H. pylori is a troublesome infection that is often resistant to treatment. What foods and supplements might help support conventional therapy? Find out here.
What is H. pylori?
H. pylori is a dangerous species of bacteria that can infect the stomach and cause ulcers [1].
Standard antibiotic therapy for H. pylori has an eradication success rate of under 60%, with several long-term side effects.
Nutritional and supplemental strategies may help support conventional antibiotic therapy. Some nutrients can lower the levels of bacterial colonization and improve symptoms of stomach damage. Nutrition can also enhance the efficacy of standard antibiotic treatment and simultaneously prevent antibiotic side effects [1].
Foods and Supplements
In most cases, supplemental and nutritional therapies cannot permanently eradicate H. pylori. The best way to ensure that an infection with H. pylori is resolved is to precisely follow your doctor’s recommendations.
That being said, some foods and supplements have been associated with decreased H. pylori load or improved response to conventional therapies. While we strongly recommend against using any of the strategies below in place of what your doctor recommends, some of them may be helpful alongside prescribed medication. Your doctor can help you determine which complementary strategies could be right for you.
Possibly Effective
1) Lactobacillus & Saccharomyces Probiotics
In many clinical studies, the addition of certain probiotics to antibiotic therapy against H. pylori improved overall efficacy and reduced negative gastrointestinal side effects [2, 3, 4].
Use of the probiotics Lactobacillus, Bifidobacterium, and Saccharomyces boulardii improved the eradication rate of H. pylori by about 10% and reduced adverse effects of therapy by about 15% [2].
Probiotics with studies to indicate that they are beneficial against H. pylori colonization include: L. acidophilus [5, 6], L. reuteri [3, 7], L. delbrueckii ssp. bulgaricus with S. thermophilus [8], L. gasseri [2, 9, 10, 11], L. johnsonii [12, 13, 14, 15], L. salivarius [2], L. brevis [16], S. boulardii [1, 17], and B. infantis [3].
Probiotics effective in reducing H. pylori therapy side effects include: L. rhamnosus [1], L. reuteri [3, 7], S. boulardii [18, 19, 20, 4]. B. animalis spp. lactis [21], C. butyricum [22, 23], and B. subtilis [24].
The specific mechanisms of action by which probiotics improve infection rates are currently unknown [2]. Studies show that probiotics reduced the ability of H. pylori to effectively colonize the stomach, but it is not clear whether the effects are explained by competition for space and nutrients, changes in the stomach pH, chemicals produced by the other bacteria, or other changes caused by probiotic colonization [2].
Probiotic supplements are generally recognized as safe, but they may rarely produce side effects in people with compromised immune systems. To avoid any adverse effects or unexpected interactions, talk to your doctor before starting a new probiotic.
2) Fermented Foods & Beverages
Certain fermented beverages – especially wine, beer, and fermented milk – have produced promising clinical results in supporting H. pylori treatment.
In a cross-sectional study of over 10,000 people in England, moderate consumption of wine and beer was found to be somewhat protective against H. pylori infection. The authors suggested that moderate wine and beer consumption could produce an environment in the stomach that is hostile to H. pylori, thereby making it easier to eradicate the bacteria [25].
However, another study found that alcohol consumption was positively associated with H. pylori infection, suggesting that a component of wine and beer other than alcohol could be responsible for their apparent benefit [26].
Fermented dairy products such as yogurt and kefir were also found to be protective against H. pylori infection. Furthermore, the addition of yogurt to conventional therapy improved eradication rates in one trial of 347 patients [2, 3, 27].
Some authors have suggested that other fermented foods could protect against H. pylori, but that our poor understanding of specific ethnic fermented foods around the world is a major obstacle to using them in a clinical setting [2].
3) Broccoli Sprouts and Brassica Vegetables
Sulforaphane, a compound found in broccoli and broccoli sprouts, may inhibit the growth of H. pylori [1].
Researchers have suggested that sulforaphane may protect the mucosal membranes of the stomach, which may lead to reduced inflammation [28]. Improved mucosal membrane health may also make it more difficult for H. pylori to colonize the stomach effectively, explaining the reduced rate of colonization found in some studies [28].
In asymptomatic patients with confirmed H. pylori infection, eating 70 g/day of broccoli sprouts resulted in a significant decrease of colonization intensity [1]. Another study also reported a loss of H. pylori colonization following broccoli sprout treatment in four out of nine test subjects [29].
In type 2 diabetic patients infected with H. pylori, broccoli sprouts powder in addition to standard triple therapy showed a considerable improvement in H. pylori eradication, and also showed improved heart health in subjects [30].
In mice, H. pylori infections were effectively eliminated by sulforaphane injections [29].
