Helicobacter pylori is a common concern, and many people are very worried when they are found to be positive for H. pylori in their physical exams and do not know what to do, so why do so many people have H. pylori and how should they be treated? What is Helicobacter pylori Helicobacter pylori is a gram-staining negative spiral bacteria, from the oral cavity into the body can be colonized in the epithelium of the stomach, after colonization of the body is difficult to spontaneously remove, resulting in persistent or lifelong infection. The environment of the human stomach is strongly acidic, and many bacteria cannot survive in this environment, and the mucus secreted by the gastric mucosa also forms a protective layer that protects the gastric mucosa from damage by bacteria. But H. pylori is a special case, it has a special structure of movement, it can pass through this protective layer on the surface of the damaged gastric mucosa into the gastric mucosa, and also secrete certain enzymes to change the gastric environment, and thus more suitable for their survival. By changing the environment, H. pylori can live comfortably in the stomach. Why are so many people infected? It has been reported that more than 50% of the world’s population is infected with H. pylori, with the rate of H. pylori infection in Western countries ranging from 25% to 50%, and even up to 90% in developing countries. The infection rate among Chinese people is also high and varies from place to place, with the lowest rate being about 20% and the highest being about 80%. The main routes of transmission of H. pylori include oral-oral transmission and fecal-oral transmission. Oral-oral transmission is easy to understand because H. pylori not only exists in the stomach of the infected person, but also enters the mouth of the infected person through the reflux route, resides in the dental plaque, and then spreads through oral saliva, so eating together, kissing, etc. can be infected with H. pylori. Chinese people have the habit of sharing meals and rarely use public chopsticks, so the probability of spreading it to each other will be higher. Fecal-oral transmission is mainly the H. pylori bacteria in the stomach, which are shed with the gastric mucosa and excreted through the feces, contaminating food and water, so if you accidentally eat such food, you will be easily infected. Studies have found that these bacteria can survive in river water for 3 years and can survive in tap water for 4 to 10 days. So it can explain why the rate of H. pylori is high in economically backward areas and lower in economically developed areas with good sanitary conditions. Does H. pylori cause stomach cancer? H. pylori does not necessarily cause stomach cancer. Although there are many people with H. pylori infection, few of them have gastric cancer, so people do not need to be too nervous. However, H. pylori infection does have a certain connection with the occurrence of gastric cancer, because the occurrence of gastric cancer is caused by many reasons, such as the patient’s own genetic background, poor diet and living habits, etc. H. pylori infection is only a foundation for the occurrence of gastric cancer and is an accomplice of gastric cancer. It is reported that only 1%-2% of H. pylori infected patients develop gastric cancer. How to treat H. pylori positive If there is no usual stomach discomfort, but the positive H. pylori is detected during physical examination, and there is no obvious abnormality in gastroscopy or just superficial gastritis, it is generally not necessary to eradicate H. pylori. Those who are positive for H. pylori and have a family history of gastric cancer, peptic ulcer or active gastritis, who require long-term non-steroidal anti-inflammatory drugs, post-gastrectomy and those with a high psychological burden can undergo routine H. pylori eradication therapy. The medical community is constantly updating its understanding of H. pylori. Previously, H. pylori was thought to be pathogenic, but now it has been found that H. pylori infection is negatively associated with the development of diseases such as GERD, asthma, inflammatory bowel disease, and multiple sclerosis, i.e., H. pylori infection has a protective effect against these diseases. Therefore, H. pylori eradication treatment is not advocated for children under 14 years of age and for elderly people over 70 years of age. How to avoid H. pylori infection First of all, it is important to develop a good habit of washing hands before and after meals. Because the stool may discharge H. pylori, if the bacteria on the hands, it may infect others or even cause secondary infection to themselves. The second thing is to practice meal sharing. Whether or not family members are infected with H. pylori, it is recommended to use special bowls and chopsticks to effectively avoid cross-infection, and to use communal chopsticks or share meals when dining out. Finally, pay attention to dietary hygiene. Food should be cleaned and cooked at high temperature, dishes should be washed and disinfected at high temperature, do not drink raw water and do not eat raw food.