Life Extension Magazine®

Man in discomfort from stomach ulcers due to H. pylori

Reduce Risk of Stomach Ulcers and Gastritis

Japanese scientists have developed a unique combination of zinc and carnosine that helps remove H. pylori, an underlying cause of ulcers, gastritis and stomach cancer. Zinc-carnosine has been shown to reduce heartburn, belching, and stomach tenderness.

Scientifically reviewed by Dr. Gary Gonzalez, MD, in August 2023. Written by: Michael Downey, Health & Wellness Author.

Helicobacter pylori (H. pylori) is a major cause of gastritis and ulcers.1-7

The two scientists who discovered this were awarded the Nobel Prize in Physiology or Medicine.8

Infection with the H. pylori bacteria is often without symptoms.1

H. pylori affects almost 50% of the population.5,9 It boosts the risk of stomach cancer10 by two- to six-fold,1 and can cause gastritis and peptic ulcer disease.11-14

Standard treatment for H. pylori involves a powerful antibiotic combination,15 but antibiotic resistance has reduced overall efficacy.16,17

Japanese researchers have developed a combination of zinc and carnosine that removes H. pylori while healing the damage it has caused.

A specific probiotic strain called Lactobacillus reuteri DSMZ 17648 has also been shown to reduce H. pylori bacteria.

This non-drug approach can safely inhibit H. pylori, heal the stomach lining, lower inflammation, and alleviate chronic stomach problems.

What you need to know

  • The most common causes of stomach pain in older adults are gastritis and peptic ulcer disease, both of which are associated with H. pylori infection.
  • Standard treatment includes multiple antibiotics and potent stomach-acid suppressor drugs.
  • Zinc-carnosine protects the stomach wall from corrosive contents, “sticks” to ulcers to quickly promote healing, inhibits dangerous H. pylori, and treats gut permeability.
  • Lactobacillus reuteri strain DSMZ 17648 binds to H. pylori, carrying them out of the body, which reduces the load of infection and helps prevent stomach cancer.
  • Together, these treatments relieve stomach pain related to gastritis and peptic ulcer disease, promote healing in the stomach, and prevent gastric cancers related to H. pylori.

The Gastrointestinal Domino Effect

The acidity of the stomach is beneficial because it acts as a primary defense against infection and assists in the early stages of digestion.

The body protects its own delicate tissues from harsh stomach acid with systems that require precise balance.

The first defense mechanism is specialized surface cells in the stomach’s lining that secrete a heavy coating of protective mucus. Second, a rapid cell-turnover in the lining itself keeps fresh cells always at the ready.

If the body’s natural defenses against stomach acids become disrupted, it can result in stomach disorders such as painful gastritis and peptic ulcer disease.11-14

Gastritis is inflammation of the stomach lining. It doesn’t always produce symptoms, but when symptoms do arise they can include abdominal pain, nausea, vomiting, and indigestion.11 Such symptoms are generally written off as an annoyance. In reality, these episodes leave lasting damage that eventually leads to mucosal damage and inflammation.11-13

While this process can be triggered by a host of factors, one of the most common causes is infection with the H. pylori bacterium.

H. pylori: A Major Threat to Your Stomach’s Defenses

The bacterium Helicobacter pylori is a major cause of ulcers, gastritis, and stomach cancer.
The bacterium Helicobacter
is a major cause of
ulcers, gastritis, and
stomach cancer.

H. pylori is a major cause of stomach and upper intestinal disorders, including ulcers of the stomach and duodenum (the beginning of the small intestine), gastritis, and stomach cancer.18,19

Over time, H. pylori erodes the essential mucosal barrier, leaving delicate tissue in the stomach and small intestine exposed to harsh acids that cause distress ranging from gastritis to cancer.2,11,20

Once imbedded in the mucous lining, this bacterium produces an influx of inflammatory cells by secreting powerful “virulence factors.”18 These bacterial proteins block normal function of certain immune cells, while boosting the free radical production,21,22 and stimulating still another group of immune cells to produce inflammatory cytokines, the messengers that call new inflammatory cells into the region.18

H. pylori can be effectively treated with antibiotics. However, there is compelling evidence that the unique combination of the mineral zinc with the amino acid-derived carnosine peptide provides effective actions against H. pylori and safely restores stomach health.23,24

Zinc-Carnosine’s Potent Gastric Protection

Supplementation with zinc has long been shown to provide gastroprotective effects.25,26

The nutrient carnosine can boost these effects even further.