However, a small study with H. pylori-colonized humans in Japan was unable to demonstrate an improvement when supplementing broccoli sprouts [29].
Other brassica vegetables (cauliflower, swede, headed cabbage, turnip, radish) also contain compounds similar to sulforaphane, called isothiocyanates. Patients who consume high amounts of isothiocyanates had a lower risk of gastric cancer [1].
4) Bismuth
According to the American College of Gastroenterology, there is significant clinical evidence to support the use of bismuth as part of a “quadruple therapy” against H. pylori, along with tetracycline, a nitroimidazole, and a proton pump inhibitor (PPI) [31].
Your doctor may or may not recommend bismuth as part of a treatment for H. pylori. Talk to your doctor before attempting to use it, as the FDA has only approved bismuth to treat diarrhea, and large amounts may be toxic to the kidneys [32].
Insufficient Evidence
The following substances have shown promise against H. pylori infection in limited, low-quality clinical studies; there is currently insufficient evidence to support their use in this context, and they should never be used to replace what your doctor prescribes. Remember to talk to your doctor before starting any new supplement or making significant changes to your diet.
5) Cranberry
In a study sponsored by a cranberry juice company, regular consumption of cranberry juice was effective in reducing levels of H. pylori colonization. However, the conflict of interest was clear here [29].
Cranberry juice contains chemicals that reduce the bacteria’s ability to cling to cells, which lowers their ability to colonize those cells [33]. This may explain why supplementation was able to improve treatment outcomes in H. pylori infection.
When cranberry juice was fed to mice infected with H. pylori, 80% of the mice were cured following the treatment. The eradication rate was 20% four weeks after the treatment [33].
Cranberry juice administered for three weeks inhibited H. pylori colonization rates in about 15% of asymptomatic, colonized children. However, in most subjects who became negative for H. pylori, the clearing effect did not persist following cessation of consumption [29].
In combination with traditional anti-H. pylori antibiotics such as metronidazole and clarithromycin, cranberry consumption improved eradication rates and suppressed infections in populations at risk for H. pylori [33].
6) Other Berries
Blueberry, raspberry, strawberry, blackberry, bilberry, and elderberry extracts enhanced the susceptibility of H. pylori to clarithromycin and demonstrate strong bacteriostatic activity against clarithromycin-resistant H. pylori strains [1, 29].
When adults with H. pylori infection were drinking blueberry juice during a 90-day period, 14% had a negative urea breath test on the 35th day. This effect was also maintained on the 90th day [1].
7) Garlic
Consumption of garlic for long periods of time did not affect the occurrence of H. pylori infection, but patients who ingested garlic had significantly lower H. pylori colonization rates than the group who did not [33].
In western China, those who ate raw garlic had a significantly lower level of H. pylori infection [33].
Several studies have proven that consuming vegetables in the garlic family is correlated with a reduced risk of gastric cancer, supporting the theory that compounds in garlic may have beneficial effects on stomach health or on H. pylori colonization [33].
Garlic contains chemicals called thiosulfinates, such as allicin, which has been shown to be toxic to bacteria, which may explain how supplementation was able to improve treatment [33]. These chemicals also have strong antioxidant abilities [33]. Downstream benefits from antioxidant intake could thus also explain the positive effects of garlic supplementation on infection and other immune processes.
Other studies have shown that garlic inhibits bacterial quorum sensing, which could also explain the decreased rate of infection [34, 35].
Extracts from raw garlic or garlic powder tablets kill H. pylori in the laboratory [33]. Garlic extract also prevents H. pylori-induced gastritis in animal studies [36].
One study found no beneficial effects on the rate of colonization in people ingesting garlic oil [33].
8) Polyunsaturated fatty acids
Polyunsaturated fatty acids, omega-3 and -6, inhibit the growth of H. pylori in the laboratory and decrease the prevalence of gastritis [1].
8-week supplementation with polyunsaturated fatty acids (PUFAs) induced bacterial clearance in 53% of patients by the end of treatment and 20% of patients 6 months later [37].
PUFAs decreased oxidative stress and inflammation induced by H. pylori infection and attenuated gastric cancer formation in mice [36].
However, a study showed that PUFAs added to a bismuth-based quadruple therapy had no effect on H. pylori eradication or inflammatory markers [37].
A specific omega-3 compound called docosahexaenoic acid (DHA) reduced the ability of H. pylori to colonize the gastric lining in 50% of mice. Combining DHA with a standard triple therapy decreased the recurrence of H. pylori infection in mice [37].
Evening primrose oil (rich in the omega-6 unsaturated linoleic acid) heals ulcers in rats [29].
Fish oil exhibited a significantly inferior H. pylori eradication rate compared with a conventional eradication regimen, but it improved symptoms in patients with non-ulcer dyspepsia regardless of H. pylori status [37].
