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 Wu Hai Wu

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Helicobacter pylori treatment for half a month, re-examination still positive, what could be the reason?

If a follow-up test for Helicobacter pylori is positive after half a month of treatment, it indicates that the treatment was not successful, and Helicobacter pylori is still present. At this point, it is necessary to adjust the medication plan and treat Helicobacter pylori again. The specific medication methods and treatment duration should be used under the guidance of a doctor. Treatment of Helicobacter pylori infection requires the use of a bismuth-containing quadruple therapy for two weeks to eradicate it. Additionally, the diet should include an increased intake of fresh vegetables and fruits rich in vitamins and avoid spicy and irritating foods. Smoking and alcohol should be avoided. (Please follow the doctor’s prescription for medication use.)

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Written by Si Li Li

Gastroenterology

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Is long-term bad breath definitely caused by Helicobacter pylori?

Chronic bad breath may be caused by Helicobacter pylori infection, but this is not always the case. Other causes of bad breath include dental issues, such as cavities and tooth decay. Additionally, stomach diseases can also cause bad breath, many of which are associated with Helicobacter pylori infection. After ruling out dental diseases, it is recommended to undergo a Carbon-14 breath test to determine if there is an infection of Helicobacter pylori. If the test for Helicobacter pylori infection is positive and accompanied by some stomach symptoms, such as upper abdominal bloating, burping, acid reflux, nausea, and vomiting, it is advisable to undergo a 14-day treatment for Helicobacter pylori. Generally, after treatment, the Helicobacter pylori can change from positive to negative.

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Written by Wang Hui Jie

Gastroenterology

1min

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Can a gastroscopy examine Helicobacter pylori?

Can a gastroscopy detect Helicobacter pylori? Helicobacter pylori is a type of bacteria, thus it cannot be seen with the naked eye. However, recent research shows that Helicobacter pylori is closely related to certain mucosal appearances observed under endoscopy. Therefore, endoscopists can infer the infection of Helicobacter pylori based on certain mucosal appearances. However, if a patient is just testing for Helicobacter pylori infection, there is no need for a gastroscopy. We can choose some non-invasive methods such as the carbon-13 breath test, carbon-14 breath test, stool antigen test, and serological antibody test, which are commonly used detection methods. Moreover, after treatment for Helicobacter pylori, it is recommended to choose the carbon-13 or carbon-14 breath test, as they are quite accurate.

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Written by Wu Hai Wu

Gastroenterology

40sec

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How long does Helicobacter pylori resistance last?

Helicobacter pylori resistance generally develops around two weeks. If Helicobacter pylori shows resistance, it is advisable to consider adjusting the treatment using other antibiotics. The eradication treatment for Helicobacter pylori infection generally involves a two-week quadruple therapy with a bismuth-containing regimen. Furthermore, one month after stopping the eradication treatment, it is necessary to recheck with a carbon-13 breath test or a carbon-14 breath test to confirm effective eradication. Helicobacter pylori infection can cause gastritis, peptic ulcers, and malignant tumors in the stomach, among other issues.

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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.