H. Pylori Affects Half the Population—But Is It Harmful?

Helicobacter pylori (H. pylori) is a type of bacteria that is found in the stomach and small intestine. It is estimated that nearly half the population in the United States has H. pylori, and it is also present in many other countries around the world. While this bacteria often resides in the gastrointestinal tract without causing any issues, it's also to blame for some of the more common issues, like ulcers, gastritis, and even cancer.

Let's find out how and where you might be exposed to H. pylori, when it becomes a problem, and how you can treat it with functional medicine.

Learn more about conditions we treat: Digestive Health

What is H. pylori?

H. pylori is a tiny, spiral-shaped bacterium. It has flagella, which allows it to move about and attach itself to the stomach lining, where it's able to survive in the acidic environment of the stomach.

We share our bodies with many other organisms, including H. pylori, which many people carry without even realizing it. Carrying this bacteria often causes no symptoms at all for many people, but it can also be at the root of a number of digestive issues.

Symptoms of a Helicobacter pylori infection include indigestion (especially in the upper abdomen), burping or bloating, nausea, vomiting, or feeling full after only eating a small amount of food.

Read: Fight the Flu with ‘Good’ Bacteria

How do you get H. pylori? Is it contagious?

H. pylori bacteria is spread from person to person through contact with an infected person’s bodily fluids. It can be transferred through direct contact, or through contaminated food or water. While anyone is susceptible to it if they come into contact with H. pylori, some people are at a higher risk. Living or traveling to areas with crowded or unsanitary living conditions, a lack of clean running water, or living with someone with an H. pylori infection will all put you at higher risk.

In the developing world, H. pylori bacteria affects almost everyone during childhood, and it tapers off with age. But it tends to be the opposite in the U.S. Here, H. pylori infections are less common in young people, while up to half of all people carry it by age 60. The bottom line is that the chances of acquiring H. pylori at some point in your life are pretty high.

Related: 9 Natural Antimicrobials to Keep You Well This Winter

Is H. pylori harmful?

While it may be easy to think that the presence of H. pylori is always detrimental to health, the truth is that the role of H. pylori is complex. Research suggests that H. pylori can be benign, a problem, or actually beneficial in some circumstances. Understanding when H. pylori is acting in a harmful way is a growing area of research.

However, one international conference concluded that H. pylori should be defined as an infectious disease even in asymptomatic patients and that all patients should receive treatment for Helicobacter pylori eradication (1).

H. pylori—like other residents of the microbiome—has more than one role and it can be difficult to examine all of its complexities. It appears it can be both protective and detrimental. For example:

  • For example, H. pylori is associated with a decreased risk of gastroesophageal reflux disease (GERD) and esophageal cancer (2).
  • Conversely, H. pylori has been linked to an increased risk of gastritis and is believed to be the cause of about 90% of stomach ulcers and duodenal ulcers (3).
  • H. pylori infection is the strongest known risk factor for gastric cancer (4).

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Symptoms of H. pylori infection

Many people who have H. pylori present in their gut don't have any symptoms of H. pylori infection. However, for those individuals who do have a problem, H. pylori symptoms include:

  • Aching, burning, or sharp stomach pain
  • Bloating and burping
  • Inflammation of the stomach lining (gastritis)
  • Stomach pain that is more severe when the stomach is empty
  • Stomach pain that is relieved when treated with antacids
  • Ulcers
  • Difficulty swallowing
  • Pale skin

If you have symptoms of H. pylori infection, it's important to get the proper tests and treatment. If left untreated, H. pylori infection is associated with peptic ulcer disease, chronic gastritis, and gastric cancer. There may be a benefit to treating H. pylori in asymptomatic people, but this will depend on your individual risk factors.

What's the connection between H. pylori and stomach ulcers?

Stomach ulcers (or peptic ulcers) are sores that form in the lining of your stomach or the upper part of your small intestine. An ulcer happens when the mucus that protects these areas from digestive juices is reduced, and the digestive acids gradually eat away at the tissues.

H. pylori causes an inflammatory response with neutrophils, lymphocytes, plasma cells, and macrophages within the mucosal layer and causes harm to epithelial cells in the gut. It's recommended that all patients found to have peptic ulcers should be tested for H. pylori (3).

