Can gastroscopy detect Helicobacter pylori?

Written by Wang Hui Jie
Gastroenterology
Updated on September 27, 2024
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Helicobacter pylori is a type of bacterium, hence it is invisible to the naked eye. However, during a gastroscopy, the gastroenterologist can infer whether a patient is infected with Helicobacter pylori by observing the mucosal appearance under the endoscope. For example, signs such as the disappearance of damages in the tiny veins, nodular changes resembling chicken skin, scattered congested spots, and others. To confirm the presence of a Helicobacter pylori infection, further tests are required. For instance, during a gastroscopy, a rapid urease test can be conducted where a tissue sample from the stomach is tested - this method is quite convenient. Alternatively, a tissue sample can be sent for pathological examination, which might take longer.

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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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Does a positive Helicobacter pylori require treatment?

Currently, the infection rate of Helicobacter pylori in our country has exceeded 50%. If there is an infection of Helicobacter pylori and it is accompanied by symptoms or diseases of the digestive system, or if the patient has a family history of gastric cancer, eradication treatment for Helicobacter pylori is needed. This is because Helicobacter pylori has been proven to be the main cause of chronic gastritis, peptic ulcers, and even gastric cancer. The method of eradication involves a proton pump inhibitor, two types of antibiotics, and a bismuth agent, with treatment lasting for 14 days. After the 14-day treatment period, medications are stopped for a month. One month later, a carbon-14 breath test is performed to confirm whether Helicobacter pylori has been converted to negative. If it has converted to negative, it means that the eradication treatment was successful.

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What is the reason that Helicobacter pylori treatment causes black stools?

If black stools occur during the treatment of Helicobacter pylori, it is very likely due to the medication-induced black stools caused by taking potassium citrate bismuth or bismuth pectin. However, to rule out the possibility of upper gastrointestinal bleeding, a fecal occult blood test can be conducted for a clear diagnosis. Treatment of Helicobacter pylori infection requires a two-week quadruple therapy that includes bismuth. At the same time, one should avoid overeating and focus on consuming fresh vegetables and fruits rich in vitamins and easy-to-digest foods. It is also advisable to quit smoking and drinking alcohol, and avoid drinking strong tea, coffee, etc.

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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.

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Written by Wang Hui Jie
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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.