Helicobacter pylori: Diagnosis, treatment, and impact on public health.

Abstract

Helicobacter pylori (H. pylori) is a gram-negative bacterium that colonizes the human stomach and is associated with chronic gastritis, peptic ulcer disease, and gastric cancer. Its high global prevalence, combined with the increasing rate of antimicrobial resistance, represents a major challenge for public health. In this context, new therapeutic strategies, including the use of probiotics and natural bioactive compounds, have been investigated as promising alternatives to conventional treatment.This study consists of an integrative literature review aimed at analyzing H. pylori infection, its risk factors, diagnostic and therapeutic methods, as well as discussing prevention strategies and innovative treatment approaches. Articles published between 2019 and 2024 were included, selected from databases such as PubMed, SciELO, LILACS, BVS, and Google Scholar, using Health Sciences Descriptors (DeCS) related to Helicobacter pylori; dysbiosis; gastrointestinal microbiome; probiotics; diet; gastric pH; gastritis; gastric ulcer; gastric neoplasms; and antibacterials.The selected studies were evaluated according to inclusion, exclusion, and methodological quality criteria. The analyzed data confirm a high global prevalence of infection, especially in developing countries, with a significant impact in Brazil, where it affects approximately 55% of the population. Diagnostic methods include invasive and non-invasive techniques, with the urea breath test and fecal antigen detection standing out for their good sensitivity, specificity, and accessibility.The growing resistance to clarithromycin, metronidazole, and levofloxacin has compromised the success of traditional therapeutic regimens, driving the search for new treatment alternatives. In this scenario, the use of probiotics and natural compounds such as curcumin, resveratrol, and cranberry polyphenols, along with nutritional strategies, has shown adjuvant effects by reducing symptoms, modulating the intestinal microbiota, and enhancing therapeutic efficacy.It is concluded that H. pylori infection remains a relevant issue in gastroenterology. Early diagnosis and appropriate treatment are still essential; however, antimicrobial resistance reinforces the need for complementary approaches. The combination of probiotics, bioactive compounds, and preventive measures based on sanitation and health education emerges as a promising strategy to reduce the prevalence of infection and minimize its clinical and social impacts.