Helicobacter pylori infection — what to take?

Medical body content is still in Romanian:

Manifestations

Chronic gastritis (often asymptomatic), gastric/duodenal ulcer, functional dyspepsia, vitamin B12 deficiency, iron deficiency anaemia, a risk factor for gastric cancer.

Diagnosis

Non-invasive: labelled urea breath test, stool antigen, IgG antibodies (screening only). Invasive: endoscopic biopsy with rapid urease test or culture/PCR.

Treatment — triple therapy for 14 days

• PPI 20-40 mg twice daily.
• Amoxicillin 1000 mg twice daily.
• Clarithromycin 500 mg twice daily.

In penicillin allergy — metronidazole instead of amoxicillin.

In treatment failure or resistance — quadruple bismuth therapy (bismuth subcitrate + metronidazole + tetracycline + PPI) for 10-14 days.

Confirmation of eradication

Breath test or stool antigen 4-8 weeks after completing treatment (with PPI stopped 2 weeks beforehand).

OTC adjuvants with evidence

• Bovine lactoferrin — synergistic antibacterial effect.
• Probiotics (Saccharomyces boulardii, Lactobacillus) — reduce antibiotic side effects.
• Broccoli extract/sulforaphane.
• Manuka honey — mild antibacterial effect.

Medical disclaimer: the information in this guide is for informational purposes only and does not replace advice from a doctor or pharmacist. For diagnosis and treatment, consult a healthcare professional.