing with your prescriber.

The gut microbiome

Researchers are interested in the wider gut bacteria because antibiotics disturb them. A meta-analysis of 12 trials found probiotics taken before eradication therapy were linked to higher eradication and fewer side effects, although a separate trial of Saccharomyces boulardii or a broccoli-sprout extract found no benefit.^{[10, 11]}

Stress and digestive symptoms

People with long-term upper digestive symptoms often feel worried about symptoms, testing and treatment. We found no studies of stress reduction specific to H. pylori, so any help from relaxation-focused care would be for symptoms and stress in general and not for the infection.

Acupuncture as supportive care in H. pylori Infection

What the research shows

A PubMed search found no clinical trials showing that acupuncture clears H. pylori or changes the course of the infection. Evidence for acupuncture is for related conditions only. A 2025 review of acupuncture and related external therapies for chronic gastritis, covering animal and clinical studies, reported symptom benefits for abdominal distension, acid reflux and stomach pain, and said high-quality, large clinical trials are still needed to establish efficacy.^[12]

Acupuncture does not replace antibiotics. People with H. pylori need testing and the prescribed regimen.^[5]

How acupuncture may work

The proposed mechanisms come from the chronic gastritis review. It lists effects on stomach lining function, inflammation, oxidative stress, gastrointestinal hormones and gut bacteria, and says these still need confirmation.^[12] These are proposed explanations, not proven effects on the infection.

What treatment involves

Treatment uses fine, sterile, single-use needles placed at points on the abdomen, arms, legs and back, usually left in place for about 20 to 40 minutes. A course is several visits, with reassessment along the way. If you are taking an antibiotic course, tell us the dates so visits can be planned around it.

Serious problems from acupuncture are rare. In prospective studies, about 9 in 100 patients had a minor reaction such as bleeding, soreness or redness at a needle site, and serious events occurred in about 1 in 10,000 patients.^[13] Tell the practitioner first if you have a bleeding disorder, take blood thinners, are pregnant, or have a pacemaker (relevant to electroacupuncture).

Ayurvedic medicine as supportive care in H. pylori Infection

The Ayurvedic view

Ayurveda does not have a category for a bacterial infection of the stomach. Burning, sour, acidic stomach complaints are traditionally described as Amlapitta, linked to aggravated Pitta and weak digestive fire (agni). These are traditional categories for choosing supportive care, not biomedical diagnoses.

Therapies that may be used

Care is chosen for the individual and traditionally combines:

• Regular meal times and a diet that avoids very spicy, sour, fried and heavy foods
• Stress-reducing routines and steady sleep hours
• Herbs traditionally used for Pitta-type digestive complaints, prescribed individually

Panchakarma is not appropriate for people with an active infection or ulcer symptoms, during pregnancy, acute illness or frailty, or before a physician has assessed the symptoms.

What the research shows

We found no trials of Ayurvedic treatment for H. pylori infection. The closest evidence is for turmeric (curcumin), a spice used in Ayurveda. In a randomized trial of people with H. pylori gastritis, curcumin alone cleared the infection in about 6 percent, against about 79 percent with a standard three-drug regimen, and it did not lower stomach inflammation markers.^[14] Another trial found that adding curcumin to standard triple therapy improved inflammation scores and eradication compared with triple therapy alone.^[15] That is an addition to medical treatment, studied in a single trial, and not a substitute.

Herbal medicine as supportive care in H. pylori Infection

Herbs and formulas that have been studied

Research covers Chinese herbal decoctions for atrophic gastritis and for precancerous stomach lesions, and food-derived products such as garlic and broccoli sprout extract in people with H. pylori. Individual herbs are used in Chinese medicine for stomach complaints, but this research is mainly in people who already have gastritis.

What the research shows

Evidence is limited and mixed. A meta-analysis of 42 trials (3,874 patients) found Chinese herbal decoctions, alone or with Western medicine, improved symptoms and biopsy findings in atrophic gastritis compared with Western medicine, but the evidence did not support their use on their own to clear H. pylori.^[16] A meta-analysis of trials in precancerous stomach lesions found traditional Chinese medicine did better than routine drugs for clinical efficacy and H. pylori eradication rate, and called for more rigorous trials.^[17]

A long-term randomized trial in a high-risk region of China found that garlic supplements were linked to fewer stomach cancer deaths, but not to a significant drop in new cancers.^[8] The trial does not show that eating garlic clears the infection, and results may not apply in the United States.

Safety and herb-drug interactions

Eradication regimens combine several prescription drugs, so every herb or supplement should be reviewed by your prescribing physician and by us. Case reports describe extra bleeding when warfarin or aspirin was combined with herbs including dan shen, garlic and ginkgo.^[18] Tell us about all antibiotics, acid reducers and blood thinners you take.

Some herbal products can injure the liver, and about one fifth of Ayurvedic products bought online contained detectable lead, mercury or arsenic.^{[19, 20]} Herbs should come from tested sources and be prescribed individually. Tell us if you are pregnant or breastfeeding, or have liver or kidney disease. A herbal preparation applied to the skin (transdermal medication therapy) is also available, but we are not aware of trials of it for H. pylori infection.

Translating traditional medicine into modern biological language

The links drawn here are interpretation, not equivalence. Chinese medicine describes many chronic stomach complaints as a pattern of spleen-stomach deficiency with cold, or of liver qi stagnation in which stress disturbs digestion. Researchers studying supportive care in gastritis look at things that loosely parallel this picture: lining inflammation, oxidative stress, digestive hormones and gut bacteria.^[12]

Ayurveda's aggravated Pitta and weak agni describe burning discomfort and poor digestion. No study has shown that a dosha or agni corresponds to infection with a specific bacterium.

How this care fits with your medical care

Supportive care is complementary. H. pylori is an infection that needs a physician's diagnosis and prescribed treatment. Do not stop or change antibiotics or other prescribed medicines without your prescriber, and complete the course you are given. We do not test for or treat H. pylori itself.

For a condition like this, we ask that you are under a physician's care for it and that your treating team knows you are receiving complementary care. Please bring your test results, any endoscopy or biopsy reports, the dates and names of your treatment, and a full list of medicines and supplements.

When to seek urgent medical care

Some symptoms point to a bleeding ulcer or another serious complication that needs prompt medical care.^[5]

• Vomiting blood or material that looks like coffee grounds
• Black, tarry or bloody stools
• Sudden or severe abdominal pain
• Repeated vomiting or being unable to keep fluids down
• Trouble swallowing or unintended weight loss
• Dizziness, fainting or unusual paleness

If any of these occur, call 911 or go to the nearest emergency department.