In less than a year, 35-year-old Dagang (a pseudonym) developed from superficial gastritis to gastric cancer. After the surgery, the remnants of his stomach had “intestinal epithelial metaplasia”, which is a cellular lesion in the stomach that should only be found in the intestines, and is a “precancerous lesion”. H. pylori is not that scary H. pylori is currently the most common human infection, half of the world’s population is infected with H. pylori. In 2005, Australian scientists Barry Marshall and Robyn K. K. Hoffman, who have been working on the study, said that H. pylori is the main cause of chronic gastritis and peptic ulcers in humans, and that 67 to 80 percent of gastric ulcers and 95 percent of duodenal ulcers are caused by H. pylori. In 2005, Australian scientists Barry Marshall and Robyn Warren was awarded the Nobel Prize in Physiology and Medicine for their discovery that H. pylori can cause gastritis and gastric ulcers. Research by Chinese professors has also found that H. pylori is the cause of stomach cancer and that eradicating H. pylori can reduce the incidence of stomach cancer in 37% of the population. Other studies have shown that H. pylori infection can be detected in 60% of patients with gastric cancer. The International Agency for Research on Cancer under the World Health Organization has designated H. pylori as a human class I carcinogen. As a major cause of chronic gastritis, peptic ulcer and gastric cancer, one of the feasible measures to treat peptic ulcer and prevent gastric cancer is to prevent and eradicate H. pylori infection in China. Most H. pylori infections occur in childhood, and most of them develop into chronic gastritis, 10%-15% into peptic ulcers, and less than 1% into gastric cancer. H. pylori is actually very easy to kill, using triple therapy – clarithromycin + proton pump inhibitor + amoxicillin can be. However, since the number of people infected with H. pylori is very large, but the chance of developing gastric cancer is small, in fact, “this bacteria is not that scary, do not talk about the bacteria”. However, it should be noted that after a period of treatment, H. pylori disappears, but the symptoms do not disappear completely, and there is an obvious feature that is the fear of cancer. In response to the question of “how far is the distance from gastritis to gastric cancer”, it is actually: “one hundred thousand eight hundred thousand miles.” There are more than 20 factors that contribute to cancer, and to attribute it to H. pylori alone is one-sided. Medicine believes that not only what germs cause what disease, but also closely related to various factors such as environmental and psychological. One patient with chronic atrophic gastritis was worried about carcinogenesis due to enterosis with atypical hyperplasia. Cancer is multifactorial, and H. pylori infection is not the only factor. Many patients with gastritis fearfully ask “will it progress to gastric cancer”. How long does it take for H. pylori infection to cause cancer? How high is the cancer rate? This question is as difficult to answer as how long does it take for hepatitis B virus infection to cause primary liver cancer. But the cancer rate, even if not high, is considered entirely possible for every infected person. The fear of stomach cancer leads them to depression, anxiety, somatoform disorders and even suicide. At this level, the psychological disorders are more harmful than the H. pylori. Atrophic gastritis is not equal to gastric cancer There is a medical term “trilogy of gastric cancer”: gastritis – gastric ulcer – gastric cancer, especially chronic atrophic gastritis, which is considered to be the “neighbor” of gastric cancer. Chronic atrophic gastritis, in particular, is considered the “neighbor” of gastric cancer. Chronic atrophic gastritis is likely to be part of the degenerative changes in the body’s overall aging. Medical doctors have found that the incidence of atrophic gastritis increases with age, just as the atrophy of the gastric mucosa is part of aging with age. It is hard to imagine that older people are aging in every part of their body and only the stomach is still young. Therefore, the diagnosis of atrophic gastritis should be made in the context of the pathology and the situation should be differentiated. In some patients with gastric disease, gastroscopy also reveals “intestinal epithelial hyperplasia”, what kind of disease is this? When chronic superficial gastritis develops into chronic atrophic gastritis, the gastric mucosa is often accompanied by intestinal epithelial metaplasia, which means that cells that should only be found in the intestine grow in the stomach, and the normal secretory function of the gastric mucosa changes to an absorptive function of the intestine. Since the gastric mucosa is unable to detoxify what is absorbed, over time, carcinogenic substances are formed locally in the stomach of some patients, which is why “intestinal epithelial metaplasia” is also called precancerous lesion. In recent years, the number of patients with “intestinal epithelial metaplasia” is increasing, accounting for one or two percent of gastrointestinal patients, and there is a trend of youthfulness, especially in the urban white-collar population with high mental stress, which may be related to irregular diet and high stress.