Can treatment for Helicobacter pylori be stopped at any time?

Written by Wu Hai Wu
Gastroenterology
Updated on February 18, 2025
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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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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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How to treat erosive gastritis without Helicobacter pylori?

Erosive gastritis primarily presents symptoms such as upper abdominal distension, belching, acid reflux, nausea, vomiting, and indigestion. Diagnosis can be confirmed through gastroscopy, which reveals erosion of the gastric mucosa. If Helicobacter pylori is negative, treatment for erosive gastritis should involve acid suppression, gastric protection, enhancement of gastric motility, and protection of the gastric mucosa. A treatment period of four to six weeks can generally lead to recovery. Additionally, dietary adjustments are crucial: avoid smoking and alcohol, refrain from drinking strong tea and coffee, and do not consume greasy, rich, spicy, fried, grilled, sweet, or cold foods. Milk, soy milk, glutinous rice, and sweet potatoes should also be avoided, favoring instead a diet that is easy to digest. Simultaneously, it is important to increase physical activity to enhance gastrointestinal motility and avoid staying up late.

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Can a gastroscopy detect Helicobacter pylori?

The examination with a gastroscope mainly focuses on checking for any damage to the mucous membranes of the stomach and esophagus. It can detect gastritis, gastric ulcers, or stomach cancer. For some patients who might have a tendency toward cancerous changes, a pathological examination can be conducted. However, testing for Helicobacter pylori with a gastroscope requires a separate lab test. Therefore, routine gastroscopic examinations generally do not include testing for Helicobacter pylori. If testing for Helicobacter pylori is needed, it is a separate examination item. Nowadays, since undergoing a gastroscopy can be quite uncomfortable and cause symptoms like nausea for some people, testing for Helicobacter pylori is accurately conducted using a breath test.

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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.

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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.