Microaerophilic curved gram negative rods.
Human to human from fecal oral OR oral oral. Spread not well worked out. In Japan it is spread from mother to child (PubMed).
H. pylori has been in humans as long as we have been a species and we may have given it to lions when they ate us 200,000 years ago (PubMed).
Gastritis, gastric ulcers and gastric carcinomas. Also, may be a cause of bad breath (PubMed).
Sequential therapy may be superior in treatment naive patients in one meta-analysis (PubMed). Because of increasing resistance (widespread use of amoxicillin and clarithromycin is driving this phenomena and probably accounts for increasing treatment failure rates), the following regimen MAY be preferred (PubMed):
10-day sequential regimen of ppi, 1 g of amoxicillin, each bid for the first 5 days, THEN ppi, 500 mg of clarithromycin, and 500 mg of tinidazole (metronidazolein the US), all BID for the remaining 5 days.
ppi 40 mg qd PLUS clarithromycin 500 mg tid x 2 wks, then ppi qd x 2 wks.
Ranitidine bismuth citrate 400 mg bid AND clarithromycin 500 mg tid x 2 wks, then Ranitidine bismuth citrate 400 mg bid x 2 wks.
Ranitidine bismuth citrate 400 mg bid PLUS clarithromycin 500 mg bid x 2 wks, then Ranitidine bismuth citrate 400 mg bid x 2 wks.
*Although not FDA approved, amoxicillin has been substituted for tetracycline in patients for whom tetracycline is not recommended (CDC).
Treatment also reduces the risk of gastric cancer (PubMed).
The prolific use of macrolides for other reasons is, not surprisingly, leading to H. pylori resistance (PubMed). As the old saying goes: "Use it and lose it."
It pains me to mention this, but adding to standard therapy 100 mg of bovine lactoferrin PLUS the probiotic Probinol-Cadigroup 5 gm qd increased the cure rate to 92% (PubMed).
The treatment of H. pylori may result in the resolution of chronic bad breath (PubMed).
Now you may not think this is cool, but genetic testing shows helicobacter came out of Africa with humans 58,000 years ago (PubMed). And you think cardiology is neat. Ha.
And having Helicobacter may be protective for Shigella and other infectious diarrhea (PubMed).