In an exciting development, Japanese researchers developed a zinc-carnosine compound that provides gastric protection beyond that of either nutrient alone.

This zinc-carnosine compound—comprising zinc and carnosine—is sold as a prescription anti-ulcer drug in Japan.24,27 It’s also available in the United States as a non-prescription dietary supplement.

Because of its unique mechanisms, zinc-carnosine gets delivered directly to the stomach wall, where it sticks to the wall much more tightly than either zinc or carnosine alone. This allows the beneficial effects of both components to be delivered directly to the site where protection is most needed.24,28

Zinc-carnosine offers a comprehensive approach to addressing stomach issues such as gastritis and peptic ulcers. For starters, it eliminates the source of the problem by accelerating the eradication of H. pylori itself.29,30 It’s also been shown to neutralize free radicals31,32 and reduce inflammation.33

In addition to boosting the production of a growth factor important for gastric wound repair,34,35 zinc-carnosine also repairs the damaged mucous lining, which stimulates secretion of mucus and further promotes healing.31,36

Zinc-carnosine also inhibits stomach inflammation caused by H. pylori infection, a protective action that helps break the infection-inflammation-cancer chain.30

These protective actions have been borne out in animal and human studies.

Animal Studies

Giving animals zinc-carnosine can prevent—or rapidly heal—ulcers.36-40

Studies show that it protects the stomach mucosa by inducing an enzyme involved in reducing inflammation and quelling free radicals. It also protects cells through an increase in the level of (protective) heat shock proteins.41-44

In another animal study, scientists tested the effects of zinc-carnosine on animal models of stomach damage and small-intestine damage. In each case, cells were damaged by stress or by a potent NSAID (nonsteroidal anti-inflammatory drug) called indomethacin.

Zinc-carnosine reduced stomach injury by 75% and reduced small-intestine injury by 50%. It also stimulated migration and proliferation of cells at and near the injury sites by almost three-fold.45

Based on the successful animal studies, researchers then turned to human studies to verify this compound’s clinical effects.

Validating Zinc-Carnosine in Human Studies

Human studies show that zinc-carnosine is effective at reducing the symptoms associated with ulcers, while also promoting healing of the damaged area.

Scientists gave 150 mg of zinc-carnosine per day to 25 patients diagnosed with gastric ulcers.

After eight weeks, they documented a:46

  • 63.6% reduction in heartburn,
  • 80% reduction in belching,
  • 66.7% reduction in nausea,
  • 76.9% reduction in abdominal distention, and
  • 71% reduction in stomach tenderness.

The researchers also reported:46

  • Complete disappearance of nighttime pain in 91% of participants, and
  • Healing in 65% of subjects during endoscopic assessment.

Outperforms Standard Treatments

Outperforms Standard Treatments  

In a double-blind study, researchers conducted a head-to-head comparison of zinc-carnosine (150 mg) and cetraxate (a drug commonly used to treat ulcers) in patients with gastric ulcers. In the group taking zinc-carnosine, 60.4% had ulcer healing that was confirmed by endoscopy, compared with just 46.2% of the drug recipients.47

Once again, this study confirms the ability of zinc-carnosine to heal the damage caused by ulcers.

A third human trial set out to determine zinc-carnosine’s impact on H. pylori status. For this study, 66 patients with proven H. pylori infections were given the most common three-drug therapy: two antibiotics plus the proton pump inhibitor lansoprazole (Prevacid®). Half of those patients also received 300 mg of zinc-carnosine daily.

