What is Helicobacter pylori?
Helicobacter pylori, abbreviated as HP, is a spiral-shaped, slightly anaerobic bacterium with very demanding growth conditions. it was first successfully isolated from gastric mucosal biopsy tissue of patients with chronic active gastritis in 1983. Unlike people often pneumonia, we rarely see bacterial infections in the stomach, septic gastritis often occurs in patients who are very weak and have very low immunity, this is because the stomach environment is acidic, the general bacteria can not live, so we say gastritis often refers to non-bacterial inflammation, is not the need for antibiotics, we usually do not feel that it is gastritis at home to eat antibiotics Oh. The Hp, on the other hand, has a special structure and function that makes it a very acid-resistant bacterium, the only microbial species known to survive in the human stomach, and if Hp infection is detected, antibiotics should be used, but one alone is not enough, and this will be introduced later.
What diseases are H. pylori associated with?
Gastric and duodenal ulcers, gastritis, lymphoma, and gastric cancer are all associated with H. pylori, and the worst outcome is, of course, the development of gastric cancer.
Is H. pylori contagious?
H. pylori is mainly found in the stomach, mouth and feces of infected people, so it can be spread in the population through the following ways: oral-oral route: Chinese people are used to concentrated meals, when Hp is transmitted from the mouth of infected people through the tableware → dishes or soup → the mouth of uninfected people. Some mothers are accustomed to chewing food before feeding it to their children, thus infecting them with Hp. In addition, there is kissing. Therefore, it is important to pay attention to oral hygiene and prevent the disease from entering through the mouth.
Fecal-oral route: Hp in feces contaminates water or food and infects drinkers or eaters with Hp. Studies have shown that low temperature prolongs the survival period of Hp, so food preserved at low temperature that is contaminated with Hp increases the chance of Hp transmission.
Gastrointestinal route: Hp is transmitted to healthy people through the vomit of infected people. It mainly occurs in nurseries and kindergartens.
H. pylori monitoring test methods
There are three tests available: blood sampling to measure the level of relevant antibodies. A carbon breath test (C13 or C14 breath test) is performed on an empty stomach. A rapid urease test with a small biopsy taken from the gastric sinus during gastroscopy. At present, the carbon breath test is the most simple, feasible, non-invasive and accurate test.
Does H. pylori always need to be treated?
We know that the prevalence of H. pylori infection in adults in China is about 60-70%, which means that most Chinese people have it. If all infected old people are treated with sterilization, the consequences such as waste of financial resources and drug resistance rate are unimaginable. In addition scientists have discovered that African mothers are used to chewing before feeding, hence the high rate of H. pylori infection in Africa. But the incidence of gastric cancer there is very low in the world, which is what scientists call “the mystery of Africa” phenomenon. So whether a person gets stomach cancer is related to three main aspects, not a single H. pylori infection: the first factor is, of course, H. pylori, people infected with bacteria less virulent, you infected with bacteria more virulent, you are at high risk; second, whether you have the so-called family susceptibility. For example, if someone in your family has stomach cancer, then you should be careful. Thirdly, whether your living environment or lifestyle is healthy or not, and whether you are at risk of “external invasion” as Chinese medicine says. For example, people like fresh vegetables and fruits, but you like pickled foods too much. The above three aspects are interrelated and one cannot be separated from the other.
The 2014 Kyoto guidelines consider that the bacterium is infectious and needs to be completely eradicated, so it is recommended that anyone found to be infected needs to be eradicated as long as there are no obvious contraindications. However, our 2013 consensus recommends that the following patients with Hp infection require treatment (treated at three levels).
Must be treated for.
(i) peptic ulcer disease (either active or inactive, with or without complications).
(ii) Postoperative early gastric cancer.
(iii) gastric mucosa-associated lymphoid tissue (MALT) lymphoma.
(iv) Significantly abnormal chronic gastritis (combined with erosion, moderate to severe atrophy, moderate to severe intestinal hyperplasia, mild to moderate atypical hyperplasia, and severe atypical hyperplasia should be considered cancerous).
Supportive therapy.
(i) planned use of non-steroidal anti-inflammatory drugs (NSAIDs).
(ii) Partial functional dyspepsia (FD).
③Gastroesophageal reflux disease (GERD).
④Family history of gastric cancer.
Unspecified.
①Persons with strong personal requirements.
② extra-gastrointestinal diseases.
Therefore, treatment is recommended for those who meet the above conditions.