Do normal people have Helicobacter pylori?

Written by Jiang Guo Ming
Gastroenterology
Updated on September 16, 2024
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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.

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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.

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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 Si Li Li
Gastroenterology
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Is erosive gastritis related to Helicobacter pylori?

Helicobacter pylori infection has been confirmed as the primary cause of chronic gastritis, peptic ulcers, and gastric cancer. Erosive chronic gastritis is a type of chronic gastritis, thus there is a certain relationship between erosive gastritis and Helicobacter pylori, but not all chronic gastritis is caused by Helicobacter pylori; some are, but others are not. Therefore, if erosive gastritis occurs, it is necessary to conduct a carbon-14 breath test to determine whether there is an infection of Helicobacter pylori. If the Helicobacter pylori infection is positive, a 14-day anti-Helicobacter pylori treatment should be administered. The treatment includes a proton pump inhibitor, two antibiotics, and a bismuth agent. After treatment, most of the Helicobacter pylori will convert from positive to negative.

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Can you eat sweets during the treatment for Helicobacter pylori?

During the treatment of Helicobacter pylori, it is permissible to eat sweets. During this period, it is necessary to avoid spicy and irritating foods, as well as avoid drinking strong alcohol, strong tea, coffee, and so on. It is recommended to consume more fresh vegetables and fruits rich in vitamins, as well as nutritious and light foods. Smoking and drinking alcohol should be avoided, and meals should be regular and in measured quantities. Since sweet foods are not considered spicy or irritating, they can be consumed during the treatment of Helicobacter pylori. After the treatment of a Helicobacter pylori infection, it is necessary to wait one month after stopping the medication before a follow-up examination to confirm whether the bacteria have been completely eradicated.

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What is the reason that Helicobacter pylori treatment causes black stools?

If black stools occur during the treatment of Helicobacter pylori, it is very likely due to the medication-induced black stools caused by taking potassium citrate bismuth or bismuth pectin. However, to rule out the possibility of upper gastrointestinal bleeding, a fecal occult blood test can be conducted for a clear diagnosis. Treatment of Helicobacter pylori infection requires a two-week quadruple therapy that includes bismuth. At the same time, one should avoid overeating and focus on consuming fresh vegetables and fruits rich in vitamins and easy-to-digest foods. It is also advisable to quit smoking and drinking alcohol, and avoid drinking strong tea, coffee, etc.