Helicobacter pylori treatment for half a month, re-examination still positive, what could be the reason?

Written by Wu Hai Wu
Gastroenterology
Updated on May 04, 2025
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If a follow-up test for Helicobacter pylori is positive after half a month of treatment, it indicates that the treatment was not successful, and Helicobacter pylori is still present. At this point, it is necessary to adjust the medication plan and treat Helicobacter pylori again. The specific medication methods and treatment duration should be used under the guidance of a doctor. Treatment of Helicobacter pylori infection requires the use of a bismuth-containing quadruple therapy for two weeks to eradicate it. Additionally, the diet should include an increased intake of fresh vegetables and fruits rich in vitamins and avoid spicy and irritating foods. Smoking and alcohol should be avoided. (Please follow the doctor’s prescription for medication use.)

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Written by Wu Hai Wu
Gastroenterology
47sec home-news-image

Do you need to change your toothbrush when treating Helicobacter pylori?

It is recommended to change your toothbrush during the treatment period for Helicobacter pylori. This is because Helicobacter pylori exists not only in the stomach but can also be detected in the saliva, dental plaque, and tongue coating of the mouth. Once infected with Helicobacter pylori, a two-week quad therapy that includes bismuth agents is necessary to eradicate the infection. After eradication, the bacteria might still be present on the toothbrush, which could lead to a recurring infection. Therefore, it is advised that patients change their toothbrush after undergoing treatment for Helicobacter pylori. Patients infected with Helicobacter pylori should undergo the two-week quad therapy including bismuth agents for treatment.

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Written by Si Li Li
Gastroenterology
1min 3sec home-news-image

Is erosive gastritis related to Helicobacter pylori?

Helicobacter pylori infection has been confirmed as the primary cause of chronic gastritis, peptic ulcers, and gastric cancer. Erosive chronic gastritis is a type of chronic gastritis, thus there is a certain relationship between erosive gastritis and Helicobacter pylori, but not all chronic gastritis is caused by Helicobacter pylori; some are, but others are not. Therefore, if erosive gastritis occurs, it is necessary to conduct a carbon-14 breath test to determine whether there is an infection of Helicobacter pylori. If the Helicobacter pylori infection is positive, a 14-day anti-Helicobacter pylori treatment should be administered. The treatment includes a proton pump inhibitor, two antibiotics, and a bismuth agent. After treatment, most of the Helicobacter pylori will convert from positive to negative.

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Written by Yang Chun Guang
Gastroenterology
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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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Written by Wu Hai Wu
Gastroenterology
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How long does Helicobacter pylori resistance last?

Helicobacter pylori resistance generally develops around two weeks. If Helicobacter pylori shows resistance, it is advisable to consider adjusting the treatment using other antibiotics. The eradication treatment for Helicobacter pylori infection generally involves a two-week quadruple therapy with a bismuth-containing regimen. Furthermore, one month after stopping the eradication treatment, it is necessary to recheck with a carbon-13 breath test or a carbon-14 breath test to confirm effective eradication. Helicobacter pylori infection can cause gastritis, peptic ulcers, and malignant tumors in the stomach, among other issues.

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Written by Yang Chun Guang
Gastroenterology
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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.