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Helicobacter pylori infection
How many times a year should Helicobacter pylori be tested?
If Helicobacter pylori tests positive, then it is necessary to undergo standardized eradication treatment. A re-examination is needed one month after cessation of the eradication treatment to confirm whether the eradication was successful or the treatment failed. If the patient tests negative for Helicobacter pylori, then there is no need for repeated testing. Therefore, the frequency of testing for Helicobacter pylori within a year needs to be analyzed based on specific circumstances, using different testing methods and frequencies according to different situations. Patients infected with Helicobacter pylori should eat light, easily digestible foods, avoid overeating, and avoid spicy and irritating foods.
What should I do if I have a Helicobacter pylori infection?
Helicobacter pylori is closely related to the occurrence of chronic gastritis, gastric ulcers, and gastric cancer, but not everyone infected with Helicobacter pylori will develop chronic gastritis or gastric ulcers. Infections can be diagnosed with a breath test, where values more than twice the normal level, accompanied by symptoms of gastritis, gastric ulcers, stomach distension, stomach pain, and acid reflux, should be considered for antibacterial and stomach-protective treatment. Generally, with standard treatment, 90% of Helicobacter pylori can be eradicated within one to two weeks. However, reinfection is common as it can be found in food and utensils and transmitted through saliva. It is generally advised that children under 14 and individuals with low levels of Helicobacter pylori without obvious stomach inflammation symptoms do not require immediate treatment.
Helicobacter pylori symptoms
Helicobacter pylori itself is just a bacterium, often parasitizing the stomach or oral cavity of the human body. It cannot be said that Helicobacter pylori has symptoms, but rather that symptoms may occur after being infected by Helicobacter pylori. Many normal people infected with Helicobacter pylori may not exhibit any discomfort. However, if Helicobacter pylori causes gastritis or peptic ulcers, etc., related symptoms may appear. For instance, abdominal pain, bloating, belching, acid reflux, and so on; in cases of peptic ulcers, corresponding symptoms, such as periodic, recurrent episodes of upper abdominal pain associated with eating and so forth, may also occur and will need to be determined based on the specific situation.
Can gastroscopy detect Helicobacter pylori?
Helicobacter pylori is a type of bacterium, hence it is invisible to the naked eye. However, during a gastroscopy, the gastroenterologist can infer whether a patient is infected with Helicobacter pylori by observing the mucosal appearance under the endoscope. For example, signs such as the disappearance of damages in the tiny veins, nodular changes resembling chicken skin, scattered congested spots, and others. To confirm the presence of a Helicobacter pylori infection, further tests are required. For instance, during a gastroscopy, a rapid urease test can be conducted where a tissue sample from the stomach is tested - this method is quite convenient. Alternatively, a tissue sample can be sent for pathological examination, which might take longer.
Can a gastroscopy detect Helicobacter pylori?
Helicobacter pylori is a type of bacterium that can easily infect and cause chronic gastritis, and it even has the potential to lead to cancer. Therefore, patients with Helicobacter pylori generally require formal treatment. In terms of diagnostics, Helicobacter pylori can be detected through a gastroscopy, but the bacteria cannot be detected by gastroscopy alone; the test for Helicobacter pylori is performed under the scope. However, the current main method for testing Helicobacter pylori is through a breath test, since undergoing a gastroscopy just to test for the bacteria can be quite uncomfortable. Moreover, the accuracy of the breath test is relatively high, so currently, Helicobacter pylori is generally detected via breath testing rather than gastroscopy.
Can Helicobacter pylori cure itself?
Can Helicobacter pylori be self-healing? Helicobacter pylori is very stubborn; once infected, adults who do not undergo formal therapeutic interventions will be afflicted for life, meaning the cure rate is close to zero. Children, whose immune functions are not yet fully developed, may experience multiple exposures on the gastric mucosa and short-term colonization before Helicobacter pylori settles permanently, which could potentially lead to either colonization or loss of the bacteria. White populations have stronger immune resistance than colored populations. Tracking reports indicate that 50% of white children may lose the infection after contracting it, while only 4% of black children might. Generally, the infection rate is higher than the self-healing rate, indicating that Helicobacter pylori infections in adults are generally not self-resolving.
Can a gastroscopy detect Helicobacter pylori?
First, it is important to clarify that a gastroscopy and a Helicobacter pylori test are two completely different methods. Generally speaking, a gastroscopy cannot detect whether there is a Helicobacter pylori infection. A gastroscopy specifically involves passing through the pharynx, esophagus, stomach, and finally reaching the descending part of the duodenum. It allows clear observation of whether there is inflammation, ulcers, or neoplastic diseases in the upper gastrointestinal tract, and it is the clearest and most direct method for examining the upper gastrointestinal tract. Helicobacter pylori testing, on the other hand, can generally be conducted in several ways. Firstly, blood can be drawn to test for Helicobacter pylori antibodies. Secondly, a breath test can be done, which is currently the most commonly used method, such as the carbon-13 or carbon-14 breath tests. Other methods include taking a biopsy during gastroscopy for a rapid urease test, and culturing bacteria from a biopsy. Therefore, gastroscopy cannot be used to test for Helicobacter pylori.
Can a gastroscopy detect Helicobacter pylori?
Since Helicobacter pylori is a type of bacterium, it cannot be seen with the naked eye. However, current research indicates that Helicobacter pylori is strongly associated with certain mucosal appearances under endoscopy. Therefore, endoscopists can infer the presence of an infection based on certain mucosal appearances observed during the procedure. However, if the only purpose is to test for Helicobacter pylori infection without needing a gastroscopy, then we can opt for non-invasive methods such as the carbon-13 urea breath test, carbon-14 urea breath test, stool antigen test, and serological antibody tests, which are commonly used methods of testing. Moreover, after treatment for Helicobacter pylori, it is recommended to use either the carbon-13 or carbon-14 urea breath test for examination.
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.
Do normal people have Helicobacter pylori?
In my understanding, a “normal person” refers to individuals who do not experience any stomach discomfort. In our country, the infection rate of Helicobacter pylori is extremely high, with reports indicating that over 50% of adults are infected, albeit asymptomatically. Thus, it is certain that many so-called "normal people" are infected with Helicobacter pylori, also known as asymptomatic Helicobacter pylori carriers. This condition also requires antibacterial treatment because there is a close relationship between Helicobacter pylori and gastritis, ulcers, and gastric cancer. Even for patients with chronic superficial gastritis, if Helicobacter pylori is present, eradication therapy is advocated. If not completely eradicated, it often leads to the development of chronic atrophic gastritis, which is a more serious condition.