Patients with a history of peptic ulcer disease, active gastric ulcer, or active duodenal ulcer associated with H. pylori infection should receive treatment for the infection. Successful treatment of H. pylori can lead to one or more of the following:
- A higher rate of ulcer healing
- A lower risk of recurrent ulcers
- A reduced risk of complications such as bleeding
Medications — No single drug effectively cures H. pylori infection. Treatment involves taking several medications for 7 to 14 days.
- Most of the treatment regimens include a medication called a proton pump inhibitor. This medication decreases the stomach's production of acid, which allows the tissues damaged by the infection to heal. Examples of proton pump inhibitors include lansoprazole (Prevacid®) (Prilosec®) (AcipHex®) and (Nexium®).
- Two antibiotics are generally recommended; this reduces the risk of treatment failure and antibiotic resistance.
Side effects — Up to 50 percent of patients have side effects of H. pylori treatment. Side effects are usually mild, and fewer than 10 percent of patients stop treatment because of side effects. For those who do experience side effects, it may be possible to make adjustments in the dose or timing of medication. Some of the most common side effects are described below.
- Alcoholic beverages (eg, beer, wine) should be avoided while taking metronidazole; the combination can cause skin flushing, headache, nausea, vomiting, sweating and a rapid heart rate.
- Bismuth, which is contained in some of the regimens, causes the stool to become black and may cause constipation.
- Many of the regimens cause diarrhea and stomach cramps.
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