How to eradicate Helicobacter pylori

Written by Huang Ya Juan
Gastroenterology
Updated on September 19, 2024
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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.

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Written by Si Li Li
Gastroenterology
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Does the breath test for Helicobacter pylori require fasting?

Currently, the detection of Helicobacter pylori is highly accurate and specific, and a rapid, simple, and effective method is the Carbon-14 breath test. The Carbon-14 breath test requires no eating within six hours, so it is best to take it on an empty stomach. Therefore, it is preferable to test for Helicobacter pylori on an empty stomach. Currently, the infection rate of Helicobacter pylori in our country has exceeded 50%. Helicobacter pylori is the principal cause of chronic gastritis, peptic ulcers, or gastric cancer. Therefore, if symptoms of the digestive system occur, such as belching, acid reflux, upper abdominal pain, nausea, and poor appetite, it is advisable to conduct a test for Helicobacter pylori, specifically the Carbon-14 breath test, to confirm the infection of Helicobacter pylori.

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Written by Si Li Li
Gastroenterology
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Is long-term bad breath definitely caused by Helicobacter pylori?

Chronic bad breath may be caused by Helicobacter pylori infection, but this is not always the case. Other causes of bad breath include dental issues, such as cavities and tooth decay. Additionally, stomach diseases can also cause bad breath, many of which are associated with Helicobacter pylori infection. After ruling out dental diseases, it is recommended to undergo a Carbon-14 breath test to determine if there is an infection of Helicobacter pylori. If the test for Helicobacter pylori infection is positive and accompanied by some stomach symptoms, such as upper abdominal bloating, burping, acid reflux, nausea, and vomiting, it is advisable to undergo a 14-day treatment for Helicobacter pylori. Generally, after treatment, the Helicobacter pylori can change from positive to negative.

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Written by Peng Miao Yun
Internal Medicine
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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.

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Written by Wu Hai Wu
Gastroenterology
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Is the treatment process for Helicobacter pylori uncomfortable?

The treatment process for Helicobacter pylori infection is not uncomfortable, primarily involving oral medication. Treatment options include a combination of two antibiotics such as amoxicillin, clarithromycin, furazolidone, metronidazole, etc., alongside a proton pump inhibitor like omeprazole, pantoprazole, or lansoprazole, and the addition of bismuth citrate. This forms a quadruple therapy administered over two weeks to eradicate the infection. During treatment for Helicobacter pylori infection, it is advised to consume a diet rich in vitamins, incorporating fresh vegetables and fruits. It is important to eat regularly, avoid overeating or consuming oily, spicy, and irritating foods. (Please follow medical advice when using medications.)

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Written by Yang Chun Guang
Gastroenterology
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Can a gastroscopy check for Helicobacter pylori?

Normally, when conducting a gastroscopy, it is possible to test for Helicobacter pylori, but this method of detection is less commonly used in clinical practice nowadays, as it requires undergoing a gastroscopy, which can be quite distressing and may cause nausea and vomiting. Currently, the main method used in clinical practice for detecting Helicobacter pylori is the breath test, typically using carbon-13 or carbon-14. This involves swallowing a capsule and then blowing into a device to test for Helicobacter pylori infection. This method is more convenient, which is why it has increasingly replaced gastroscopy for detecting Helicobacter pylori.