Treating H.pylori infection

All ulcers associated with H. pylori should be treated with the aim of eradicating the infection, which restores normal mucosal resistance. Unlike with other treatment options, maintenance therapy to prevent ulcer recurrence is not required.

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Although H. pylori is sensitive to a variety of antibiotics in the lab, its habitat beneath the mucous lining makes it difficult to treat. The gold standard has been two weeks of triple therapy, using a proton pump inhibitor to suppress acid and protect the lining of the stomach along with two antibiotics, amoxicillin and clarithromycin. When the treatment is vigilantly followed, the cure rate is at least 90 to 95 percent. But many patients have trouble with this treatment because it may require taking up to eight pills a day. And about 20 percent of people undergoing triple therapy develop such side effects as nausea, vomiting, diarrhea, headache, and yeast infections. Newer, simpler regimens are being developed. For example, a combination pill (Prevpac) containing lansoprazole, amoxicillin, and clarithromycin in one pill requires patients to only take two pills a day.