H. pylori

Routine annual

also helicobacter pylori

What it isA spiral bacterium that colonizes the stomach lining, often acquired in childhood and persisting silently for decades. Detected by stool antigen, urea breath test, or biopsy; antibody testing remains positive after eradication and is less useful for active infection.

DoesDrives chronic gastritis and is the leading infectious cause of peptic ulcer disease and gastric adenocarcinoma.

GoodA negative stool antigen or breath test in someone with dyspepsia rules out H. pylori as the cause and avoids unnecessary antibiotics.

BadActive infection causes gastritis, peptic ulcers, iron deficiency, B12 deficiency, and over decades raises gastric cancer and MALT lymphoma risk. Untreated infection is a known carcinogen.

Standard

Negative.

Optimal

Negative on stool antigen or breath test (lower is good)

Modifiers

Proton pump inhibitors, bismuth, and antibiotics within four weeks of testing cause false negatives.

How to optimize

Lifestyle: Hand hygiene, clean water, and food safety reduce acquisition; smoking worsens ulcer disease.
Diet: Avoid heavy alcohol and NSAIDs which compound mucosal damage; broccoli sprout sulforaphane and cranberry have modest in-vitro activity.
Supplements: Mastic gum 1 g/day, broccoli sprout extract, probiotics (Lactobacillus, Saccharomyces boulardii) as adjuncts to triple therapy.
Peptides: BPC-157 (gastroprotective and ulcer-healing in preclinical work).
Drugs: Clarithromycin-based triple therapy or bismuth quadruple therapy for two weeks is standard eradication. --

within Infections