H. pylori infection is thought to be responsible for the majority of peptic ulcers. The infection can irritate the lining of your stomach, which leads to an ulcer.

Related: Is SIBO the Missing Link Between IBS and IBD?

H. pylori and gastritis

Gastritis is simply defined as inflammation of the stomach lining. It can be caused by a number of things, including H. pylori infections, certain OTC or prescription medications, autoimmune disease, and even stress.

Symptoms of gastritis include:

  • Abdominal pain
  • Hiccups
  • Acid reflux
  • Nausea and vomiting
  • Blood in stool 
  • Weight loss 
  • Bloating
  • Burping

Symptoms of gastritis are common, but if they persist it’s crucial to work with a functional medicine provider to resolve the underlying cause and regain healthy GI function.

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Treating H. pylori infection

The conventional approach to treating H. pylori infection is with a combination of antibiotics and acid-reducing medication.

The most common antibiotic treatment for H. pylori is a triple therapy of clarithromycin, amoxicillin, and metronidazole; or a combination of levofloxacin, amoxicillin, and metronidazole (5). This approach reduces stomach acid, while antibiotic therapy works to clear the H. pylori bacteria.

However, there are a few problems with this approach. First, H. pylori is becoming more and more resistant to antibiotics (6). Second, long-term use of PPIs can have serious side effects, including an increased risk of bone fractures, kidney disease, and dementia (7).

Because antibiotic resistance in some areas of the U.S. has exceeded the accepted threshold considered effective for treatment, a more functional approach is likely more beneficial.

What’s the functional medicine approach to treat H. pylori?

The first step is to test for H. pylori and identify which strains you’re infected with. This can be done with a stool test or a breath test performed in your doctor’s office. Once you know which strain you have, you can treat them with specific protocols. In some cases, an antibiotic and/or acid-reducing medication may still be recommended during treatment.

There are also a number of dietary supplements shown to be helpful in the treatment of H. pylori, including (8,9,10): 

These supplements can be taken individually or in combination. The best approach is to work with a qualified health practitioner who can tailor a treatment plan to your specific situation.

Should You Use Probiotics for H. pylori infection?

There’s growing evidence that probiotics help treat H. pylori infection. Probiotics are live bacteria and yeasts that are good for your health, and they can be found in supplements and certain foods. Given the increasing resistance of H. pylori to antibiotics, probiotics are part of a new strategy to increase the effectiveness of anti-H. pylori therapy.

Lactobacillus casei, Lactobacillus reuteri, Lactobacillus rhamnosus GG, and Saccharomyces boulardii can effectively eradicate H. pylori infection (11).  

Saccharomyces boulardii Probiotics and H. Pylori

Saccharomyces boulardii is a well-studied, yeast-based probiotic that has been shown to benefit everything from overall immune health, to Crohn’s disease, to basic digestive health. S. boulardii used in combination with conventional therapy has been shown to be effective at eradicating H. pylori, including infections in children (12). 

Lactobacillus and Bifidobacteria Probiotics and H. Pylori

Lactobacillus and Bifidobacterium probiotics have also been found to support successful treatment of H. pylori. These probiotics are found in fermented foods like yogurt and sauerkraut, or added to the diet with a supplement. 

The Bottom Line

H. pylori is a common infection that affects nearly half the world’s population. It’s important to be aware of the signs and symptoms of H. pylori and how you can be exposed to this bacteria. If you have H. pylori, there are a number of treatment options available, including the functional medicine approach. This approach uses dietary supplements, medications, and probiotics to treat the infection and support gut health. Work with a qualified health practitioner to create a treatment plan that’s right for you.


  1. https://pubmed.ncbi.nlm.nih.gov/26187502/
  2. https://www.karger.com/Article/FullText/504086
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140150/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952980
  5. https://pubmed.ncbi.nlm.nih.gov/32170476/ 
  6. https://pubmed.ncbi.nlm.nih.gov/29990487/   
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887997/ 
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925854/
  9. https://www.tandfonline.com/doi/full/10.3109/13880209.2014.952837
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146259/
  11. https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01977
  12.  https://pubmed.ncbi.nlm.nih.gov/16421034 


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