When it comes to Helicobacter pylori (hereinafter referred to as Hp), I believe no one is unfamiliar with it, and there are a large number of introductions on the Internet. Patients often come to the clinic with a checklist, or an antibody test, or a C13 test, or also with a gastroscopy report, and come to consult very nervously, “Doctor, the Internet says that this thing can cause cancer, what should I do? ” I have also seen several patients who have been to hospitals at all levels for countless times, always Hp positive, the whole person is in a state of great anxiety, there was also a patient, the number of the doctor who came out that day all over again, asked one by one, and then argued with the last doctor who asked. 1, what is Hp? Hp is short for Helicobacter pylori, unlike lung, we rarely see bacterial infections in the stomach, and patients who develop septic gastritis are often very weak and have a very low immune system. This is because the environment of the stomach is acidic, the general bacteria can not live, so we say gastritis often refers to non-bacterial inflammation, is not the need for antibiotics, you do not think it is gastritis at home to eat antibiotics Oh:) and Hp because of a special structure and function, become a very acid-resistant bacteria, mainly living in the stomach, if found to have Hp infection, we need to use antibiotics, but simply one is also Hp is indeed related to many diseases, such as ulcers and erosions, and is also considered to be one of the original culprits of stomach cancer. The majority of opinions are that Hp is contagious, so some scholars advocate that if one person is infected, the whole family should be checked. 2. Is it necessary to treat Hp when it is detected? In fact, there is now a relatively unanimous opinion that if there are ulcers or lymphoma of the gastric mucosa-related lymphoid tissues, they must be cleared. There is another situation, that is, the patient has requested, in the outpatient clinic, some patients did not do stomach examination, or gastroscopy only reported gastritis, and did not have the above-mentioned family history, etc., after introducing to them clearly can not use drugs, they will understand, but there are still some patients, the mental burden is very heavy, determined to clear, then, also can use drugs. Therefore, there is a view abroad that if there is no intention to give the patient a treatment, try not to do the test because, after the test, it will produce such an entangled result. This is why I do not advocate the practice of checking the whole family when one person is found to be infected with Hp. I will also introduce the issue of medication later on, which is relatively complicated for Hp and is not suitable for children. 3, how to treat Hp? Regarding the treatment of Hp, it used to be advocated that the triplet of drugs should be taken for a week, but now the view is updated and four drugs are recommended, and the course of treatment is 10-14 days. The regimen is bismuth + PPI (an acid suppressant) + two antibiotics, and there are four antibiotic combinations: amoxicillin + clarithromycin, amoxicillin + levofloxacin, amoxicillin + furazolidone or tetracycline + furazolidone (metronidazole). Here you need to pay particular attention to several issues: firstly, when reviewing whether the bacteria are killed clean, antibiotics must be stopped for at least 4 weeks, and acid suppressants for at least 2 weeks, never come to check as soon as you stop; secondly, if it is not cleared at once, it is recommended to perform remedial treatment at an interval of 2-3 months and not to start again immediately; thirdly, if it is cleared twice and not cleared, it is recommended to stop the medication or leave it alone for a while. Or find a doctor to analyze the cause, do drug sensitivity tests, etc.; Finally, always remember to combine medication, regular medication, never have a meal, no meal, which not only does not work, but may also cause drug resistance. From the introduction of the above program can be seen, treatment is still relatively complex, taking more kinds of drugs, so some patients will ask, why after the medication nausea and other symptoms but aggravated, which is actually the side effects of antibiotics, and, the cost is not cheap, there are also drug resistance problems (introduced later), so currently does not advocate the arbitrary expansion of the test object, blind sterilization. 4, what are the factors that can affect the effectiveness of the test? First of all, the problem of antibiotic resistance, in China, antibiotics are widely used in the clinic, which causes serious problems of antibiotic resistance, resulting in reduced efficacy; secondly, the problem of PPI use, this problem previously did not attract much attention, but now it is also considered an important factor, to try to use drugs that have a small impact on CYP2C19 (this sentence is more professional words, may not be easy to understand, for the time being (Let’s understand it). And, the first drug regimen is very important, because once there is a treatment failure, the choice of the second remedial treatment will be relatively difficult, and will also face the risk of failure.