9) Olive Oil
Olive oil led to a 10% successful eradication of H. pylori in two clinical trials. It is clearly unlikely to be effective alone, but in combination with other strategies it may help; further research is required [38].
10) Ginseng
In one early clinical study, Panax ginseng (Korean ginseng) significantly improved the eradication rate when added to the conventional H. pylori eradication regimen [36].
According to some researchers, Panax ginseng may improve the response of antibody molecules, which protect the body from invasive microbes [39]. This may help explain the improvements seen in treatment.
11) Curcumin
Curcumin has been used to heal peptic ulcers as well as to prevent H. pylori growth [33]. Treatment with turmeric healed peptic ulcers in 48% of patients after 4 weeks and 76% of patients after 12 weeks of treatment. Abdominal pain and discomfort significantly lessened during the first and second weeks [33].
Curcumin protects from ulcers and inhibits bacterial quorum sensing [40, 41, 42, 43]. This may help explain the protective effects in H. pylori treatment.
Curcumin is capable of eradicating H. pylori in mice but does not seem to completely eradicate the bacteria in people [33]. Poor absorption of curcumin in people could contribute to this ineffectiveness [44, 33].
12) Licorice
In patients with peptic ulcer disease or non-ulcer dyspepsia, clarithromycin treatment in combination with licorice helped reduce colonization levels [45].
In patients with peptic ulcer disease, licorice was as effective as bismuth at reducing H. pylori [46].
Some chemicals in licorice help reduce inflammation and improve immunity, which could help explain the benefits of supplementation [47].
Licorice ameliorated H. pylori-induced stomach lesions in mice [36].
13) Cinnamon
In a clinical trial in patients with high H. pylori colonization, there was a decline in H. pylori following cinnamon ingestion [29].
14) Mastic Gum
Mastic gum is a resin produced by the Pistacia plant that is being investigated for the treatment of stomach ailments [33].
Clinical trials of mastic gum in H. pylori treatment showed both negative and positive outcomes, indicating that benefits may be limited or purely complementary [29].
In some studies, mastic gum was unable to eradicate H. pylori infection in mice or humans [33].
Other studies showed that mastic gum prevented H. pylori-related inflammation in patients [33] and led to eradication in some cases [48].
15) Lactoferrin
Lactoferrin binds to iron ions, and thus limits the availability of iron to bacteria [1].
There have been both positive and negative results in clinical trials testing the effects of oral lactoferrin [29]. The supplementation of lactoferrin, in addition to antibiotic and proton pump inhibitor therapy, increased the rate of effective eradication and decreased side effect severity [1].
Another study with H. pylori-positive patients showed that the administration of lactoferrin alone effectively suppressed the colonization of H. pylori in the stomach [49].
In mice, lactoferrin decreased bacterial colonization and H. pylori-induced gastritis [1].
16) Propolis & Honey
Propolis and raw honey have anti-H. pylori activity. Propolis also has anti-inflammatory and immune-stimulatory activity – both mechanisms clearly important in the pathophysiology of H. pylori infection [29, 50].
Oaktree and manuka honey, exhibit strong anti-H. pylori activity. In patients with dyspepsia, honey intake at least once a week was associated with a significantly lower prevalence of H. pylori infection [1].
17) CoQ10
The combination of standard antibiotic triple therapy with CoQ10 had a positive effect on the stomach lining inflammation and decreased oxidative stress in patients with chronic gastritis [51].
Animal Research (Lacking Evidence)
No clinical evidence supports the approaches listed below to combat H. pylori infection. Below is a summary of the existing animal and cell-based research, which should guide further investigational efforts. However, the studies listed below should not be interpreted as supportive of any health benefit.
18) Ginger
Ginger root has traditionally been used for treating various gastrointestinal ailments including dyspepsia, peptic ulcer, motion sickness, and inflammation [33].
Ginger extract can protect the stomach from stress-induced stomach lining lesions and inhibit gastric acid secretion, thus restricting H. pylori growth [33].
In animal studies, ginger extract prevents and treats H. pylori-induced infection and inflammation [33].
Studies have shown that ginger inhibits bacterial quorum sensing, which could explain the decreased rate of infection [52].
19) Green Tea
Green tea extract showed anti-H. pylori adhesion effects in a small trial of rhesus monkeys [29].
Green tea extract was also shown to partially inhibit enzymes used by the bacteria, which could limit their growth [29].
In animal studies, green tea catechin administration resulted in a 36% H. pylori eradication [53].
Similarly, the administration of green tea polyphenol in drinking water dose-dependently suppressed H. pylori infection in animal studies [54].
