The stomach bacterium most people want to eliminate is Helicobacter pylori, a spiral-shaped organism that burrows into the stomach lining and can cause ulcers, chronic gastritis, and in rare cases, stomach cancer. Getting rid of it requires a specific combination of antibiotics taken for 14 days, often paired with an acid-reducing medication. The infection won’t clear on its own, and no home remedy can fully replace antibiotic treatment, though certain foods and supplements can meaningfully support the process.
How H. Pylori Is Diagnosed
Before treatment starts, you need a confirmed diagnosis. The two most common non-invasive tests are the urea breath test and the stool antigen test. The breath test has you swallow a small capsule or liquid containing a tagged form of urea. If H. pylori is present, the bacteria break down the urea and release carbon dioxide that shows up in your breath sample. This test catches the infection about 92 to 94% of the time.
The stool antigen test looks for H. pylori proteins directly in a stool sample and has a sensitivity around 83%. Blood tests (serology) can detect antibodies, but they only tell you that you were exposed at some point. They can’t confirm an active, current infection. For that reason, breath and stool tests are preferred both for initial diagnosis and for confirming the bacteria are gone after treatment.
The Standard Antibiotic Regimen
The recommended first-line treatment is called bismuth quadruple therapy, and it involves four medications taken together for 14 days: an acid-suppressing drug (a proton pump inhibitor, or PPI) taken twice daily, bismuth (the active ingredient in Pepto-Bismol) four times daily, tetracycline four times daily, and metronidazole three or four times daily. A 14-day course clears the infection in about 97% of people. A 10-day course is slightly less effective at around 90%.
This four-drug approach has become the global standard because antibiotic resistance has made older, simpler regimens unreliable. The previous go-to treatment, a three-drug combination built around the antibiotic clarithromycin, is no longer recommended unless lab testing has confirmed the bacteria in your stomach are sensitive to it. Clarithromycin resistance now exceeds 15% in the majority of countries surveyed, which means roughly one in six or more infections simply won’t respond to it. Tetracycline resistance, by contrast, remains below 1% worldwide, making it a far more dependable backbone for treatment.
If quadruple therapy fails or isn’t tolerated, alternatives include a rifabutin-based triple therapy and a newer dual therapy pairing a potent acid blocker called vonoprazan with amoxicillin. Rifabutin resistance is essentially zero globally (0 to 0.2%), so it serves as a reliable backup.
What Treatment Feels Like
Fourteen days of four medications is a demanding regimen. The most common side effects are nausea, a metallic taste in your mouth, headache, and abdominal discomfort. Bismuth can temporarily darken your tongue and stool, which is harmless. Metronidazole interacts poorly with alcohol, so you’ll need to avoid drinking entirely during treatment and for a couple of days after finishing.
The pill burden is significant. You’re taking medications up to four times a day, sometimes on specific schedules relative to meals. Missing doses is one of the most common reasons treatment fails, so setting phone alarms or using a pill organizer makes a real difference. Most people start feeling better within the first week as stomach inflammation begins to settle, but finishing the full 14 days is critical even if symptoms improve early.
Confirming the Bacteria Are Gone
After completing treatment, you need to wait at least four weeks before retesting. Testing too soon can produce a false negative because a small surviving population of bacteria needs time to rebound to detectable levels if eradication failed. The retest typically uses either a urea breath test or stool antigen test. Current guidelines say every treated patient should get this confirmation test, not just those who still have symptoms.
Foods That Help During Treatment
Certain foods won’t replace antibiotics, but clinical evidence shows they can improve your odds of clearing the infection and reduce side effects along the way.
Broccoli Sprouts
Broccoli sprouts are rich in a compound called sulforaphane that works against H. pylori in two ways: it acts as a direct antimicrobial agent and it activates the body’s own protective, anti-inflammatory defenses in the stomach lining. In a clinical trial published by the American Association for Cancer Research, people who ate broccoli sprouts daily for eight weeks showed significantly lower markers of H. pylori colonization and stomach inflammation compared to baseline. Eight out of 25 participants even dropped below the detection threshold on stool antigen testing. However, once they stopped eating the sprouts, bacterial markers climbed back to pre-treatment levels within two months. This suggests broccoli sprouts suppress H. pylori rather than permanently eradicate it, making them a useful complement to antibiotics rather than a standalone cure.
Probiotics
Adding a probiotic during and after antibiotic treatment can substantially boost eradication rates. In one trial, patients who took a Lactobacillus reuteri probiotic alongside standard therapy achieved a 93.2% eradication rate compared to 68.9% in the placebo group. The probiotic group also reported significantly less indigestion, abdominal pain, and constipation. Probiotics help by replenishing beneficial gut bacteria that antibiotics wipe out, which reduces gastrointestinal side effects and may create a less hospitable environment for H. pylori to survive.
Mastic Gum
Mastic gum, a resin from a Mediterranean tree, has a long folk reputation as a stomach remedy. A pilot study testing it as an add-on to standard quadruple therapy found an eradication rate of 85% in the mastic gum group versus 67% in the standard-treatment-only group. That’s a meaningful difference in absolute terms, but the study was too small to confirm the result statistically. What was clearly demonstrated is that mastic gum significantly improved dyspepsia symptoms like bloating and stomach discomfort, and it caused no additional side effects. It’s reasonable to try as a supportive measure, but not as a replacement for antibiotics.
Why Resistance Matters for Your Treatment
H. pylori is becoming harder to kill. Resistance to clarithromycin and levofloxacin (two antibiotics historically used in first-line and second-line regimens) now exceeds 15% in the majority of countries studied. Metronidazole resistance is the highest of any H. pylori antibiotic worldwide, though bismuth quadruple therapy can partially overcome metronidazole resistance through the combined action of the other three drugs.
This is why guidelines have shifted toward bismuth quadruple therapy as the default starting point. It doesn’t require knowing the resistance profile of your particular infection ahead of time, which matters because most people aren’t getting cultures done before treatment. If your first round of treatment fails, your doctor will likely switch to a different antibiotic combination, and at that point, susceptibility testing (growing the bacteria from a biopsy and checking which drugs kill it) becomes more important.
Preventing Reinfection
Once you’ve successfully cleared H. pylori, the annual risk of reinfection in Western countries is low, between 0.5% and 2%. In regions with higher prevalence and less reliable water sanitation, that rate can climb to 13% per year. The bacteria spread through contact with infected saliva, stool, or vomit, and through contaminated water and food.
Practical steps to reduce your risk:
- Don’t share utensils or cups with household members, especially if anyone’s infection status is unknown.
- Wash hands thoroughly after using the bathroom and before eating. Poor hand hygiene is a primary transmission route.
- Drink clean water, particularly when traveling to areas with less reliable water treatment.
- Test household members if you keep getting reinfected. A partner or family member may be carrying the bacteria and passing it back to you.
Most adults who are successfully treated and follow basic hygiene precautions stay infection-free long term. The combination of a full 14-day antibiotic course, confirmation testing at least four weeks later, and simple prevention habits gives you the best chance of eliminating H. pylori permanently.