Therapeutic Promise of Medicinal Herbs in the Management of Helicobacter pylori Infection: Mechanisms, Evidence, and Future Prospects

Abstract

Helicobacter pylori infection remains a major global health concern, implicated in chronic gastritis, peptic ulcer disease, and gastric carcinoma. Conventional triple and quadruple therapies, though initially effective, are increasingly undermined by escalating antimicrobial resistance, high recurrence rates, and patient non‑compliance. Against this backdrop, the exploration of herbal medicines as alternative or complementary anti‑H. pylori strategies has gained substantial momentum. This literature review synthesizes recent empirical and theoretical research on the antimicrobial, anti‑inflammatory, and gastroprotective properties of key phytochemicals and medicinal plants, including Curcuma longa (curcumin), Berberis vulgaris (berberine), Camellia sinensis (catechins), Glycyrrhiza glabra (licorice), and Nigella sativa (thymoquinone). Evidence from in vitro studies, animal models, and early clinical trials indicates that these compounds inhibit H. pylori growth, downregulate virulence factors such as urease and CagA, and attenuate mucosal inflammation through modulation of NF‑κB and oxidative stress pathways. Moreover, herbal preparations demonstrate synergistic efficacy when combined with conventional antibiotics, improving eradication rates and reducing adverse effects. Despite promising results, challenges persist regarding standardization, bioavailability, and regulatory harmonization. Advances in nanotechnology, systems pharmacology, and integrative clinical frameworks are identified as pivotal for translating these findings into clinically reliable therapies. Overall, this review underscores the potential of evidence‑based phytotherapy as a complementary or adjunctive approach to conventional H. pylori management, emphasizing the necessity of interdisciplinary research to refine safety, efficacy, and global accessibility of herbal‑derived therapeutics.