Gastro-Esophageal Reflux & H.pylori – What’s the Connection?

Back when reflux was known simply as heartburn, people often associated this digestive complaint with the incidence of stomach ulcers. Previously thought to be caused by too much pastrami and other spicy foods, the discovery of Helicobacter pylori infection as a leading cause of gastric ulcers led to relief for countless patients. Soon after, heartburn—aka gastroesophageal reflux—got a new acronym. But what’s the connection, if any, between H. pylori and GERD?

There are three basic types of H. pylori infection, each named for the specific portion of the stomach in which they occur, and each associated with distinct effects on gastric acid secretion.

1. “Body-predominant” H. pylori infection occurs in the middle region or “body” of the stomach. It is one of the most common types of H. pylori infection and is associated with low stomach acid secretion.

2. “Antral-predominant” H. pylori infection, the least common type of H. pylori infection, occurs in the lower part of the stomach and is associated with increased stomach acid secretion.

3. “Mixed type” H. pylori infection occurs in both the middle and lower portion of the stomach, and typically has a neutral affect on stomach acid secretion.

As described above, body-predominant H. pylori infection results in reduced gastric acid production, or hypochlorhydria. Hypochlorhydria impairs protein digestion, mineral absorption and vitamin B12 bioavailability. It also disarms the body’s first line of immune defense: killing food-borne microbes and pathogens in the upper GI tract with hydrochloric acid. This explains why insufficient stomach acid is a cause of intestinal bacterial overgrowth—a condition which, in turn, is associated with Irritable Bowel Syndrome, SIBO and heartburn.

Could restoration of normal stomach acid levels help explain research suggesting antibiotic therapy, which leads to H. pylori eradication, also may help relieve functional dyspepsia? Or why diets low in fermentable carbohydrates (which, by their very nature, inhibit the activity of gut bacteria) may help to improve symptoms not only of IBS and SIBO, but of reflux syndromes such as GERD and Laryngopharyngeal Reflux (also known as silent reflux or LPR) as well?

Even in the absence of body-predominant H. pylori infection, hypochlorhydria is extremely common, particularly in older individuals. Supplemental hydrochloric acid (as betaine HCl) is a cost-effective way to enhance stomach acid levels and improve digestive power while helping to reduce H. pylori and other unwanted microbes. A number of natural substances, including deglycyrrhizinated licorice root extract and mastic gum (Pistacia lentiscus) also have been studied for their ability to combat excess H. pylori in the gut, providing complementary botanical support.

Clinical Suggestions

Betaine HClProvides a significant 750 mg betaine hydrochloride (hydrochloric acid) per capsule.*

GastroSelect® – Contains ingredients researched for their ability to enhance upper GI comfort & function via various pathways: promoting normal gastric and duodenal mucus secretion, soothing irritated esophageal tissues, combating H. pylori, and gently buffering excess stomach acids without eradicating their beneficial presence.* Request a copy of the GastroSelect® Technical Sheet or visit our website to learn more.

By Diana Allen, MS, CNS, Product Development Manager

Moss Nutrition Digest #15 – 10/19/2019 – PDF Version


1. Ghoshal UC1, Chourasia D. Gastroesophageal Reflux Disease and Helicobacter pylori: What May Be the Relationship? J Neurogastroenterol Motil. 2010 Jul;16(3):243-50.

2. Dyspepsia and Gastro-oesophageal Reflux: A Systematic Review [Internet]. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2007 Oct. SBU Yellow Report No. 185.

3. Norman Robillard, PhD. Fast Tract Digestion: Heartburn. 2012 Self Health Publishing;


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