In the subjects taking the drug combination (without the addition of zinc-carnosine), H. pylori was eradicated in 86%. But in subjects also taking zinc-carnosine, H. pylori was eradicated in 100% of subjects—in just seven days!29

Gut Permeability

Gut Permeability  

Next, scientists looked beyond stomach protection to see what effects zinc-carnosine might have on gut permeability.

There is a critical barrier between the gut and the rest of the body. It serves a dual purpose of allowing nutrients to pass through the gut, while also keeping harmful substances from spreading through the body.

Stresses such as prolonged strenuous exercise, heat stress, and NSAIDs can damage gut-barrier integrity.48 Research shows that zinc-carnosine can help protect against increased gut permeability caused by NSAIDs and exercise.

In one clinical trial, 10 healthy volunteers took 150 mg a day of the NSAID drug indomethacin with either a placebo or with zinc-carnosine.45

  • Taking indomethacin alone increased (worsened) gut permeability by a factor of three.

  • In the group taking the NSAID along with zinc-carnosine, there was no significant increase in permeability.

The researchers concluded that zinc-carnosine stabilized the cells of the mucosal lining of both the stomach and small intestine, suggesting potent gastroprotective effects.45

In another trial, scientists tested zinc-carnosine’s effects on gut permeability in athletes. In a double-blind, placebo-controlled crossover protocol, two arms included eight athletes who took a placebo or zinc-carnosine, for 14 days.48

  • In subjects taking the placebo, exercising 14 days after the start of the treatment resulted in a three-fold increase (worsening) in gut permeability.

  • But in the zinc-carnosine group, exercising 14 days after the start of treatment prevented the increase (worsening) in gut permeability by 70%.

Researchers found that zinc-carnosine had increased epithelial resistance and improved the structure of “tight junctions”—a network of sealing strands that play a role in barrier permeability.48

In all, this unique zinc-carnosine compound provides protective gastrointestinal effects by directly combatting H. pylori, protecting the vulnerable stomach lining, quelling inflammation caused by gastritis and peptic ulcer disease, and ultimately helping prevent stomach cancer.

Readers should be cautioned that NSAID drugs taken over a prolonged period can cause organ damage beyond the stomach lining. For example:

  • Current users of ibuprofen (for 1-7 days) have 1.48-fold greater odds of suffering a heart attack,49

  • Current users of naproxen (Aleve®) (for 1-7 days) have 1.53-fold greater odds of suffering a heart attack,49

  • Regularly taking NSAID drugs (such as ibuprofen) increases the risk of kidney impairment by 32%.50

So zinc-carnosine should not be thought of as a systemic protector against chronic use of NSAID drugs like ibuprofen and naproxen.

While zinc-carnosine protects the stomach against common over-the-counter pain relievers like ibuprofen, the kidneys and the heart are still vulnerable to the toxic side effects of these drugs.

Lactobacillus reuteri Eradicates H. pylori

Lactobacillus reuteri Eradicates H. pylori  

For additional stomach protection, a strain of beneficial bacteria can be a useful addition to zinc-carnosine because of its capacity to remove H. pylori from the body.

After investigating about 700 strains of Lactobacillus species, scientists identified one that has the ability to bind to H. pylori organisms and carry them harmlessly out of the gastrointestinal tract.

Doing so substantially decreases the number of H. pylori bacteria residing in the stomach—without antibiotics and their risks.51 This unique form of heat-treated bacteria is known as Lactobacillus reuteri strain DSMZ 17648.

Two human studies were conducted to determine the effect of Lactobacillus reuteri strain DSMZ 17648 on H. pylori.51,52 Each used a urea breath test that indicates whether H. pylori is present in the stomach. This test detects a product of H. pylori metabolism in the subject’s breath.

Volunteers took either two tablets of Lactobacillus reuteri strain DSMZ 17648 or a placebo twice daily for two weeks. In both studies, there was a significant reduction in the number of H. pylori in the stomachs of those taking the probiotic, while the placebo had no effect.51,52

Despite having documented H. pylori infections, none of these individuals had any symptoms. Since H. pylori is known to contribute to stomach cancer even in patients without symptoms,9,53 the ability of the Lactobacillus reuteri strain DSMZ 17648 to reduce H. pylori makes these studies important.



