How to treat Helicobacter pylori positivity?

Written by Wang Jing Bin
Gastroenterology
Updated on December 19, 2024
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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 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 Yang Chun Guang
Gastroenterology
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Can a gastroscopy check for Helicobacter pylori?

Normally, when conducting a gastroscopy, it is possible to test for Helicobacter pylori, but this method of detection is less commonly used in clinical practice nowadays, as it requires undergoing a gastroscopy, which can be quite distressing and may cause nausea and vomiting. Currently, the main method used in clinical practice for detecting Helicobacter pylori is the breath test, typically using carbon-13 or carbon-14. This involves swallowing a capsule and then blowing into a device to test for Helicobacter pylori infection. This method is more convenient, which is why it has increasingly replaced gastroscopy for detecting Helicobacter pylori.

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Written by Wu Hai Wu
Gastroenterology
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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.

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Written by Si Li Li
Gastroenterology
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How to treat Helicobacter pylori infection

Currently, the infection rate of Helicobacter pylori in our country has exceeded 50%. The carbon-14 breath test can be used to detect the presence of Helicobacter pylori infection. If the infection is positive and is accompanied by some symptoms or diseases of the digestive system, eradication treatment for Helicobacter pylori is required. The treatment regimen consists of a proton pump inhibitor, two antibiotics, and a bismuth agent, lasting for 14 days. After stopping the medication for a month, the carbon-14 breath test is rechecked to confirm whether the Helicobacter pylori has been converted to negative. If the conversion is negative, it indicates that the eradication treatment for Helicobacter pylori was successful. Helicobacter pylori has been confirmed as the main cause of chronic gastritis, peptic ulcer, and gastric cancer, thus if the Helicobacter pylori infection is positive, eradication treatment is necessary.

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Written by Jiang Guo Ming
Gastroenterology
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What are the symptoms of Helicobacter pylori infection?

Helicobacter pylori is a pathogen produced in the stomach or oral cavity. It cannot be said that Helicobacter pylori causes any specific symptoms, rather, it is the infection of Helicobacter pylori that leads to a series of diseases presenting symptoms. Some people infected with Helicobacter pylori may not show any symptoms at all. If related diseases occur, such as gastritis or ulcers, symptoms such as acid reflux, heartburn, nausea, and vomiting may appear. Additionally, some patients, like those with refractory iron deficiency anemia or idiopathic thrombocytopenic purpura, may also have conditions associated with Helicobacter pylori infection.