Does a positive Helicobacter pylori require treatment?

Written by Si Li Li
Gastroenterology
Updated on March 02, 2025
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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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Written by Yang Chun Guang
Gastroenterology
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Can a barium meal detect Helicobacter pylori?

The most commonly used test for detecting Helicobacter pylori at present is the breath test, which generally comes in two types: carbon-13 and carbon-14, though the testing method is basically fixed. A barium meal test can only detect whether there are large gastric ulcers or the presence of gastric cancer, but Helicobacter pylori is quite small and cannot be detected through a barium meal. Therefore, the detection of Helicobacter pylori typically relies on traditional methods, such as breath tests or tests performed during gastroscopy.

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Written by Yang Chun Guang
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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 Peng Miao Yun
Internal Medicine
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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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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 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.