An important update in Brazilian medicine has changed the way we treat a very common bacterium in the stomach: Helicobacter pylori (or simply H. pylori).

It is linked to problems such as gastritis, ulcers, and even stomach cancer. And now, in 2026, the main treatment is no longer the same as before.

What is this bacterium?

H. pylori is a bacterium that lives in the stomach.

Many people have it and don't even know it.

In some cases, it can cause symptoms such as:

  • Pain or burning in the stomach

  • Feeling of bloating

  • Nausea

  • Frequent heartburn

But the biggest problem is when it stays untreated for a long time, which can cause damage to the stomach.

What changed in the treatment?

For many years, the most commonly used treatment was a combination of 3 medications (known as "triple therapy").

Now that has changed.

Doctors have begun to avoid this regimen as a first option because it stopped working as well as before.

The main reason is that the bacterium became more resistant to one of the antibiotics used.

What is the recommended treatment today?

The new guidelines indicate a treatment with 4 medications at the same time.

It includes:

  • A medication to protect the stomach (such as omeprazole)

  • Bismuth (which helps fight the bacterium)

  • Two different antibiotics

This treatment is given for 10 to 14 days.

Why use more medications?

It may seem more "powerful," but there is a clear reason:

To increase the chances of eliminating the bacterium right on the first attempt

When treatment fails:

  • The bacterium remains in the body

  • Symptoms may return

  • Treatment becomes more difficult afterward

That is why the new strategy is to be more effective from the start.

Why did the treatment duration increase?

Before, some treatments were shorter.

Today we know that this may not be sufficient.

With 10 to 14 days:

  • The chance of cure is greater

  • The risk of the bacterium returning decreases

Are there new developments coming?

Yes. Some studies already show new possibilities for the future, such as:

  • New types of medications to control stomach acidity

  • Adjustments in antibiotic doses

  • Use of probiotics to help with treatment

But for now, these options still do not replace the main treatment.

Attention: do not self-medicate

Even though it is a well-known treatment, it needs to be prescribed by a doctor.

Each person may need a different regimen, depending on:

  • Health history

  • Previous antibiotic use

  • Medication reactions

What does this change mean in practice?

Treatment became more strategic

The chance of cure increased

And the focus now is to solve the problem right on the first attempt

In summary

  • The H. pylori bacterium is common and can cause stomach problems

  • The old treatment with 3 medications is being phased out

  • The new standard uses 4 medications for up to 14 days

  • The change seeks greater effectiveness and fewer failures

If you have already been diagnosed with H. pylori or have frequent stomach symptoms, it's worth talking to a doctor. The treatment has evolved and that makes a difference in the outcome

Dr. Rebeca Soares Andrade CRM-GO 39335