Can a barium meal detect Helicobacter pylori?

Written by Yang Chun Guang
Gastroenterology
Updated on September 01, 2024
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The most commonly used test for detecting Helicobacter pylori at present is the breath test, which generally comes in two types: carbon-13 and carbon-14, though the testing method is basically fixed. A barium meal test can only detect whether there are large gastric ulcers or the presence of gastric cancer, but Helicobacter pylori is quite small and cannot be detected through a barium meal. Therefore, the detection of Helicobacter pylori typically relies on traditional methods, such as breath tests or tests performed during gastroscopy.

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Written by Wang Hui Jie
Gastroenterology
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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.

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Written by Si Li Li
Gastroenterology
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Does the breath test for Helicobacter pylori require fasting?

Currently, the detection of Helicobacter pylori is highly accurate and specific, and a rapid, simple, and effective method is the Carbon-14 breath test. The Carbon-14 breath test requires no eating within six hours, so it is best to take it on an empty stomach. Therefore, it is preferable to test for Helicobacter pylori on an empty stomach. Currently, the infection rate of Helicobacter pylori in our country has exceeded 50%. Helicobacter pylori is the principal cause of chronic gastritis, peptic ulcers, or gastric cancer. Therefore, if symptoms of the digestive system occur, such as belching, acid reflux, upper abdominal pain, nausea, and poor appetite, it is advisable to conduct a test for Helicobacter pylori, specifically the Carbon-14 breath test, to confirm the infection of Helicobacter pylori.

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Written by Huang Ya Juan
Gastroenterology
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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 Si Li Li
Gastroenterology
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Can Helicobacter pylori infection heal itself?

Helicobacter pylori infection generally does not heal on its own. Currently, the infection rate of Helicobacter pylori in our country has exceeded 50%, which is very high. After being infected with Helicobacter pylori, most patients do not show any symptoms. However, some patients may develop chronic gastritis, peptic ulcer, and even stomach cancer due to Helicobacter pylori infection, presenting symptoms such as upper abdominal pain, belching, acid reflux, nausea, vomiting, and indigestion. These patients need to undergo gastroscopy to confirm the diagnosis. Additionally, eradication treatment for Helicobacter pylori is required, involving a proton pump inhibitor plus two antibiotics, along with a bismuth agent, totaling 14 days of treatment. If eradication treatment for Helicobacter pylori is not conducted, Helicobacter pylori will not heal on its own.

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Written by Yang Chun Guang
Gastroenterology
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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.