Is a gastroscopy examination accurate for detecting Helicobacter pylori?

Written by Yang Chun Guang
Gastroenterology
Updated on September 16, 2024
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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.

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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 Wu Hai Wu
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If Helicobacter pylori is not treated properly, will it become more severe?

Helicobacter pylori infection, if not treated properly, does not necessarily become more severe. However, if treatment fails, it is necessary to undergo re-treatment. It is recommended to visit a hospital and consult with a qualified gastroenterologist to adjust the treatment plan. The choice of specific medications, as well as their dosages and usage, should be carried out according to medical advice. During the treatment of Helicobacter pylori infection, it is important to avoid overeating, maintain regular meal times and portions, consume easily digestible foods, and eat plenty of fresh vegetables and fruits rich in vitamins. Spicy and irritating foods should be avoided.

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Can a barium meal detect Helicobacter pylori?

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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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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Symptoms of Helicobacter pylori infection

Helicobacter pylori, once settled in the stomach and duodenum, can cause chronic inflammation of the gastric mucosa, leading to reduced stomach digestive function. Over time, this may lead to chronic gastritis, gastric ulcers, and even cause gastric cancer. So, what are the symptoms of Helicobacter pylori infection? In cases of mild infection, where the bacteria count is low, there might be no obvious symptoms, with only bad breath occurring. If a high bacteria count causes an inflammatory reaction in the gastric mucosa, symptoms can include stomach bloating, stomach pain, acid reflux, a feeling of fullness in the stomach, along with nausea and bad breath.