Helicobacter pylori (HP) is a bacterium which infects the mucous lining of the human stomach. The bacterium Helicobacter pylori is mainly responsible for chronic gastritis, duodenal ulcers and plays an important role in the genesis of some gastric cancers. Only known since 1980, this infection is acquired in the childhood and in the vast majority of cases, it becomes chronic, comes along with an inflammation of the gastric mucous and is the cause of 90 % of all the chronic gastritis.
The transmission is intra-family (mother / child, sibship) and continues during decades, even all the life of the infected person. Approximately 10 % of the infected persons, will develop an ulcerous disease.
Forty percent of the European population are infected and more than 80 % in poor countries.
The HP lives exclusively in the human stomach and is the only known organism that can survive in an environment so acidic. It has a helical shape (hence the name "Helicobacter") and can literally screw into the stomach lining to colonize it ! The stomach produces two substances, hydrochloric acid and pepsin. These very irritating substances are kept at a distance from the stomach wall by the mucus.
The pathologies appear during an excessive secretion of acid or during an insufficient protection by the mucus.
The presence of HP multiplies by 30 the risk of stomach cancer and it seems that stomach cancer cannot develop in its absence. A strong relationship is established between poverty and infection by Helicobacter pylori.
Currently, it is advisable to systematically eradicate Helicobacter, to make preventive treatment for patients who had a partial gastrectomy for cancer, detect the first-degree relatives and the carriers of preneoplastic histological lesions (atrophy, metaplasia).
Alcohol, stress, some medications (aspirin and anti-inflammatory drugs) and primary infection to Helicobacter pylori are the main causes of several gastro-duodenal pathologies.
Usually, bacteria do not resist in the acid middle of the stomach, however, Helicobacter pylori secretes an enzyme (urease) which allows it to survive at the gastric juices by neutralizing them. The bacterium then acts in two ways, it increases the secretion of gastric juices and weakens the structure of the gastro-duodenal mucous. Less protected, the wall of stomach or the duodenum is then attacked by the gastric juices.
Classically a biopsy is performed at any endoscopy, it allows to identifies the presence of HP.
Other tests have been developed but are not used or present in all European countries.
The screening by analysis of exhaled breath to marked urea is available in some countries (France). A kit is available in pharmacies and sent to the laboratory, it has an interest to check the effectiveness of the treatment.
The blood screening can be useful. Unfortunately, it remains positive many months after eradication of the HP and is thus difficult to use.
A final technique of diagnosis of Helicobacter pylori is based on the revealing in the saddles of antigens of this germ by immunological dosage, this test gives a 96 % sensibility, a 93 % specificity and positive predictive values of 92 % and negative of 96 % and is not currently performed routinely.
In conventional medicine treatment, a triple therapy of seven days associating an inhibitor of the proton pump with two antibiotics, allows to get rid of it in 70 % of the cases. For resistant patients, a second treatment, quadritherapy, more powerful and longer, removes the bacteria in 63 % of cases, in total, an eradication rate of 90 %. The inflammation persists for 6-24 months and the mucosa returns to normal. If it was already reached, the lesions persist, but their extension and aggravation are definitively stopped.
The lesions of chronic gastritis settle down and injuring the mucous membranes, slowing the transit and allowing the relocation of the bacterium.
The treatment of the infection is typically made through essential oils.
Fight against the infection or recurrence.
Essential oils are in first place in the fight against Helicobacter pylori.
The anti-infective are mainly essential oils such as Phenol as Origanum compactum, Thymus vulgaris in thymol, Melaleuca alternifolia, Cinnamomum zeylanicum leaves. The Clove (Eugenia caryophyllata) inhibits the growth of Helicobacter pylori.
The inhibitive average concentration (IAC) is 40 µg / ml for Clove.
Will be found in the essential oils rich in aldehydes as Cinnamomum zeylanicum or rich in sequiterpene as Chamomilla recutita and Zingiber officinalis an important anti-inflammatory action.
Some essential oils rich in monoterpenes as Foeniculum vulgare or Salvia officinalis exert a cicatrizant action.
The antispasmodic action is marked in Artemisia dranunculus and Zingiber officinalis.
Several essential oils as Mentha piperita and Lemongrass showed a clear in vitro inhibition of proliferation of HP.
In the treatment of gastro-duodenal pathologies, herbal medicine can also be useful.
Some isoflavones inhibit the growth of Helicobacter pylori. This action is less important than their oestrogenic action, which limits the use of standardized manner. It is about Glycine max, Medicago sativa (alfalfa), Cimifuga racemosa.
The glycyrrhizin has an anti-inflammatory action, it inhibits the production of PGE2 and increases the production of stomach mucus, the lifetimes of the epithelial cells of the stomach and inhibits the secretion of pepsinogen. The glycyrrhetic acid partially blocks the degradation of adrenal hormones, in particular the cortisol. Therefore, it prolongs their biological effects in humans. In vitro, the hydroalcoholic extract of Liquorice inhibits Helicobacter pylori strains with minimum inhibitory concentration (MIC) of 50 to 400 mg/ml.
Some Brassicaceae like cabbage or broccoli Brassica oleacera contains glucosinolates which under the action of an enzyme, are transformed into sulforaphane. This molecule inhibits the growth of Helicobacter pylori in 8 of 11 cases. The antiacid activity of these vegetables disappears in the cooking.
Cranberry, the cranberry has an antiinfective action and allows a better absorbtion of vitamins B12 in atrophic gastritis. The high molecular weight polysaccharides of cranberry inhibit the adhesion of Helicobacter pylori on human gastric mucus.
