Phytochemicals as Promising Anti-H. pylori Agents: Molecular Insights and Therapeutic Potential

Abstract

Helicobacter pylori (H. pylori) infection remains a major cause of chronic gastritis, peptic ulcer disease, and gastric cancer, while increasing antibiotic resistance compromises the effectiveness of standard eradication regimens. This structured scoping-style narrative review maps current evidence on phytochemicals with anti-H. pylori activity and synthesizes their reported effects on bacterial adhesion and colonization, motility, urease activity, virulence factors, inflammatory and oxidative-stress pathways, and biofilm formation. PubMed, Scopus, and Web of Science were searched using predefined terms, and eligible in vitro, in vivo, and clinical studies were charted according to compound source, experimental model, antimicrobial activity, molecular targets, major outcomes, antibiotic interactions, and safety. The available evidence indicates multi-target activity for several phytochemicals; however, the evidence base is dominated by in vitro experiments and small animal studies, with limited clinical confirmation, substantial methodological heterogeneity, and incomplete safety and pharmacokinetic data. Accordingly, phytochemicals should currently be regarded as promising lead compounds or adjunctive candidates rather than established substitutes for guideline-recommended eradication therapy. Standardized susceptibility testing, clinically relevant models, dose and formulation optimization, and well-designed human studies are required before translation into routine practice.