Can Helicobacter pylori infection recur after treatment?

Written by Si Li Li
Gastroenterology
Updated on March 21, 2025
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Helicobacter pylori, once treated, does not recur, but it is possible to be infected again after the treatment is completed.

Currently, the infection rate of Helicobacter pylori in our country has exceeded 50%, so it is important to be cautious during communal meals. Due to the Chinese dietary habit of sharing dishes using the same chopsticks, it is easy to spread Helicobacter pylori. Therefore, it is advisable to use serving chopsticks, which can significantly reduce the infection rate of Helicobacter pylori.

If reinfected with Helicobacter pylori, it is necessary to undergo eradication treatment again. The treatment involves a proton pump inhibitor, two types of antibiotics, and a bismuth agent, totaling a 14-day treatment. After infection with Helicobacter pylori, dietary precautions are also needed, focusing on a light, easily digestible diet, and avoiding difficult-to-digest foods.

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Reactions during the treatment of Helicobacter pylori

During the treatment of Helicobacter pylori, there usually isn't significant discomfort, but a small number of patients may experience upper abdominal discomfort, nausea, vomiting, and other symptoms after taking antibiotics. Treatment of Helicobacter pylori requires a two-week quadruple therapy including a bismuth-containing agent. During the treatment of Helicobacter pylori infection, it is recommended to consume fresh vegetables and fruits rich in vitamins, avoid spicy and irritating foods, quit smoking and drinking, and avoid strong tea and coffee. Furthermore, it is advisable to avoid overeating and drinking excessively during the treatment period.

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Written by Wang Jing Bin
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How to treat Helicobacter pylori positivity?

A positive test for Helicobacter pylori requires distinguishing the specific method used for detection. If it is a positive result from a Helicobacter pylori antibody test, a breath test, including both the Carbon-14 and Carbon-13 breath tests, should be conducted. If the breath test comes back positive, further examinations are necessary, including gastroscopy and analysis of Helicobacter pylori virulence factors. The analysis of virulence factors can help determine if the Helicobacter pylori infection is highly toxic. If positive, it may indicate a potential for severe gastric diseases and necessitate treatment. For individuals with a positive Helicobacter pylori breath test, a gastroscopy is also recommended, as it is the only way to precisely determine the type of gastric disease present, such as ulcers or gastritis. Depending on the gastroscopy results, some individuals may need eradication treatment for Helicobacter pylori, especially those with a history of gastric ulcers, a family history of gastric cancer, gastric polyps, erosive gastritis, or gastric mucosa-associated lymphoid tissue lymphoma. Others, if the virulence factor analysis is negative, might not require immediate treatment for Helicobacter pylori. However, if a patient insists on treatment for Helicobacter pylori, it can be considered, but it must be clear that there are risks involved and that the treatment should be conducted properly. Finally, treatment for Helicobacter pylori is not recommended for minors, i.e., individuals under 18 years of age.

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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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Is the treatment process for Helicobacter pylori uncomfortable?

The treatment process for Helicobacter pylori infection is not uncomfortable, primarily involving oral medication. Treatment options include a combination of two antibiotics such as amoxicillin, clarithromycin, furazolidone, metronidazole, etc., alongside a proton pump inhibitor like omeprazole, pantoprazole, or lansoprazole, and the addition of bismuth citrate. This forms a quadruple therapy administered over two weeks to eradicate the infection. During treatment for Helicobacter pylori infection, it is advised to consume a diet rich in vitamins, incorporating fresh vegetables and fruits. It is important to eat regularly, avoid overeating or consuming oily, spicy, and irritating foods. (Please follow medical advice when using medications.)

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Can I eat chocolate while treating Helicobacter pylori?

During the treatment of Helicobacter pylori infection, it is permissible to eat chocolate, but it is also advisable not to consume too much chocolate. During the treatment period, one should avoid spicy and irritating foods, abstain from alcohol, and avoid drinking strong tea, coffee, etc. It is beneficial to eat easily digestible foods and fresh vegetables and fruits rich in vitamins, such as apples, bananas, and kiwis. Since chocolate is not considered a spicy and irritating food, it is permissible to eat chocolate during the treatment of Helicobacter pylori infection. However, during this period, it is also important to avoid overeating and to chew food slowly and thoroughly.