Do you have to take medication if you test positive for Helicobacter pylori?

Written by Si Li Li

Gastroenterology

Updated on June 10, 2025

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Helicobacter pylori has been confirmed as a significant cause of chronic gastritis, peptic ulcers, and gastric cancer. The infection rate of Helicobacter pylori in China is very high, exceeding 50%, and is closely related to the dietary habits of the Chinese people, as they tend to share dishes, making it easy to transmit Helicobacter pylori. Is medication necessary if one is infected with Helicobacter pylori? The answer is not necessarily. Treatment for Helicobacter pylori is only needed if there is accompanying chronic gastritis, erosion, peptic ulcers, or a family history of certain gastrointestinal diseases. If there are no symptoms and no family history of such diseases, and only a positive Helicobacter pylori test, medication may not be necessary.

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Written by Wu Hai Wu

Gastroenterology

43sec

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If Helicobacter pylori is not treated properly, will it become more severe?

Helicobacter pylori infection, if not treated properly, does not necessarily become more severe. However, if treatment fails, it is necessary to undergo re-treatment. It is recommended to visit a hospital and consult with a qualified gastroenterologist to adjust the treatment plan. The choice of specific medications, as well as their dosages and usage, should be carried out according to medical advice. During the treatment of Helicobacter pylori infection, it is important to avoid overeating, maintain regular meal times and portions, consume easily digestible foods, and eat plenty of fresh vegetables and fruits rich in vitamins. Spicy and irritating foods should be avoided.

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Written by Huang Ya Juan

Gastroenterology

1min 43sec

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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 Yang Chun Guang

Gastroenterology

43sec

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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.

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Written by Si Li Li

Gastroenterology

1min 9sec

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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.

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Written by Yang Chun Guang

Gastroenterology

51sec

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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.