Reactions during the treatment of Helicobacter pylori

Written by Wu Hai Wu
Gastroenterology
Updated on February 17, 2025
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During the treatment of Helicobacter pylori, there usually isn't significant discomfort, but a small number of patients may experience upper abdominal discomfort, nausea, vomiting, and other symptoms after taking antibiotics. Treatment of Helicobacter pylori requires a two-week quadruple therapy including a bismuth-containing agent. During the treatment of Helicobacter pylori infection, it is recommended to consume fresh vegetables and fruits rich in vitamins, avoid spicy and irritating foods, quit smoking and drinking, and avoid strong tea and coffee. Furthermore, it is advisable to avoid overeating and drinking excessively during the treatment period.

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Written by Wu Hai Wu
Gastroenterology
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How many times a year should Helicobacter pylori be tested?

If Helicobacter pylori tests positive, then it is necessary to undergo standardized eradication treatment. A re-examination is needed one month after cessation of the eradication treatment to confirm whether the eradication was successful or the treatment failed. If the patient tests negative for Helicobacter pylori, then there is no need for repeated testing. Therefore, the frequency of testing for Helicobacter pylori within a year needs to be analyzed based on specific circumstances, using different testing methods and frequencies according to different situations. Patients infected with Helicobacter pylori should eat light, easily digestible foods, avoid overeating, and avoid spicy and irritating foods.

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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 Yang Chun Guang
Gastroenterology
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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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Written by Wu Hai Wu
Gastroenterology
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Why is there an increase in flatulence after the treatment of Helicobacter pylori?

After treatment for Helicobacter pylori, having more flatulence generally isn't directly related to the treatment, as the medication used includes proton pump inhibitors, antibiotics such as amoxicillin, clarithromycin, as well as bismuth citrate potassium. None of these drugs typically cause increased flatulence. If a patient experiences more flatulence after treatment, it might be due to functional dyspepsia. At this point, treating the condition with medications that regulate the gut flora, such as combined lactobacilli and Bifidobacterium triple live bacteria, might be effective. If the increased flatulence persists, it is advisable to promptly undergo a digital colonoscopy to rule out the possibility of organic intestinal diseases. (Specific medications should be used under the guidance of a doctor.)

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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.