Helicobacter pylori – are antibiotics the right way to treat it?

Helicobacter pylori infects 34% of Western Europeans, causes 95% of stomach ulcers, and is a major cause of stomach cancer. Currently it is treat by 'Triple therapy', two antibiotics and a Proton Pump Inhibitor (PPI). But is there a better way?

How long have we known about Helicobacter pylori?
Helicobacter pylori was discovered twice. It was discovered in the 19th century by German pathologists, who saw it in the stomach [although, they didn’t know at the time what organism it was. We now know that what they saw was probably H. pylori.]. It was present in everybody’s stomach — it hadn’t yet disappeared. They couldn’t grow it in culture, however, so doctors and scientists ignored it and ultimately forgot about it.
Then in the 1970s, a pathologist in Australia named Robin Warren and his associate, a physician named Barry Marshall, re-examined this, and they saw the organism again. But at this point, approximately only-half the people had it. They put together the idea that every person who had peptic ulcer disease had this organism and that it was, by and large, necessary for ulcers to form. Then they showed that if you treated people who had ulcers with antibiotics and got rid of the organisms, their ulcers would heal and stay away. This transformed medicine; it changed the treatment of ulcer disease, and in fact, they won the Nobel Prize [in Physiology or Medicine] in 2005 for that discovery.
And then others — my group and several other groups — showed that the bacterium was a cause of stomach cancer. Stomach cancer is a very important cause of death; worldwide, it’s number two or number three in all cancer deaths. It’s a very important disease, and Helicobacter pylori is the major risk factor for stomach cancer.
So between ulcers and stomach cancer, Helicobacter pylori was squarely put in the class of a pathogen — a bad organism. For decades, doctors thought the only good Helicobacter pylori was a dead one.

What is H. pylori doing in our stomachs when we have an ulcer?
That’s a very simple and good question, but the answer is not quite simple. We don’t fully know the answer. One of the ideas is that it’s causing an inflammatory state, and that’s changing the regulation of the hormones that control gastric acidity. It could be that the inflammation is like a weakening in the wall. Imagine there’s a wall, and it’s just getting eroded and weakened. That’s what an ulcer is.

How is it treated conventionally?

The standard medical treat meant for H. pylori is known as ‘Triple therapy’ – two antibiotics and a Proton Pump Inhibitor. The antibiotics are usually Clarithromycin, Amoxicillin, and Metronidazole.

The trouble is, these have a whole lot of side effects, and the reinfection rate is 80% after twelve months. That means the H. pylori comes back again. More antibiotics follow, more side effects follow, and often the bug comes back. If the patient has three rounds of this treatment, and H. pylori returns, it is deemed to be ‘resistant’, and no further treatment will be given.

What are the side effects of this treatment?

Common Side effects of Clarithromycin include:

  • gastrointestinal (GI) effects, general.
  • abnormal taste.
  • diarrhea.
  • nausea.
  • vomiting.
  • elevated blood urea nitrogen (BUN)
  • abdominal pain.
  • rash.
  • There are dozens more side effects which are less common.
Common Metronidazole side effects may include:
  • nausea, vomiting, loss of appetite, stomach pain;
  • diarrhea, constipation;
  • headache;
  • unpleasant metallic taste;
  • rash, itching;
  • vaginal itching or discharge;
  • mouth sores; or.
  • swollen, red, or “hairy” tongue.
  • There are dozens more side effects which are less common.

Common side effects of Amoxicillin include:

  • nausea.
  • vomiting.
  • diarrhea.
  • stomach pain.
  • vaginal itching or discharge.
  • headache.
  • rash, and.
  • swollen, black, or “hairy” tongue.
  • There are dozens more side effects which are less common.

What are the side effects of Proton Pump Inhibitors (PPIs)?

  • Headache.
  • Diarrhea.
  • Constipation.
  • Abdominal pain.
  • Flatulence.
  • Fever.
  • Vomiting.
  • Nausea.
  • For more information on the dangers of PPI’s go here.

Remember, these are just the common side effects, there is a whole host of other side effects.

Pylopass Study Overview