Do normal people have Helicobacter pylori?

Written by Jiang Guo Ming
Gastroenterology
Updated on September 16, 2024
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In my understanding, a “normal person” refers to individuals who do not experience any stomach discomfort. In our country, the infection rate of Helicobacter pylori is extremely high, with reports indicating that over 50% of adults are infected, albeit asymptomatically. Thus, it is certain that many so-called "normal people" are infected with Helicobacter pylori, also known as asymptomatic Helicobacter pylori carriers. This condition also requires antibacterial treatment because there is a close relationship between Helicobacter pylori and gastritis, ulcers, and gastric cancer. Even for patients with chronic superficial gastritis, if Helicobacter pylori is present, eradication therapy is advocated. If not completely eradicated, it often leads to the development of chronic atrophic gastritis, which is a more serious condition.

Other Voices

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Written by Wang Hui Jie
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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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Written by Huang Ya Juan
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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 Si Li Li
Gastroenterology
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What are the early symptoms of Helicobacter pylori infection?

Helicobacter pylori can cause chronic gastritis, peptic ulcers, and even stomach cancer. Infection with Helicobacter pylori may result in symptoms such as upper abdominal distension and pain, belching, acid reflux, nausea, vomiting, poor appetite, bad breath, and indigestion. A carbon-14 breath test can confirm a Helicobacter pylori infection. Currently, the infection rate of Helicobacter pylori in our country has exceeded 50%. If an infection is present and symptoms or diseases of the digestive system occur, eradication treatment for Helicobacter pylori is necessary. The treatment regimen consists of a proton pump inhibitor, two types of antibiotics, and a bismuth agent, adjusted to a 14-day course.

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Written by Si Li Li
Gastroenterology
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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 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.