Does everyone have Helicobacter pylori?

Written by Wang Li Wei
Gastroenterology
Updated on September 10, 2024
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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.

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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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Can drinking clove water cure Helicobacter pylori?

Drinking clove-infused water is not an effective treatment for Helicobacter pylori. For effective treatment of Helicobacter pylori, it is necessary to use a bismuth-containing quadruple therapy for two weeks to eradicate Helicobacter pylori. You can choose one type of proton pump inhibitor, such as omeprazole, lansoprazole, rabeprazole, esomeprazole, etc., combined with two of the antibiotics amoxicillin, clarithromycin, metronidazole, and furazolidone, and either bismuth citrate or bismuth pectin to form a quadruple therapy. Helicobacter pylori is a microaerophilic bacterium. If infected with Helicobacter pylori, it may cause gastritis, gastric ulcers, gastric cancer, and other diseases. (Please follow medical advice when using medication.)

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What should I do if I have a Helicobacter pylori infection?

Helicobacter pylori is closely related to the occurrence of chronic gastritis, gastric ulcers, and gastric cancer, but not everyone infected with Helicobacter pylori will develop chronic gastritis or gastric ulcers. Infections can be diagnosed with a breath test, where values more than twice the normal level, accompanied by symptoms of gastritis, gastric ulcers, stomach distension, stomach pain, and acid reflux, should be considered for antibacterial and stomach-protective treatment. Generally, with standard treatment, 90% of Helicobacter pylori can be eradicated within one to two weeks. However, reinfection is common as it can be found in food and utensils and transmitted through saliva. It is generally advised that children under 14 and individuals with low levels of Helicobacter pylori without obvious stomach inflammation symptoms do not require immediate treatment.

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Can a gastroscopy detect Helicobacter pylori?

First, it is important to clarify that a gastroscopy and a Helicobacter pylori test are two completely different methods. Generally speaking, a gastroscopy cannot detect whether there is a Helicobacter pylori infection. A gastroscopy specifically involves passing through the pharynx, esophagus, stomach, and finally reaching the descending part of the duodenum. It allows clear observation of whether there is inflammation, ulcers, or neoplastic diseases in the upper gastrointestinal tract, and it is the clearest and most direct method for examining the upper gastrointestinal tract. Helicobacter pylori testing, on the other hand, can generally be conducted in several ways. Firstly, blood can be drawn to test for Helicobacter pylori antibodies. Secondly, a breath test can be done, which is currently the most commonly used method, such as the carbon-13 or carbon-14 breath tests. Other methods include taking a biopsy during gastroscopy for a rapid urease test, and culturing bacteria from a biopsy. Therefore, gastroscopy cannot be used to test for Helicobacter pylori.

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How many times a year should Helicobacter pylori be tested?

If Helicobacter pylori tests positive, then it is necessary to undergo standardized eradication treatment. A re-examination is needed one month after cessation of the eradication treatment to confirm whether the eradication was successful or the treatment failed. If the patient tests negative for Helicobacter pylori, then there is no need for repeated testing. Therefore, the frequency of testing for Helicobacter pylori within a year needs to be analyzed based on specific circumstances, using different testing methods and frequencies according to different situations. Patients infected with Helicobacter pylori should eat light, easily digestible foods, avoid overeating, and avoid spicy and irritating foods.