What are the symptoms of Helicobacter pylori infection?

Written by Jiang Guo Ming
Gastroenterology
Updated on September 14, 2024
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Helicobacter pylori is a pathogen produced in the stomach or oral cavity. It cannot be said that Helicobacter pylori causes any specific symptoms, rather, it is the infection of Helicobacter pylori that leads to a series of diseases presenting symptoms. Some people infected with Helicobacter pylori may not show any symptoms at all. If related diseases occur, such as gastritis or ulcers, symptoms such as acid reflux, heartburn, nausea, and vomiting may appear. Additionally, some patients, like those with refractory iron deficiency anemia or idiopathic thrombocytopenic purpura, may also have conditions associated with Helicobacter pylori infection.

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How to treat Helicobacter pylori positivity?

A positive test for Helicobacter pylori requires distinguishing the specific method used for detection. If it is a positive result from a Helicobacter pylori antibody test, a breath test, including both the Carbon-14 and Carbon-13 breath tests, should be conducted. If the breath test comes back positive, further examinations are necessary, including gastroscopy and analysis of Helicobacter pylori virulence factors. The analysis of virulence factors can help determine if the Helicobacter pylori infection is highly toxic. If positive, it may indicate a potential for severe gastric diseases and necessitate treatment. For individuals with a positive Helicobacter pylori breath test, a gastroscopy is also recommended, as it is the only way to precisely determine the type of gastric disease present, such as ulcers or gastritis. Depending on the gastroscopy results, some individuals may need eradication treatment for Helicobacter pylori, especially those with a history of gastric ulcers, a family history of gastric cancer, gastric polyps, erosive gastritis, or gastric mucosa-associated lymphoid tissue lymphoma. Others, if the virulence factor analysis is negative, might not require immediate treatment for Helicobacter pylori. However, if a patient insists on treatment for Helicobacter pylori, it can be considered, but it must be clear that there are risks involved and that the treatment should be conducted properly. Finally, treatment for Helicobacter pylori is not recommended for minors, i.e., individuals under 18 years of age.

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Is a gastroscopy examination accurate for detecting Helicobacter pylori?

Gastroscope testing for Helicobacter pylori is conducted under a gastroscope and is quite accurate. However, nowadays, if one is only testing for Helicobacter pylori, it generally does not require an endoscopic examination, since undergoing a gastroscope is an uncomfortable process that can cause nausea. Currently, Helicobacter pylori can be detected using a breath test method involving carbon-13 or carbon-14. This involves swallowing a capsule and then performing a breath test. It is crucial to fast before the test, as eating can affect the accuracy of the results. Therefore, although gastroscope testing for Helicobacter pylori is accurate, it is less commonly used nowadays.

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Can Helicobacter pylori tests be done during the pregnancy preparation stage?

During the preconception stage, it is possible to test for Helicobacter pylori, but if testing is to be conducted, breath tests should be avoided. This is because breath tests use carbon-14 or carbon-13, which are radioactive, making them unsuitable for women planning pregnancy. At this time, it is also important to weigh the pros and cons. If there are chronic gastric or duodenal ulcers, and the symptoms are quite apparent, it is necessary to conduct tests. It is advisable to postpone pregnancy, address the gastrointestinal diseases first, and then proceed with pregnancy. If there are gastric or duodenal diseases at such time, pregnancy could possibly exacerbate the condition.

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Can Helicobacter pylori cure itself?

Can Helicobacter pylori be self-healing? Helicobacter pylori is very stubborn; once infected, adults who do not undergo formal therapeutic interventions will be afflicted for life, meaning the cure rate is close to zero. Children, whose immune functions are not yet fully developed, may experience multiple exposures on the gastric mucosa and short-term colonization before Helicobacter pylori settles permanently, which could potentially lead to either colonization or loss of the bacteria. White populations have stronger immune resistance than colored populations. Tracking reports indicate that 50% of white children may lose the infection after contracting it, while only 4% of black children might. Generally, the infection rate is higher than the self-healing rate, indicating that Helicobacter pylori infections in adults are generally not self-resolving.

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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.