Helicobacter Pylori: Diagnosis, Treatment, and Follow-Up Care

Q: Helicobacter Pylori: Diagnosis, Treatment, and Follow-Up Care

Hello： Since over 95% of duodenal ulcers are associated with Helicobacter pylori, when a duodenal ulcer is first diagnosed, it is usually acceptable to initiate antibiotic treatment without necessarily performing a Helicobacter pylori test. <br>However, after treatment, a carbon-

Helicobacter pylori

Helicobacter pylori: 1.
Is it correct for doctors to determine the presence of Helicobacter pylori based on experience during an endoscopy? 2.
If Helicobacter pylori is sometimes detected during regular examinations and sometimes only ulcers are found without Helicobacter pylori, what does this indicate? 3.
Is there a possibility that Helicobacter pylori has developed antibiotic resistance in my case? Could there be other pathological changes? 4.
After treatment (4 months), if I still feel unwell, should I undergo another endoscopy for follow-up? Thank you for your response, doctor.

Jue Sheng, 40~49 year old female. Ask Date: 2003/11/13

Dr. Yang Peizhen reply Gastroenterology and Hepatology

Hello: Since over 95% of duodenal ulcers are associated with Helicobacter pylori, when a duodenal ulcer is first diagnosed, it is usually acceptable to initiate antibiotic treatment without necessarily performing a Helicobacter pylori test.
However, after treatment, a carbon-13 urea breath test can be conducted to check for the presence of the bacteria.
If discomfort persists, a follow-up esophagogastroduodenoscopy (EGD) should be performed.
The presence of Helicobacter pylori does not necessarily indicate the existence of a peptic ulcer; if no ulcer is found, eradication therapy may not be required.
In contrast, approximately 70-80% of gastric ulcers are associated with Helicobacter pylori, so if a gastric ulcer is detected during an EGD, a biopsy is essential to determine whether it is benign or malignant and to check for Helicobacter pylori.
It is advisable to undergo another EGD three months after treatment to confirm complete healing; if healing is not observed, further investigation for other lesions should be considered.
Sincerely, Dr.
Yang Pei-Chen, Chief of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2003/11/13

More Info

Understanding Helicobacter Pylori: Diagnosis, Treatment, and Follow-Up Care
Helicobacter pylori (H. pylori) is a type of bacteria that can infect the stomach and is a well-known cause of various gastrointestinal disorders, including chronic gastritis, peptic ulcers, and even gastric cancer. Understanding how to diagnose and treat H. pylori infections, as well as the importance of follow-up care, is crucial for effective management.

1. Diagnosis of H. pylori:
While endoscopy (gastroscopy) can provide valuable information about the stomach's mucosal lining, it is not the only method for diagnosing H. pylori. During an endoscopy, a doctor may take biopsies from the stomach lining to test for the presence of H. pylori. However, there are other diagnostic methods available, such as breath tests, stool antigen tests, and blood tests. Each method has its advantages and limitations. For example, breath tests are non-invasive and can provide quick results, while stool tests can confirm active infections. Blood tests, on the other hand, may indicate past infections but are not reliable for current infections.

2. Variability in H. pylori Presence:
It is not uncommon for H. pylori to be absent in some tests while ulcers are present. This can occur for several reasons. For instance, ulcers can be caused by other factors such as the use of non-steroidal anti-inflammatory drugs (NSAIDs), excessive alcohol consumption, or stress. Additionally, H. pylori can sometimes be difficult to detect, especially if the infection is not active at the time of testing. Therefore, a comprehensive evaluation by a healthcare provider is essential to determine the underlying cause of symptoms.

3. Antibiotic Resistance:
H. pylori can develop resistance to antibiotics, which can complicate treatment. If you have undergone treatment for H. pylori and continue to experience symptoms, it is possible that the bacteria have developed resistance to the antibiotics used. This is why it is crucial to follow up with your healthcare provider if symptoms persist after treatment. They may recommend a different combination of antibiotics or additional testing to assess the effectiveness of the treatment.

4. Follow-Up Care:
After treatment for H. pylori, it is generally recommended to follow up with your healthcare provider to ensure that the infection has been eradicated. This is typically done through breath or stool tests about four weeks after completing the treatment. If you continue to experience discomfort or gastrointestinal symptoms after treatment, further evaluation may be necessary. This could include repeat endoscopy or imaging studies to assess for any complications or other underlying conditions.

In summary, understanding H. pylori involves recognizing the various diagnostic methods available, acknowledging the potential for variability in test results, being aware of antibiotic resistance, and the importance of follow-up care. If you have concerns about your symptoms or the effectiveness of your treatment, it is essential to communicate with your healthcare provider for personalized advice and management. Regular monitoring and open communication can help ensure that any issues are addressed promptly and effectively.

Similar Q&A

Understanding Helicobacter Pylori: Treatment and Follow-Up Questions

Dear Doctor, I previously experienced discomfort in my stomach and underwent an endoscopy at the hospital. The doctor diagnosed me with gastroesophageal reflux disease (GERD) and Helicobacter pylori infection. I was prescribed antibiotics and a medication called clarithromycin,...

Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: You can determine whether the eradication was successful through a carbon-13 breath test or a stool antigen test for Helicobacter pylori. Changhua Hospital cares about your health. Dr. Tsai An-Shun.

Understanding Helicobacter Pylori Treatment and Side Effects

The patient, CHERRY, a 31-year-old female, underwent an upper gastrointestinal endoscopy on December 9, 2016. The doctor diagnosed her with mild gastritis, esophagitis, gastroesophageal reflux disease (GERD), and Helicobacter pylori infection. She was prescribed a one-week course...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
You can wait until the completion of the Helicobacter pylori eradication treatment before monitoring any subsequent symptoms.

Understanding Helicobacter Pylori: Symptoms, Test Results, and Treatment Options

Hello Doctor, I recently had a health check-up and received my report a few days ago. The report indicates that the normal range for Helicobacter pylori in the gastric examination is 0-6, and my value is 6.5. What does this mean? I've been experiencing frequent discomfort in...

Dr. Chen Zhiping reply Gastroenterology and Hepatology
Hello, Helicobacter pylori, now referred to as H. pylori, is a type of bacteria that resides in the stomach. It can cause gastritis, duodenitis, and gastrointestinal ulcers, and is even associated with certain low-grade lymphomas of the stomach as well as gastric cancer. However,...

Choosing the Right Treatment for Helicobacter Pylori: Options and Recurrence Risks

Hello Dr. Chen, I underwent a blood test and my Helicobacter pylori level was 4.42. Later, I visited a clinic where the doctor prescribed medication (Amoxil 500mg, Flagyl, KBT, Tagamet 400mg) for a treatment duration of 3 months, which is covered by health insurance. Subsequent...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello, it is recommended to first perform an upper gastrointestinal endoscopy. If it falls within the coverage of health insurance, medication can be prescribed under the insurance plan. Generally, Helicobacter pylori can be treated with a triple therapy for one to two weeks. The...