From the Guidelines
Helicobacter pylori (H. pylori) infection can cause nutrient malabsorption, particularly of iron, vitamin B12, and other essential nutrients. The primary mechanism behind this malabsorption is the chronic inflammation of the gastric mucosa caused by H. pylori, leading to reduced stomach acid production and impaired breakdown of food and nutrients 1. Key points to consider include:
- H. pylori infection can lead to atrophic gastritis, reducing stomach acid secretion necessary for iron and vitamin B12 absorption.
- The infection can interfere with intrinsic factor production, essential for vitamin B12 absorption.
- Damage to the small intestine's mucosal lining can further compromise nutrient absorption.
- Treatment typically involves triple therapy with antibiotics and a proton pump inhibitor for 7-14 days, which can lead to improvement in nutrient absorption and resolution of deficiencies 1. It is crucial to address H. pylori infection to prevent long-term nutritional deficiencies and their associated health complications.
From the Research
Helicobacter Pylori Infection and Nutrient Malabsorption
- Helicobacter pylori (H. pylori) infection has been associated with malabsorption of essential nutrients, including iron, vitamin B12, vitamin A, vitamin C, folic acid, and vitamin E 2, 3.
- The main mechanism related to malabsorption of these components is the modified intragastric pH (hypo-achlorhydria) due to H. pylori infection 2.
- H. pylori infection can also affect appetite and promote the occurrence of dyspeptic symptoms by modifying gastrointestinal hormones, such as reducing plasma levels of ghrelin and increasing those of leptin and gastrin 2, 3.
- Eradication of H. pylori has been shown to improve serum levels of iron and vitamin B12, and has some effects on vitamin A and vitamin E absorption 2.
Effects of H. pylori Infection on Nutritional Status
- H. pylori infection is associated with childhood malnutrition in developing countries, either due to malabsorption or increased susceptibility to enteric infections caused by hypochlorhydria 2.
- The infection can have strong consequences on nutritional status, particularly in areas where the infection is prevalent 3.
- Diet, food, plants, and specific nutrients may play a role in the treatment of H. pylori infection, considering that eradication rates with standard triple-therapy have fallen to a low level in recent years 3.
Treatment and Eradication of H. pylori
- Various treatment regimens have been studied for the eradication of H. pylori, including proton-pump inhibitor and amoxicillin-based triple therapy, and quadruple therapies with clarithromycin, metronidazole, and bismuth 4, 5, 6.
- The effectiveness of these treatments can vary depending on factors such as the dose and duration of proton-pump inhibitor therapy, and the presence of antibiotic resistance 4, 5.