Prescription drugs, fast food, alcohol, and chronic stress can all trigger gastric distress, leading eventually to serious damage to delicate stomach tissue.

A key culprit in this scenario is H. pylori. This ulcer-inducing bacterium affects almost 50% of the population and boosts the risk of stomach cancer by two- to six-fold.

Zinc-carnosine protects the stomach wall, reduces inflammation, decreases H. pylori numbers, and improves gut permeability.

The probiotic Lactobacillus reuteri strain DSMZ 17648 dramatically reduces H. pylori populations.

Zinc-carnosine and this L. reuteri strain can be expected to relieve stomach discomfort related to gastritis and peptic ulcer disease, promote natural healing, and help reduce risk factors involved in gastric cancers related to H. pylori.

Zinc-carnosine plus this specific probiotic can be used in conjunction with antibiotic therapy to eradicate H.pylori. Patients currently taking antibiotics should not stop taking them unless so advised by a physician.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.


  1. Available at: Accessed July 16, 2018.
  2. Available at: Accessed July 16, 2018.
  3. Available at: Accessed July 16, 2018.
  4. Lopes D, Nunes C, Martins MC, et al. Eradication of Helicobacter pylori: Past, present and future. J Control Release. 2014;189:169-86.
  5. Malfertheiner P, Megraud F, O’Morain CA, et al. Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report. Gut. 2012;61(5):646-64.
  6. Meurer LN, Bower DJ. Management of Helicobacter pylori infection. Am Fam Physician. 2002;65(7):1327-36.
  7. Wu TS, Hu HM, Kuo FC, et al. Eradication of Helicobacter pylori infection. Kaohsiung J Med Sci. 2014;30(4):167-72.
  8. Available at: Accessed July 13, 2018.
  9. Lee YC, Chiang TH, Chou CK, et al. Association Between Helicobacter pylori Eradication and Gastric Cancer Incidence: A Systematic Review and Meta-analysis. Gastroenterology. 2016;150(5):1113-24 e5.
  10. Peek RM, Jr. New Biology to New Treatment of Helicobacter pylori-Induced Gastric Cancer. Dig Dis. 2016;34(5):510-6.
  11. Available at: Accessed July 16, 2018.
  12. Available at: Accessed July 13, 2018.
  13. Varbanova M, Malfertheiner P. Bacterial load and degree of gastric mucosal inflammation in Helicobacter pylori infection. Dig Dis. 2011;29(6):592-9.
  14. Available at: Accessed July 16, 2018.
  15. Bohr UR, Malfertheiner P. Eradication of H. pylori Infection: the Challenge is on if Standard Therapy Fails. Therap Adv Gastroenterol. 2009;2(1):59-66.
  16. Hsu PI, Wu DC, Chen WC, et al. Randomized controlled trial comparing 7-day triple, 10-day sequential, and 7-day concomitant therapies for Helicobacter pylori infection. Antimicrob Agents Chemother. 2014;58(10):5936-42.
  17. Urgesi R, Cianci R, Riccioni ME. Update on triple therapy for eradication of Helicobacter pylori: current status of the art. Clin Exp Gastroenterol. 2012;5:151-7.
  18. D’Elios MM, Montecucco C, de Bernard M. VacA and HP-NAP, Ying and Yang of Helicobacter pylori-associated gastric inflammation. Clin Chim Acta. 2007;381(1):32-8.
  19. Muller A, Oertli M, Arnold IC. H. pylori exploits and manipulates innate and adaptive immune cell signaling pathways to establish persistent infection. Cell Commun Signal. 2011;9(1):25.
