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Helicobacter pylori infection
How to eradicate Helicobacter pylori
The spontaneous clearance rate of Helicobacter pylori infection is extremely low, meaning that it is almost impossible to cure itself. If not treated medically, it may lead to a lifelong infection. Currently, the consensus both domestically and internationally on handling Helicobacter pylori is that eradication requires combination therapy with multiple drugs, categorized into triple therapy and quadruple therapy, with a treatment duration of 2 weeks. Triple therapy consists of a proton pump inhibitor (PPI) plus two antibiotics. We currently use quadruple therapy, which includes two antibiotics, a gastric mucosal protectant, and a proton pump inhibitor. The choice of these drugs is complex. Common anti-inflammatory drugs include amoxicillin, clarithromycin, metronidazole, and levofloxacin; in cases of bacterial resistance, we recommend using furazolidone or tetracycline. Specific medications should be consulted in detail with a doctor. After the treatment course, we need to assess whether the eradication was successful, with a re-examination one month after stopping the drugs. After the eradication of Helicobacter pylori, the rate of reinfection in adults is very low, but the reinfection rate in children is somewhat higher than in adults. Not everyone infected with Helicobacter pylori needs eradication; it is necessary only for those with ulcers, erosion, atrophy, or related symptoms.
Do normal people have Helicobacter pylori?
In my understanding, a “normal person” refers to individuals who do not experience any stomach discomfort. In our country, the infection rate of Helicobacter pylori is extremely high, with reports indicating that over 50% of adults are infected, albeit asymptomatically. Thus, it is certain that many so-called "normal people" are infected with Helicobacter pylori, also known as asymptomatic Helicobacter pylori carriers. This condition also requires antibacterial treatment because there is a close relationship between Helicobacter pylori and gastritis, ulcers, and gastric cancer. Even for patients with chronic superficial gastritis, if Helicobacter pylori is present, eradication therapy is advocated. If not completely eradicated, it often leads to the development of chronic atrophic gastritis, which is a more serious condition.
Is Helicobacter pylori a serious illness?
Helicobacter pylori is not a major disease, so patients do not need to be overly anxious and worried. Once an infection of Helicobacter pylori is detected, patients can consider visiting the gastroenterology department of a formal hospital. The choice of medication should be based on the doctor's experience. Also, the use and dosage of the medication should be followed according to the doctor's instructions. For the treatment of Helicobacter pylori infections, it is recommended to use a bismuth-containing quadruple therapy for two weeks to eradicate the infection. During the treatment period, it is advisable to avoid eating spicy and irritating foods, and also to avoid alcohol, strong tea, coffee, etc. Avoid overeating and eat small, easily digestible meals more frequently. (Please follow the doctor’s prescription when using medication.)
Is a gastroscopy examination accurate for detecting Helicobacter pylori?
Gastroscope testing for Helicobacter pylori is conducted under a gastroscope and is quite accurate. However, nowadays, if one is only testing for Helicobacter pylori, it generally does not require an endoscopic examination, since undergoing a gastroscope is an uncomfortable process that can cause nausea. Currently, Helicobacter pylori can be detected using a breath test method involving carbon-13 or carbon-14. This involves swallowing a capsule and then performing a breath test. It is crucial to fast before the test, as eating can affect the accuracy of the results. Therefore, although gastroscope testing for Helicobacter pylori is accurate, it is less commonly used nowadays.
What are the symptoms of Helicobacter pylori infection?
Helicobacter pylori is a pathogen produced in the stomach or oral cavity. It cannot be said that Helicobacter pylori causes any specific symptoms, rather, it is the infection of Helicobacter pylori that leads to a series of diseases presenting symptoms. Some people infected with Helicobacter pylori may not show any symptoms at all. If related diseases occur, such as gastritis or ulcers, symptoms such as acid reflux, heartburn, nausea, and vomiting may appear. Additionally, some patients, like those with refractory iron deficiency anemia or idiopathic thrombocytopenic purpura, may also have conditions associated with Helicobacter pylori infection.
Can a gastroscopy examine Helicobacter pylori?
Can a gastroscopy detect Helicobacter pylori? Helicobacter pylori is a type of bacteria, thus it cannot be seen with the naked eye. However, recent research shows that Helicobacter pylori is closely related to certain mucosal appearances observed under endoscopy. Therefore, endoscopists can infer the infection of Helicobacter pylori based on certain mucosal appearances. However, if a patient is just testing for Helicobacter pylori infection, there is no need for a gastroscopy. We can choose some non-invasive methods such as the carbon-13 breath test, carbon-14 breath test, stool antigen test, and serological antibody test, which are commonly used detection methods. Moreover, after treatment for Helicobacter pylori, it is recommended to choose the carbon-13 or carbon-14 breath test, as they are quite accurate.
How long does Helicobacter pylori resistance last?
Helicobacter pylori resistance generally develops around two weeks. If Helicobacter pylori shows resistance, it is advisable to consider adjusting the treatment using other antibiotics. The eradication treatment for Helicobacter pylori infection generally involves a two-week quadruple therapy with a bismuth-containing regimen. Furthermore, one month after stopping the eradication treatment, it is necessary to recheck with a carbon-13 breath test or a carbon-14 breath test to confirm effective eradication. Helicobacter pylori infection can cause gastritis, peptic ulcers, and malignant tumors in the stomach, among other issues.
Symptoms of Helicobacter pylori infection
Helicobacter pylori, once settled in the stomach and duodenum, can cause chronic inflammation of the gastric mucosa, leading to reduced stomach digestive function. Over time, this may lead to chronic gastritis, gastric ulcers, and even cause gastric cancer. So, what are the symptoms of Helicobacter pylori infection? In cases of mild infection, where the bacteria count is low, there might be no obvious symptoms, with only bad breath occurring. If a high bacteria count causes an inflammatory reaction in the gastric mucosa, symptoms can include stomach bloating, stomach pain, acid reflux, a feeling of fullness in the stomach, along with nausea and bad breath.
Can a gastroscopy detect Helicobacter pylori?
The examination with a gastroscope mainly focuses on checking for any damage to the mucous membranes of the stomach and esophagus. It can detect gastritis, gastric ulcers, or stomach cancer. For some patients who might have a tendency toward cancerous changes, a pathological examination can be conducted. However, testing for Helicobacter pylori with a gastroscope requires a separate lab test. Therefore, routine gastroscopic examinations generally do not include testing for Helicobacter pylori. If testing for Helicobacter pylori is needed, it is a separate examination item. Nowadays, since undergoing a gastroscopy can be quite uncomfortable and cause symptoms like nausea for some people, testing for Helicobacter pylori is accurately conducted using a breath test.
Does everyone have Helicobacter pylori?
Helicobacter pylori is not present in everyone; the infection rate among the general population can reach about 60%. However, some people who are infected with Helicobacter pylori do not necessarily experience symptoms such as acid reflux, bloating, stomach pain, or bad breath. Some people develop symptoms after being infected with Helicobacter pylori, and subsequently, when they visit a hospital for examination, the infection with this bacterium can be detected. Additionally, there are individuals who exhibit such symptoms but are not infected with Helicobacter pylori. In summary, not everyone is infected with Helicobacter pylori, and not everyone who is infected shows symptoms.