The standard eradication treatment of the hostile Helicobacter pylori (H. pylori) stomach infection is facing
increasing alarming antibiotic resistance worldwide and calls for alternative strategies to the use of antibiotics.
One new perspective in this direction is cytoprotective compounds for targeted prevention of the adhesion of the
bacteria to the stomach host cell and to inhibit the bacterial cell-cell communication via quorum sensing by specific
inhibitors. Bacterial adhesion of H. pylori to the host cells is mainly mediated by carbohydrate-protein interactions.
Therefore, the use of polyvalent carbohydrates, (e.g. plant-derived polysaccharides), as potential antiadhesive compounds,
seems to be a promising tool to prevent the initial docking of the bacterium to the stomach cells. Polysaccharides
are common constituents of daily food, either as starch or as dietary fiber and often also function as excipients
for galenic drug-delivery formulations. In addition, polysaccharides with defined pharmacodynamics action against bacterial
outer membrane proteins can have potential as therapeutic tools in the treatment of bacterial infections. Some polysaccharides are known
to possess antibacterial properties against gram-positive bacteria, others to inhibit bacterial colonization by blocking specific carbohydrate
receptors involved in host-bacteria interaction. This mode of action is advocated as alternative antiadhesion therapy. Ongoing research
is also seeking for polysaccharide-based nanoformulations with potential for local drug delivery at the stomach as novel H. pylori
therapies. These approaches pose challenges concerned with the stability of the nanomaterials in the harsh conditions of the gastric environment
and their capacity to adhere to the stomach mucosa. In a global scenario, geographical diversity and social habits, namely lifestyle
and dietary factors, influence the prevalence of the H. pylori-associated diseases and their severity. In this context, the exploration
of the biological activity of plant-derived products or polysaccharides commonly present in foods is increasingly becoming more and
more attractive. This review aims to present the current state-of-the-art on the antiadhesive capacity of different polysaccharide families,
on polysaccharide-based nanosystems and the proof-of-concept evidence of their potential use as alternative medicines against H. pylori.