  20. Neelapu N, Nammi D, Pasupuleti A, et al. Helicobacter pylori induced gastric inflammation, ulcer, and cancer: A pathogenesis perspective. Interdiscip J Microinflammation. 2014;1(2):113.
  21. Gotz JM, Thio JL, Verspaget HW, et al. Treatment of Helicobacter pylori infection favourably affects gastric mucosal superoxide dismutases. Gut. 1997;40(5):591-6.
  22. Gotz JM, van Kan CI, Verspaget HW, et al. Gastric mucosal superoxide dismutases in Helicobacter pylori infection. Gut. 1996;38(4):502-6.
  23. Matsukura T, Takahashi T, Nishimura Y, et al. Characterization of crystalline L-carnosine Zn(II) complex (Z-103), a novel anti-gastric ulcer agent: tautomeric change of imidazole moiety upon complexation. Chem Pharm Bull (Tokyo). 1990;38(11):3140-6.
  24. Matsukura T, Tanaka H. Applicability of zinc complex of L-carnosine for medical use. Biochemistry (Mosc). 2000;65(7):817-23.
  25. Varas Lorenzo MJ, Lopez Martinez A, Gordillo Bernal J, et al. [Comparative study of 3 drugs (aceglutamide aluminum, zinc acexamate, and magaldrate) in the long-term maintenance treatment (1 year) of peptic ulcer]. Rev Esp Enferm Dig. 1991;80(2):91-4.
  26. Rodriguez de la Serna A, Diaz-Rubio M. Multicenter clinical trial of zinc acexamate in the prevention of nonsteroidal antiinflammatory drug induced gastroenteropathy. Spanish Study Group on NSAID Induced Gastroenteropathy Prevention. J Rheumatol. 1994;21(5):927-33.
  27. Sakae K, Yanagisawa H. Oral treatment of pressure ulcers with polaprezinc (zinc L-carnosine complex): 8-week open-label trial. Biol Trace Elem Res. 2014;158(3):280-8.
  28. Furuta S, Toyama S, Miwa M, et al. Residence time of polaprezinc (zinc L-carnosine complex) in the rat stomach and adhesiveness to ulcerous sites. Jpn J Pharmacol. 1995;67(4):271-8.
  29. Kashimura H, Suzuki K, Hassan M, et al. Polaprezinc, a mucosal protective agent, in combination with lansoprazole, amoxycillin and clarithromycin increases the cure rate of Helicobacter pylori infection. Aliment Pharmacol Ther. 1999;13(4):483-7.
  30. Suzuki H, Mori M, Seto K, et al. Polaprezinc attenuates the Helicobacter pylori-induced gastric mucosal leucocyte activation in Mongolian gerbils--a study using intravital videomicroscopy. Aliment Pharmacol Ther. 2001;15(5):715-25.
  31. Hiraishi H, Sasai T, Oinuma T, et al. Polaprezinc protects gastric mucosal cells from noxious agents through antioxidant properties in vitro. Aliment Pharmacol Ther. 1999;13(2):261-9.
  32. Nishiwaki H, Kato S, Sugamoto S, et al. Ulcerogenic and healing impairing actions of monochloramine in rat stomachs: effects of zinc L-carnosine, polaprezinc. J Physiol Pharmacol. 1999;50(2):183-95.
  33. Shimada T, Watanabe N, Ohtsuka Y, et al. Polaprezinc down-regulates proinflammatory cytokine-induced nuclear factor-kappaB activiation and interleukin-8 expression in gastric epithelial cells. J Pharmacol Exp Ther. 1999;291(1):345-52.
  34. Watanabe S, Wang XE, Hirose M, et al. Insulin-like growth factor I plays a role in gastric wound healing: evidence using a zinc derivative, polaprezinc, and an in vitro rabbit wound repair model. Aliment Pharmacol Ther. 1998;12(11):1131-8.
  35. Kato S, Tanaka A, Ogawa Y, et al. Effect of polaprezinc on impaired healing of chronic gastric ulcers in adjuvant-induced arthritic rats--role of insulin-like growth factors (IGF)-1. Med Sci Monit. 2001;7(1):20-5.
