How to treat Helicobacter pylori infection?

Written by Si Li Li
Gastroenterology
Updated on January 21, 2025
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Helicobacter pylori has been confirmed as a major cause of chronic gastritis, peptic ulcers, and even gastric cancer. The infection rate of Helicobacter pylori in China is very high, exceeding 50%. It is related to the dietary structure in China, often linked significantly to the practice of sharing dishes during meals, which correlates with China's dietary habits. If someone tests positive for Helicobacter pylori and has symptoms of gastrointestinal disorders, such as indigestion, stomach pain, or bloating, then it is necessary to undergo treatment for Helicobacter pylori. The current standard treatment for Helicobacter pylori involves quadruple therapy: a proton pump inhibitor, two types of antibiotics, and a bismuth agent. This combination of medications is administered over a period of 14 days, representing the standardized treatment for Helicobacter pylori.

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Helicobacter pylori symptoms

Helicobacter pylori itself is just a bacterium, often parasitizing the stomach or oral cavity of the human body. It cannot be said that Helicobacter pylori has symptoms, but rather that symptoms may occur after being infected by Helicobacter pylori. Many normal people infected with Helicobacter pylori may not exhibit any discomfort. However, if Helicobacter pylori causes gastritis or peptic ulcers, etc., related symptoms may appear. For instance, abdominal pain, bloating, belching, acid reflux, and so on; in cases of peptic ulcers, corresponding symptoms, such as periodic, recurrent episodes of upper abdominal pain associated with eating and so forth, may also occur and will need to be determined based on the specific situation.

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Can treatment for Helicobacter pylori be stopped at any time?

During the treatment of Helicobacter pylori, it is not advisable to stop the medication arbitrarily, as doing so may lead to insufficient treatment duration and result in a failure to eradicate the bacteria. Therefore, it is recommended to use a bismuth-containing quadruple therapy for two weeks to eradicate Helicobacter pylori. The specific medications included in this two-week quadruple therapy are a proton pump inhibitor such as pantoprazole or lansoprazole, plus two antibiotics such as amoxicillin, clarithromycin, or metronidazole, combined with bismuth potassium citrate. The medication should be taken under medical supervision. Helicobacter pylori infection can be detected through a carbon-13 breath test or a carbon-14 breath test.

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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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How long does Helicobacter pylori resistance last?

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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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.