How long does Helicobacter pylori resistance last?

Written by Wu Hai Wu
Gastroenterology
Updated on September 11, 2024
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Helicobacter pylori resistance generally develops around two weeks. If Helicobacter pylori shows resistance, it is advisable to consider adjusting the treatment using other antibiotics. The eradication treatment for Helicobacter pylori infection generally involves a two-week quadruple therapy with a bismuth-containing regimen. Furthermore, one month after stopping the eradication treatment, it is necessary to recheck with a carbon-13 breath test or a carbon-14 breath test to confirm effective eradication. Helicobacter pylori infection can cause gastritis, peptic ulcers, and malignant tumors in the stomach, among other issues.

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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 Wang Li Wei
Gastroenterology
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Does everyone have Helicobacter pylori?

Helicobacter pylori is not present in everyone; the infection rate among the general population can reach about 60%. However, some people who are infected with Helicobacter pylori do not necessarily experience symptoms such as acid reflux, bloating, stomach pain, or bad breath. Some people develop symptoms after being infected with Helicobacter pylori, and subsequently, when they visit a hospital for examination, the infection with this bacterium can be detected. Additionally, there are individuals who exhibit such symptoms but are not infected with Helicobacter pylori. In summary, not everyone is infected with Helicobacter pylori, and not everyone who is infected shows symptoms.

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Written by Wang Hui Jie
Gastroenterology
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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 Wang Jing Bin
Gastroenterology
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How to treat Helicobacter pylori positivity?

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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Do you need to change your toothbrush when treating Helicobacter pylori?

It is recommended to change your toothbrush during the treatment period for Helicobacter pylori. This is because Helicobacter pylori exists not only in the stomach but can also be detected in the saliva, dental plaque, and tongue coating of the mouth. Once infected with Helicobacter pylori, a two-week quad therapy that includes bismuth agents is necessary to eradicate the infection. After eradication, the bacteria might still be present on the toothbrush, which could lead to a recurring infection. Therefore, it is advised that patients change their toothbrush after undergoing treatment for Helicobacter pylori. Patients infected with Helicobacter pylori should undergo the two-week quad therapy including bismuth agents for treatment.