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 Wu Hai Wu
Gastroenterology
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Can treatment for Helicobacter pylori be stopped at any time?

During the treatment of Helicobacter pylori, it is not advisable to stop the medication arbitrarily, as doing so may lead to insufficient treatment duration and result in a failure to eradicate the bacteria. Therefore, it is recommended to use a bismuth-containing quadruple therapy for two weeks to eradicate Helicobacter pylori. The specific medications included in this two-week quadruple therapy are a proton pump inhibitor such as pantoprazole or lansoprazole, plus two antibiotics such as amoxicillin, clarithromycin, or metronidazole, combined with bismuth potassium citrate. The medication should be taken under medical supervision. Helicobacter pylori infection can be detected through a carbon-13 breath test or a carbon-14 breath test.

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Written by Yang Chun Guang
Gastroenterology
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Can a barium meal detect Helicobacter pylori?

The most commonly used test for detecting Helicobacter pylori at present is the breath test, which generally comes in two types: carbon-13 and carbon-14, though the testing method is basically fixed. A barium meal test can only detect whether there are large gastric ulcers or the presence of gastric cancer, but Helicobacter pylori is quite small and cannot be detected through a barium meal. Therefore, the detection of Helicobacter pylori typically relies on traditional methods, such as breath tests or tests performed during gastroscopy.

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Written by Wang Hui Jie
Gastroenterology
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Can a gastroscopy detect Helicobacter pylori?

Since Helicobacter pylori is a type of bacterium, it cannot be seen with the naked eye. However, current research indicates that Helicobacter pylori is strongly associated with certain mucosal appearances under endoscopy. Therefore, endoscopists can infer the presence of an infection based on certain mucosal appearances observed during the procedure. However, if the only purpose is to test for Helicobacter pylori infection without needing a gastroscopy, then we can opt for non-invasive methods such as the carbon-13 urea breath test, carbon-14 urea breath test, stool antigen test, and serological antibody tests, which are commonly used methods of testing. Moreover, after treatment for Helicobacter pylori, it is recommended to use either the carbon-13 or carbon-14 urea breath test for examination.

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Written by Wu Hai Wu
Gastroenterology
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Can I eat cake during the treatment of Helicobacter pylori?

During the treatment process for Helicobacter pylori, it is permissible to eat cake, as there are no specific dietary restrictions. However, it is important to avoid spicy and stimulating foods, as well as strong liquor, strong tea, coffee, etc. Treatment for Helicobacter pylori infection may include the use of proton pump inhibitors such as omeprazole and lansoprazole combined with antibiotics like amoxicillin, clarithromycin, and metronidazole, often in a quadruple therapy regimen with bismuth citrate for two weeks aimed at eradicating the infection. Patients with Helicobacter pylori infection should consume easy-to-digest, bland foods and avoid overly spicy and stimulating foods. (Please follow your doctor's prescription when using medications.)

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Written by Wu Hai Wu
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Can I drink coffee during the treatment for Helicobacter pylori?

It is not recommended to drink coffee during the treatment for Helicobacter pylori. During the treatment for Helicobacter pylori infection, it is advised to consume more fresh vegetables and fruits rich in vitamins, maintain regular meals, and eat light, easily digestible foods. Avoid strong alcohol, strong tea, coffee, and also greasy foods. The main methods for detecting Helicobacter pylori infection are the carbon-13 urea breath test or the carbon-14 urea breath test. If the test results are positive, a standard eradication treatment using a bismuth-containing quadruple therapy for two weeks should be implemented. Additionally, a re-examination is needed one month after discontinuing the medication to confirm whether the eradication is complete.