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
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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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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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Can treatment for Helicobacter pylori be stopped at any time?

During the treatment of Helicobacter pylori, it is not advisable to stop the medication arbitrarily, as doing so may lead to insufficient treatment duration and result in a failure to eradicate the bacteria. Therefore, it is recommended to use a bismuth-containing quadruple therapy for two weeks to eradicate Helicobacter pylori. The specific medications included in this two-week quadruple therapy are a proton pump inhibitor such as pantoprazole or lansoprazole, plus two antibiotics such as amoxicillin, clarithromycin, or metronidazole, combined with bismuth potassium citrate. The medication should be taken under medical supervision. Helicobacter pylori infection can be detected through a carbon-13 breath test or a carbon-14 breath test.

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Written by Wu Hai Wu
Gastroenterology
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Can I eat cake during the treatment of Helicobacter pylori?

During the treatment process for Helicobacter pylori, it is permissible to eat cake, as there are no specific dietary restrictions. However, it is important to avoid spicy and stimulating foods, as well as strong liquor, strong tea, coffee, etc. Treatment for Helicobacter pylori infection may include the use of proton pump inhibitors such as omeprazole and lansoprazole combined with antibiotics like amoxicillin, clarithromycin, and metronidazole, often in a quadruple therapy regimen with bismuth citrate for two weeks aimed at eradicating the infection. Patients with Helicobacter pylori infection should consume easy-to-digest, bland foods and avoid overly spicy and stimulating foods. (Please follow your doctor's prescription when using medications.)

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Written by Si Li Li
Gastroenterology
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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.