Helicobacter pylori (Hp) is a Gram-negative, microaerobic bacterium that lives in all areas of the stomach and duodenum. It causes mild chronic inflammation of the gastric mucosa and can lead to gastric and duodenal ulcers and gastric cancer. In recent years, as health awareness increases and the welfare of many units improves, screening for H. pylori is often added to medical examinations. As a result, many people are screened positive for H. pylori, and the moment they get the report card, many people’s hearts start to wander, thinking, “Am I a high-risk group for gastric cancer? How can I kill these bacteria? Will I get stomach cancer soon if I don’t cure it immediately?” For this reason, experts explain that it is not recommended for everyone to be screened for H. pylori, and that a positive test does not mean that it must be cured or that you will definitely get stomach cancer in the future. There is a relationship between the two, but it is not inevitable. H. pylori is a spiral-shaped bacterium that exists in the stomach and duodenal bulb, and it was not discovered until the 1980s. According to statistics, China is a large country with H. pylori infections, with up to 50%-80% of the general population infected with H. pylori. Current research suggests that H. pylori is the main causative agent of chronic gastritis, as 90-95% of people screened for H. pylori in the population with chronic gastritis are positive for the bacteria, far more than other populations. Also, if gastroscopy is performed on people who are positive for H. pylori, they all have varying degrees of gastritis. In addition, H. pylori is considered to be the main causative agent of peptic ulcers, and the eradication of H. pylori is currently one of the main treatments for peptic ulcers. As for the relationship between gastric cancer and H. pylori, which is of great concern, current research suggests that there may be a link between the two. Epidemiological surveys in China have shown that areas with a high rate of positive H. pylori detection also have a high incidence of gastric cancer. In animal experiments, the incidence of gastric cancer in mice infected with H. pylori after a period of observation was higher than in control animals. C.R. Tseng cautioned that gastric cancer has a long progression time, so the above studies have some limitations. Positive H. pylori does not mean that you will definitely get gastric cancer in the future; positive H. pylori is only one part of the development of gastric cancer, and human and environmental factors are also crucial. Screening for H. pylori is recommended for those with a family history of stomach cancer. Since the rate of H. pylori infection is so high in China, should we all go for this program? The answer is “No! People with a family history of stomach cancer are a high-risk group for the development of stomach cancer, and it is very meaningful for them to be screened for H. pylori, and if they are found to be positive, they should be treated as soon as possible to reduce the incidence of stomach cancer. As for other people, it is not very meaningful to screen for H. pylori, but it is more stressful to find out that they are positive. For people with frequent upper abdominal distension and pain and a history of gastritis, the preferred test is not H. pylori, but rather gastroscopy. Gastroscopy is the first choice to avoid the detection of malignant diseases of the digestive tract such as gastric cancer and cardia cancer. Doctors can take the gastric mucosa for H. pylori examination under the microscope at the same time as the endoscopy. How is H. pylori contracted? In most cases, the first H. pylori infection occurs in infancy and childhood (mostly before the age of 10), while infections in adulthood are relatively uncommon (but do occur). The main source of infection may come from family members, such as parents and siblings. The transmission route is generally oral-oral, fecal-oral, intimate contact, eating contaminated food and drinking water. Foreign studies have found that the detection rate of H. pylori in urban drinking water is as high as 4%, and it can also be detected on the surface of food such as vegetables. Once infected, if left untreated, H. pylori may stay with you for the rest of your life. Some people relapse after H. pylori eradication, and there are regional and ethnic differences in the relapse rate. In developed countries and developed regions in the West, the relapse rate is very low, averaging only about 2-3% per year, while in less developed regions, the relapse rate can be as high as 10-13% per year. The recurrence here includes two cases, the first one is due to incomplete eradication and the resurgence of a small amount of bacteria left in the body, which mostly occurs within one year after successful treatment; the second case is the re-infection with new H. pylori. In developed countries, the former is predominant, while in less developed regions, the latter is usually predominant. How to prevent infection and recurrence? How to prevent infections and recurrences? The fundamental solution is to improve the living and sanitary conditions of the whole society, but this is a long process. The main things that can be done at present are: 1. As mentioned earlier, it is common for family members to infect each other, so if possible, family members should be tested and treated for H. pylori at the same time. 2, the first treatment on the choice of effective drugs and programs, as thorough as possible. 3, research shows that H. pylori also exists in the human mouth, so in the treatment of H. pylori infection in the stomach should be detected and treated at the same time oral H. pylori infection (plus mouthwash rinse can be). 4, after treatment, regular re-testing of H. pylori, if recurrence, can be treated again. There are still many unknown aspects of H. pylori, and some studies have even found that H. pylori has a protective effect on the human body. If there is a peptic ulcer, stomach cancer and a host of other conditions, it must be treated. For a normal person, it is a question of whether to treat or not to treat.