Antibiotics are still the treatment of choice for H. Pylori bacteria

Q: My husband was diagnosed with H. pylori, and his doctor wants to use antibiotics to treat it. I am wondering if there are any natural approaches he could use instead.

A: Helicobacter pylori, otherwise known as H. Pylori, is a bacterium that can infect the stomach, and is found worldwide. Most people who are infected will never develop any problems, but it can also cause ulcers and stomach cancer. The downside is that it is sometimes hard to figure out who is going to develop problems from the infection and who isn't.

This puts doctors in a bind. On the one hand, you don't want to treat people with antibiotics if they don't really need them. On the other, you definitely want to treat people who are likely to develop negative consequences — such as cancer — from H. pylori infection. Different medical organizations have done their best to come up with criteria about who should be tested and treated for H. pylori. For instance, it makes sense that people with ulcer symptoms, or who have been diagnosed with an ulcer using imaging studies, should be tested and treated, typically with antibiotics.

The typical treatment for H. pylori is antibiotics. Because the bacteria are tough, you usually have to use more than one antibiotic at once to get rid of them.

If your doctor recommends that your husband be treated for H. pylori, I would do that. You can always get a second opinion, but I would still follow the doctors' recommendations. When it comes to treatment, I would choose the method that has the most data supporting it — and so far, that is still antibiotics.

As for natural methods, the best research suggests combining probiotics — otherwise known as "healthy bacteria" — with conventional medical antibiotic treatment. There isn't much convincing data to support using natural treatments alone to treat H. pylori.

Some studies have shown that taking probiotics helps to offset some of the side effects of antibiotic treatment, such as diarrhea and changes in taste. Probiotics that studies have found helpful include Lactobacillus, bifidobacteria and Saccharomyces boulardii. You can find these in a health-food store, usually in the refrigerated section. Some brands will combine several of them into one capsule.

Dr. Astrid Pujari is a Seattle M.D. with an additional degree as a medical herbalist; she practices at the Pujari Center and teaches as part of the residency programs at Virginia Mason and Swedish/Cherry Hill hospitals. Send questions to apujari@seattletimes.com for possible use in future columns. All information is intended for education and not a substitute for medical advice. Consult your doctor before following any suggestions given here.