What should I do if Helicobacter pylori infection is not cured after two treatments?

Written by Wu Hai Wu
Gastroenterology
Updated on March 21, 2025
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If Helicobacter pylori infection has not been cured after two treatments, it is necessary to consider the possibility of bacterial resistance or that the treatment was not standardized. It is advisable to visit the gastroenterology department of a hospital. Based on the doctor's experience, it may be necessary to adjust the medication plan. The choice of specific medications and their dosage should be determined according to the doctor's prescription. During the treatment period, one should eat easily digestible food and avoid spicy and irritating foods, as well as avoid drinking alcohol, strong tea, coffee, etc. It is also important to eat slowly and avoid overeating or drinking excessively.

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Written by Wu Hai Wu
Gastroenterology
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Can you kiss during the treatment period for Helicobacter pylori?

During the treatment of Helicobacter pylori, it is advisable to avoid kissing, as Helicobacter pylori may be present in saliva, and kissing could transmit the infection to a partner. Also, avoid consuming strong alcohol, strong tea, coffee, and other spicy and irritant foods. Eat regularly and in moderation, chew slowly, and consume easily digestible foods along with fresh vegetables and fruits rich in vitamins, such as apples, bananas, tomatoes, and kiwis. It is recommended to use separate meals during the treatment of Helicobacter pylori infection to prevent transmission.

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Written by Wu Hai Wu
Gastroenterology
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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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Written by Lian Wen Xi
Pediatrics
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What are the symptoms of children infected with Helicobacter pylori?

Children infected with Helicobacter pylori typically show no symptoms initially, but may later develop chronic gastritis and gastrointestinal ulcers. Clinical manifestations mainly include vomiting, nausea, abdominal distension, acid reflux, and abdominal pain, and may even present symptoms such as bloody stools or vomiting blood. If a child is infected with Helicobacter pylori but exhibits mild symptoms, treatment can focus solely on the infection. However, if there are gastrointestinal ulcers or repeated gastrointestinal discomfort, treatment should include antibiotics along with medications that suppress stomach acid production. Treatment duration usually lasts about one to two months, depending on the specific condition of the child.

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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 Si Li Li
Gastroenterology
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How to treat duodenal ulcer with Helicobacter pylori infection?

The treatment of duodenal ulcer accompanied by Helicobacter pylori infection begins primarily with anti-Helicobacter pylori therapy. The regimen includes a proton pump inhibitor, two types of antibiotics, and a bismuth agent, lasting a total of 14 days. In addition, for duodenal ulcers, it is necessary to use acid-suppressing and stomach-protecting medications to promote gastric mobility and protect the gastric mucosa, with the treatment course lasting six weeks. At the same time, it is important to focus on a light and easily digestible diet, avoiding smoking and drinking alcohol, as well as avoiding strong tea, coffee, spicy, irritating, fried, grilled, raw, cold, and sweet foods. It is also crucial to avoid adverse emotional effects such as anxiety, depression, and stress, prevent excessive fatigue or staying up late, and it is advised to moderately increase physical activity.