20) Others
More than 80 plant extracts exhibit anti-H. pylori activity. In most cases, however, studies in humans are lacking; this means that there is no clinical evidence to recommend using them against H. pylori infection. Some of the plants, compounds, and supplements currently under investigation are listed below:
- Acacia nilotica, a medicinal plant native to Africa and India [55].
- Apigenin, a natural product found in various plants, was effective in Mongolian gerbils. Apigenin has the remarkable ability to inhibit H. pylori-induced gastric cancer progression [55].
- Apple peel polyphenols, effective in mice [55].
- Aristolochia paucinervis, a Moroccan medicinal plant [55].
- Avocado plant [55]
- Bacopa or water hyssop [56].
- Basil [57]
- Berberine (from the barberry bush and goldenseal) [29, 3].
- Bixa Orellana from tropical Americas [57].
- Black Cumin seed [58]
- Brown seaweed [29]
- Byrsonima fagifolia and B. intermedia, Brazilian traditional herbal remedy, leaf extract [57].
- Carvacrol, a compound found in the essential oil of oregano, oil of thyme, oil obtained from pepperwort, and wild bergamot [3].
- Casuarina equisetifolia, a plant native to southeast Asia, Australia and Oceania [55].
- Centaurea solstitialis flowers, Turkish anti-ulcerogenic folk remedy [55].
- Chamomile [57]
- Chelerythrine, an alkaloid present in the plant Chelidonium majus (greater celandine) [3].
- Chinese mushroom extracts [57].
- Cinnamaldehyde, found in cinnamon [3].
- Davilla nitida leaf extract, a South- and Central-American plant [57].
- Eucalyptus [57]
- Eugenol, found in clove oil, nutmeg, cinnamon, basil and bay leaf [3].
- Evodia rutaecarpa fruit alkaloids, traditionally used in Chinese medicine [55].
- Fagonia Arabica, a tropical herb found in India [55].
- Feijoa sellowiana fruit extract, a South American tree [57].
- Fermented rice extract [29]
- Fingerroot (Boesenbergia rotunda), found in China and Southeast Asia, effective in Mongolian gerbils [55, 29].
- Green Algae (Haematococcus and Chlorococcum), effective in mice [59, 60].
- Hancornia speciose, South American plant bark extract [57].
- Impatiens balsamina, a Taiwanese folk medicinal plant [55].
- Juniper [57]
- Larrea divaricate, or chaparral, a South American plant [57].
- Lavender [57]
- Lemon grass essential oil, effective in mice [29, 57].
- Lemon verbena [57]
- Licoisoflavone B and licoricidin, found in licorice [3].
- Marjoram [57]
- Mediterranean cypress [57]
- Melaleuca alternifolia or narrow-leaved paperbark [57].
- Mint [57]
- Myrtle [57]
- Nepeta camphorata and argolica essential oils, found in Europe and Asia [57].
- Nutmeg [29]
- Okinawamozuku (Cladosiphon okamuranus), edible seaweed from Okinawa, effective in Mongolian gerbils [50].
- Okra [29]
- Pau D’arco (pink trumpet tree) bark tea [61].
- Peppermint oil [29]
- Plumbagin, found in the Plumbago plants [3].
- Polyphenolic catechins, found in green tea [3].
- Pomegranate [57]
- Qualea parviflora bark extract, a South American plant [57].
- Quercetin, a compound found in many fruits, vegetables, leaves, and grains [62, 3].
- Ravensara aromatic, from Madagascar [57].
- Rosemary [29, 57]
- Sanguinarine, found in the bloodroot plant [3].
- Sicilian lemon essential oil [57].
- Strychnos pseudoquina, a Brazilian plant [57].
- Tannins, present in various plant tissues [3].
- Vitamin C eradicates pylori infection in 30% of patients treated [63].
- Walnut (Juglans regia) [57]
- Yerba Mate [57]
- Zinc [64, 65]
- Refined deep seawater (RDSW) – actually exhibited anti-H. pylori activity and its intake significantly decreased H. pylori colonization in infected patients [50].
Factors that May Promote H. pylori Infections
1) Salt
Higher salt intake is associated with an increased rate of H. pylori infection [66].
Studies have found that H. pylori bacteria thrive better in conditions with high salt, which may explain this correlation [66].
This is only one of many adverse effects that can result from excessive salt intake. For a more in-depth discussion of the two faces of salt, check out this post.
2) Smoking
H. pylori infection is more common in smokers, and eradication therapy is less effective. Nicotine increases the toxic activity of H. pylori in the stomach [67].
Smoking patients with more virulent H. pylori infection have a strongly increased risk of gastric cancer [68].
Smoking is well-known to cause many poor health outcomes and adverse effects. If you smoke, we strongly recommend talking to your doctor about strategies that could help you quit [69].
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