H. pylori is associated with chronic gastritis, peptic ulcers, and even gastric cancer. In particular, H. pylori is associated with duodenal bulb ulcers in about 90-95% of cases. It is interesting to note that Eskimos without H. pylori infection do not get duodenal ulcers. During the period without the H. pylori concept, the recurrence rate of duodenal ulcers was 75% at 1 year and almost 100% at 5 years. The results after H. pylori eradication were shocking: the 1-year recurrence rate dropped sharply to less than 3 percent. The chances of bleeding duodenal ulcers were also greatly reduced. Follow-up of the population also revealed that people with H. pylori infection were several times more likely to develop duodenal ulcers in the next 10 years than those without infection. However, why is the prevalence of H. pylori infection in humans generally 50-60%, while the incidence of duodenal ulcers is much lower than this figure. Medical doctors explain this by the fact that some H. pylori bacteria are highly pathogenic, while others are weaker. In relatives living in close contact in the same family, they have a higher rate of H. pylori infection; in addition to contact, certain blood types also have an effect, such as blood type O, who have a certain substance on their gastric mucosa, that is exactly what H. pylori needs to settle. Chronic gastritis, peptic ulcers and other diseases that are not actively treated can develop into atrophic gastritis and intestinal chemosis, both of which are precancerous, and further down the line, they can form the cancer that we all fear so much. You can’t get H. pylori from eating a meal with someone. H. pylori is a lifelong infection that won’t die out on its own without treatment. Because H. pylori is not as likely to cause very serious consequences as hepatitis, many people do not pay much attention to this bacteria. H. pylori can only infect humans in general and is parasitic in the human gastric mucosa. Due to gastroesophageal reflux, H. pylori reaches the oral cavity and can be transmitted by the oral-oral route or through the fecal-oral route by excretion from the stool. The most advanced and sensitive detection method, PCR, can detect H. pylori in the stool or dental plaque of many infected patients, which indicates that the above two transmission methods, oral-oral and fecal-oral, are the modes of transmission of H. pylori. Mouth-to-mouth transmission requires direct person-to-person contact, and mouth-to-mouth feeding and sharing of utensils during childhood increases the chance of H. pylori transmission. Fecal-oral transmission is dependent on environmental contamination, as well as survival time in the environment. Generally, H. pylori can survive for several days in distilled water, salt water, and seawater under refrigerated conditions. One may ask, H. pylori is transmitted through mouth-to-mouth, so does that mean that a friend with H. pylori will infect himself with H. pylori if he eats with him? It’s not that scary. H. pylori is not like the flu virus, which is highly transmissible and widespread. H. pylori has family aggregation and is mostly transmitted vertically. Therefore, parents with H. pylori can easily infect their children through prolonged contact. Of course, to avoid the spread of H. pylori, meal sharing system still needs to be implemented. But Chinese people do not have the habit of sharing meals, so the hygiene of the dishes is very important. “If you have the conditions, you can of course buy a disinfection cabinet and disinfect the dishes every day. If you don’t have the conditions, don’t stress, drying the washed dishes is also a good way to eliminate H. pylori.” Xu Shunfu introduced, because H. pylori is microaerobic bacteria, surviving longer in water, and put into the atmosphere, due to sufficient oxygen, so it will soon die. In addition, hand washing before and after meals, diet, especially eating raw and cold food to be hygienic are necessary. Biopsy, breath plus blood test for H. pylori As many people with stomach problems know, there is a breath test, which is a non-invasive method to test for H. pylori infection. Currently, it is believed that the non-invasive method is more appropriate for patients without a family history of gastric cancer and for those with symptoms suggestive of early gastric cancer. Breath test, simply put, is a method to diagnose diseases by collecting the composition of gas exhaled by patients and analyzing the difference between it and the composition of gas exhaled by normal people. In fact, it can diagnose many diseases, applied to H. pylori infection, mainly refers to the 13C breath test and 14C breath test two. Their common features are simple operation, accurate results and good reproducibility. The test subject only needs to fast for more than 2 hours, take a capsule orally during the test, blow and collect after half an hour (13C breath test also requires blowing and collecting once before taking the capsule orally), and the result can be obtained within 2 to 5 minutes, and the whole process takes less than 1 hour. In addition to the breath test, other methods of H. pylori detection include gastroscopic biopsy and blood sampling. Either way, H. pylori cannot be fully detected. For example, the accuracy of the breath test is about 95%; while a positive gastroscopy biopsy is reliable, a negative result does not mean that the person is not infected with H. pylori. This is because it takes 10,000 H. pylori in the tissue removed from the stomach to detect a positive result. Therefore, a negative result is not necessarily accurate; the reliability rate for serum is about 70%. Therefore, for those who have ulcers or chronic inflammation, a combination of tests is the best way to confirm the presence of H. pylori. Early treatment of H. pylori For the treatment of H. pylori, due to the high incidence of gastric cancer in Southeast Asia, the following groups of people need to be actively treated for H. pylori: young people with atrophic gastritis or intestinal metaplasia; people with severe gastritis; people with ulcers, family history of gastric cancer; people who still have H. pylori after treatment for early gastric cancer, and people who are paranoid all day long when they are found to have H. pylori. In the case of atrophic gastritis, for example, the gastric mucosa ages like other organs in the body, and if there is atrophy at an older age, it may not cause much of a problem. Young people with atrophic gastritis, on the other hand, may undergo changes over a long period of time and may develop into a more serious disease, so they should be treated actively. When infected with H. pylori, there are usually no specific symptoms and some indigestion will usually occur, such as belching, abdominal pain, discomfort, etc. Some people may also develop acne, allergic purpura, asthma, hair loss, diarrhea, and other conditions that seem to have little to do with the digestive system. Treatment of H. pylori infection is difficult, and the preferred regimen is eradicated in about 70% of patients. Patients who fail can be treated later with second- and third-line therapy. “Clinically, we also encounter many patients who cannot be eradicated with repeated treatment. Most of this is due to increased bacterial resistance, and some are reinfected.” Xu Shunfu said there are two solutions in such cases: one is to wait for new treatment options, and the other is to monitor changes in the condition over time. Some people with H. pylori, but no significant inflammation of the gastric mucosa and no progression to the bad side, can be left untreated; if there is some inflammation, you can also take some stomach medication to ease the development of inflammation. In outpatient clinics, we often encounter patients who come to see the doctor without anything, empty-handed, feeling that what is seen in small hospitals is useless in big hospitals. In fact, it is not, as long as it has been seen in the hospital, there is always a reference value. For people with H. pylori infection, coming empty-handed, the tests can be redone, but not only is it a waste of time as well as human and material resources, but if the previous medication is not clear, it may also affect the doctor’s choice of medication, thus affecting the effectiveness of treatment at this visit. In addition, by comparing the results with past examinations, the doctor can find out the development of some diseases, and based on these conditions, the doctor can determine whether the disease is getting better or more serious. Therefore, it is recommended that patients who visit the clinic should bring their previous gastroscopy reports, medical records, etc., so that the doctor can make a more accurate determination and treatment.