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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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.

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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.

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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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Does a positive Helicobacter pylori require treatment?

Currently, the infection rate of Helicobacter pylori in our country has exceeded 50%. If there is an infection of Helicobacter pylori and it is accompanied by symptoms or diseases of the digestive system, or if the patient has a family history of gastric cancer, eradication treatment for Helicobacter pylori is needed. This is because Helicobacter pylori has been proven to be the main cause of chronic gastritis, peptic ulcers, and even gastric cancer. The method of eradication involves a proton pump inhibitor, two types of antibiotics, and a bismuth agent, with treatment lasting for 14 days. After the 14-day treatment period, medications are stopped for a month. One month later, a carbon-14 breath test is performed to confirm whether Helicobacter pylori has been converted to negative. If it has converted to negative, it means that the eradication treatment was successful.

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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.