The Roman camomile shows in a meta-analysis a clear decrease of dyspepsia and stomach acidity. Its local antiinflammatory action is well known and has been compared to inhibitors of proton pump. Its essential oil has shown an in vitro inhibition of Helicobacter.
The Great Gentian (Gentiana lutea) contains triterpens and xanthones which presents an anti-inflammatory action direct on the mucous of the stomach but also by xanthones, an antistress and antidepressant action very useful in the problems of the stomach. For the alcoholic extract, the MIC of Helicobacter is 100 μg/ml.
Humulus lupulus, the hop seems to have a calming effect on the stomach, its mode of action is not determined but it could involve an action close to oestrogenic plants.
New lines of work are currently under study. The ghrelin is an orexigenic polypeptide, secreted mainly by the stomach and to a lesser degree by the intestine, pancreas, kidney, hypothalamus, pituitary.
The infections to H. pilory, are associated with reduced circulating ghrelin levels independently of sex and BMI.
The ghrelin possesses a protective gastrointestinal action dose-dependent and opens clinical implications in gastroenterology.
Unfortunately it is a double-edged sword because this polypeptide increases appetite , which of course is interesting for people with a chronic Helicobacter pylori but also contraindicate in case of overweight.
Some plants such as Avena sativa or Zingiber officinalis would act through an increase in ghrelin ; their effect on the increased of appetite is well known.
For example the alcoholic extracts and the Ginger fresh root powder and even individual components such as -,-,-gingerol and -shogoal inhibit, in vitro, Helicobacter pylori.
The combination of several pre and probiotics, ie the bifidobacterium, saccharomyces and lactobacillus has been studied and clearly demonstrates a better tolerance to the triple therapy. These substances seem to have an effect of prevention but no complete study has been conducted.
Nevertheless, given their mode of action and given the lack of contraindication, their use is logical.
The use of natural vitamin C during the treatment of the HP entails a decrease of the risks of precancerization of the stomach tissues.
The use of fish oils provides a positive effect in addition to eradication treatment of HP.
But this intake is insufficient to treat the bacterium in comparison with the classic substances.
The eradication of Helicobacter is essential when it is highlighted to avoid the risk of stomach cancer. This eradication by classic treatment (triple therapy, antibiotic) is not always sufficient. The addition of a natural treatment will reduce the risks of recurrence. Different plants have shown a clear action on Helicobacter pylori and reduces risks.
Haristoy X, Angioi-Duprez K, Duprez A, Lozniewski A. Efficacy of sulforaphane in eradicating Helicobacter pylori in human gastric xenografts implanted in nude mice. Antimicrob Agents Chemother. 2003 Dec; 47(12): 3982-4.
Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998
(2) Toshio Fukai. Ai Marumo, Kiyoshi Kaitou, Toshihisa Kanda, Sumio Terada and Taro Nomura. Anti-Helicobacter pylori flavonoids from licorice extract. Life Sciences. Volume 71, Issue 12 , 9 August 2002, Pages 1449-1463
Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279-87.
M.Jafarian et K. Ghazvini. Réglisse contre Helicobacter pylori. Mashhad. Iran. 2004.
Burger O, Weiss E, Sharon N, Tabak M, Neeman I, Ofek I. Inhibition of Helicobacter pylori adhesion to human gastric mucus by a high-molecular-weight constituent of cranberry juice. Crit Rev Food Sci Nutr. 2002;42(3 Suppl):279-84.
Tomic M, Tovilovic G, Butorovic B, et al. Neuropharmacological evaluation of diethylether extract and xanthones of Gentiana kochiana. Pharmacol Biochem Behav 2005;81:535-42.
Mahady GB, Pendland SL, Stoia A, Hamill FA, Fabricant D, Dietz BM, Chadwick LR. In Vitro susceptibility of Helicobacter pylori to botanical extracts used traditionally for the treatment of gastrointestinal disorders. Phytother Res. 2005 Nov;19(11):988-91.
Yang Li, Chen Xu, Qiang Zhang, Jun Yan Liu and Ren Xiang Tan. In vitro anti-Helicobacter pylori action of 30 Chinese herbal medicines used to treat ulcer diseases. Journal of Ethnopharmacology Volume 98, Issue 3 , 26 April 2005, Pages 329-333
G.B. Mahady, S.L. Pendland, G.S. Yun, Z.Z. Lu and A. Stoia, Ginger (Zingiber officinale Roscoe) and the gingerols inhibit the growth of Cag A+ strains of Helicobacter pylori, Anticancer Res. 23 (2003), pp. 3699-3702.
Imai H, Osawa K, Yasuda H, Hamashima H, Arai T, Sasatsu M. Inhibition by the essential oils of peppermint and spearmint of the growth of pathogenic bacteria. Microbios. 2001;106 Suppl 1:31-9.
Sakamoto I, Igarashi M, Kimura K, et al. Suppressive effect of Lactobacillus gasseri OLL 2716 (LG21) on Helicobacter pylori infection in humans. J Antimicrob Chemother 2001;47:709-10.
Ohno T, Kita M, Yamaoka Y, Imamura S, Yamamoto T, Mitsufuji S, Kodama T, Kashima K, Imanishi J. Antimicrobial activity of essential oils against Helicobacter pylori. Helicobacter. 2003 Jun;8(3):207-15.
Cremonini F, Di Caro S, Covino M, et al. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol 2002;97:2744-9.
Zullo A, Rinaldi V, Hassan C, et al. Ascorbic acid and intestinal metaplasia in the stomach: a prospective, randomized study. Aliment Pharmacol Ther 2000;14:1303-9.