  36. Yoshikawa T, Naito Y, Tanigawa T, et al. Effect of zinc-carnosine chelate compound (Z-103), a novel antioxidant, on acute gastric mucosal injury induced by ischemia-reperfusion in rats. Free Radic Res Commun. 1991;14(4):289-96.
  37. Cho CH, Hui WM, Chen BW, et al. The cytoprotective effect of zinc L-carnosine on ethanol-induced gastric gland damage in rabbits. J Pharm Pharmacol. 1992;44(4):364-5.
  38. Arakawa T, Satoh H, Nakamura A, et al. Effects of zinc L-carnosine on gastric mucosal and cell damage caused by ethanol in rats. Correlation with endogenous prostaglandin E2. Dig Dis Sci. 1990;35(5):559-66.
  39. Ito M, Tanaka T, Suzuki Y. Effect of N-(3-aminopropionyl)-L-histidinato zinc (Z-103) on healing and hydrocortisone-induced relapse of acetic acid ulcers in rats with limited food-intake-time. Jpn J Pharmacol. 1990;52(4):513-21.
  40. Seiki M, Ueki S, Tanaka Y, et al. [Studies on anti-ulcer effects of a new compound, zinc L-carnosine (Z-103)]. Nihon Yakurigaku Zasshi. 1990;95(5):257-69.
  41. Ueda K, Ueyama T, Oka M, et al. Polaprezinc (Zinc L-carnosine) is a potent inducer of anti-oxidative stress enzyme, heme oxygenase (HO)-1 - a new mechanism of gastric mucosal protection. J Pharmacol Sci. 2009;110(3):285-94.
  42. Choi HS, Lim JY, Chun HJ, et al. The effect of polaprezinc on gastric mucosal protection in rats with ethanol-induced gastric mucosal damage: comparison study with rebamipide. Life Sci. 2013;93(2-3):69-77.
  43. Aburaya M, Tanaka K, Hoshino T, et al. Heme oxygenase-1 protects gastric mucosal cells against non-steroidal anti-inflammatory drugs. J Biol Chem. 2006;281(44):33422-32.
  44. Almolki A, Guenegou A, Golda S, et al. Heme oxygenase-1 prevents airway mucus hypersecretion induced by cigarette smoke in rodents and humans. Am J Pathol. 2008;173(4):981-92.
  45. Mahmood A, FitzGerald AJ, Marchbank T, et al. Zinc carnosine, a health food supplement that stabilises small bowel integrity and stimulates gut repair processes. Gut. 2007;56(2):168-75.
  46. Amakawa T. Clinical Effect of Z-103 Tablets against Gastric Ulcers: Phase III Clinical Study. Jpn Pharmacol Ther. 1992;20(1):199-223.
  47. Miyoshi A, Namiki M, Asagi S, et al. Clinical Evaluation of Z-103 on Gastric Ulcer - A Multicenter Double-Blind Comparative Study with Cetraxate Hydrochloride. Jpn Pharmacol Ther. 1992;20(1):199-223.
  48. Davison G, Marchbank T, March DS, et al. Zinc carnosine works with bovine colostrum in truncating heavy exercise-induced increase in gut permeability in healthy volunteers. Am J Clin Nutr. 2016;104(2):526-36.
  49. Bally M, Dendukuri N, Rich B, et al. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ. 2017;357:j1909.
  50. Hsu CC, Wang H, Hsu YH, et al. Use of Nonsteroidal Anti-Inflammatory Drugs and Risk of Chronic Kidney Disease in Subjects With Hypertension: Nationwide Longitudinal Cohort Study. Hypertension. 2015;66(3):524-33.
  51. Holz C, Busjahn A, Mehling H, et al. Significant Reduction in Helicobacter pylori Load in Humans with Non-viable Lactobacillus reuteri DSM17648: A Pilot Study. Probiotics Antimicrob Proteins. 2015;7(2):91-100.
  52. Mehling H, Busjahn A. Non-viable Lactobacillus reuteri DSMZ 17648 (Pylopass) as a new approach to Helicobacter pylori control in humans. Nutrients. 2013;5(8):3062-73.
  53. Ford AC, Forman D, Hunt R, et al. Helicobacter pylori eradication for the prevention of gastric neoplasia. Cochrane Database Syst Rev. 2015(7):CD005583.