How to treat Helicobacter pylori positivity?

Written by Wang Jing Bin
Gastroenterology
Updated on December 19, 2024
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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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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 Yang Chun Guang
Gastroenterology
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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.

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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 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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Can I eat cake during the treatment of Helicobacter pylori?

During the treatment process for Helicobacter pylori, it is permissible to eat cake, as there are no specific dietary restrictions. However, it is important to avoid spicy and stimulating foods, as well as strong liquor, strong tea, coffee, etc. Treatment for Helicobacter pylori infection may include the use of proton pump inhibitors such as omeprazole and lansoprazole combined with antibiotics like amoxicillin, clarithromycin, and metronidazole, often in a quadruple therapy regimen with bismuth citrate for two weeks aimed at eradicating the infection. Patients with Helicobacter pylori infection should consume easy-to-digest, bland foods and avoid overly spicy and stimulating foods. (Please follow your doctor's prescription when using medications.)