Does a positive Helicobacter pylori require treatment?

Written by Si Li Li
Gastroenterology
Updated on March 02, 2025
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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.

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Written by Si Li Li
Gastroenterology
1min 6sec home-news-image

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.

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Written by Wang Jing Bin
Gastroenterology
1min 44sec home-news-image

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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Written by Wu Hai Wu
Gastroenterology
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Why is there an increase in flatulence after the treatment of Helicobacter pylori?

After treatment for Helicobacter pylori, having more flatulence generally isn't directly related to the treatment, as the medication used includes proton pump inhibitors, antibiotics such as amoxicillin, clarithromycin, as well as bismuth citrate potassium. None of these drugs typically cause increased flatulence. If a patient experiences more flatulence after treatment, it might be due to functional dyspepsia. At this point, treating the condition with medications that regulate the gut flora, such as combined lactobacilli and Bifidobacterium triple live bacteria, might be effective. If the increased flatulence persists, it is advisable to promptly undergo a digital colonoscopy to rule out the possibility of organic intestinal diseases. (Specific medications should be used under the guidance of a doctor.)

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Written by Huang Ya Juan
Gastroenterology
1min 43sec home-news-image

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 Wu Hai Wu
Gastroenterology
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Can I take vitamins B1 and B12 during treatment for Helicobacter pylori?

During the treatment of Helicobacter pylori, it is possible to consume Vitamin B1 and Vitamin B12. The treatment of Helicobacter pylori infection can consider using a bismuth-containing quadruple therapy for two weeks to eradicate the infection. During the treatment of Helicobacter pylori infection, one can also eat fresh vegetables and fruits rich in vitamins, such as kiwis, bananas, apples, etc. It is important to eat regularly and in moderation, consume light, easily digestible foods, and avoid overeating. Spicy and stimulative foods should be avoided, including strong alcohol, strong tea, coffee, etc. At the same time, patients with Helicobacter pylori infection should also ensure adequate rest.