Symptoms of Helicobacter pylori infection

Written by Peng Miao Yun
Internal Medicine
Updated on September 10, 2024
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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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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.

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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.

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Written by Wu Hai Wu
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What should I do if I feel uncomfortable in my stomach and intestines after treatment for Helicobacter pylori?

The main reason for discomfort in the stomach and intestines after treatment for Helicobacter pylori might very likely be due to the consumption of clarithromycin, metronidazole, etc., as metronidazole, clarithromycin, and others can also irritate the gastrointestinal tract. Therefore, it is recommended to take metronidazole, clarithromycin, and other similar medications about half an hour after meals to reduce their side effects. If the patient experiences gastrointestinal discomfort, consider using medications that regulate the gut flora for treatment, such as compounded lactobacillus, bifidobacterium triple live bacteria, and bacillus coagulans, etc. If the stomach discomfort is quite severe, medications that protect the gastric mucosa, such as magnesium trisilicate or vitamin B6, may be taken. These medications can help alleviate the side effects of other drugs and reduce symptoms of nausea and vomiting. Discomfort might also be due to incomplete healing. First, it is necessary to return to a regular hospital for a follow-up consultation. If the symptoms have not worsened, it is important to continue taking the prescribed medications as advised by the doctor. Recent dietary habits should include eating regularly, having smaller, more frequent meals, and avoiding spicy, stimulating, and greasy foods. Rest should also be prioritized. (Please follow medical advice when using medications.)

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How to treat Helicobacter pylori positive?

The infection rate of Helicobacter pylori in our country has already exceeded 50%, and Helicobacter pylori has been confirmed as the main cause of chronic gastritis, peptic ulcers, and even gastric cancer. If Helicobacter pylori tests positive and is accompanied by symptoms or diseases of the digestive system, eradication treatment for Helicobacter pylori is necessary. The medication involves a proton pump inhibitor, two types of antibiotics, and a bismuth agent, with a treatment period of 14 days. After the 14-day treatment, the medication should be discontinued for a month before rechecking with a carbon-14 breath test to confirm whether Helicobacter pylori has turned negative. If it has turned negative, it indicates that the eradication treatment of Helicobacter pylori is successful. After infection with Helicobacter pylori, a diet easy to digest is recommended.

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Can you eat sweets during the treatment for Helicobacter pylori?

During the treatment of Helicobacter pylori, it is permissible to eat sweets. During this period, it is necessary to avoid spicy and irritating foods, as well as avoid drinking strong alcohol, strong tea, coffee, and so on. It is recommended to consume more fresh vegetables and fruits rich in vitamins, as well as nutritious and light foods. Smoking and drinking alcohol should be avoided, and meals should be regular and in measured quantities. Since sweet foods are not considered spicy or irritating, they can be consumed during the treatment of Helicobacter pylori. After the treatment of a Helicobacter pylori infection, it is necessary to wait one month after stopping the medication before a follow-up examination to confirm whether the bacteria have been completely eradicated.