1. How was H. pylori discovered?
In 1982, Australian scholars Warren and Marshall from chronic gastritis and peptic ulcer patients gastric mucosa biopsies cultured a bacterium called Helicobacter pylori, and in 2005 won the Nobel Prize in physiology and medicine, Helicobacter pylori has attracted the attention of more and more physicians and scientists, and even some of the general population is familiar with this, these are for the relevant disease Prevention and treatment of these diseases has laid a good foundation.
2.What is H. pylori?
Helicobacter pylori (Hp) is a unipolar, multi-flagellated, bluntly rounded, spirally curved bacterium that often has a typical spiral or curved shape on the epithelial cell surface of the gastric mucosa. H. pylori is microaerobic bacteria, ambient oxygen requirements of 5 to 8%, in the atmosphere or absolute anaerobic environment can not grow.
3, what is the rate of infection and transmission of H. pylori?
Epidemiological studies have shown that H. pylori infects more than half of the world’s population, and the incidence rate is more closely related to socioeconomic level, population density, public health conditions and water supply. The prevalence of H. pylori infection in China is about 60%.
Most scholars believe that “human-to-human” and “fecal-to-mouth” are the main modes and routes of transmission, as well as endoscopic transmission, and that H. pylori infection has a significant concentration in families. There is a clear clustering of H. pylori infection within families. Children of parents infected with H. pylori have a much higher chance of infection than other families. Once humans are infected with H. pylori, if they are not treated, they remain infected for almost their entire lives, so the rate of infection may increase with age.
4. How does H. pylori cause disease?
H. pylori enters the stomach and crosses the mucus layer with the help of the flagella on the side of the bacterium to provide power, and power is an important factor in the pathogenicity of H. pylori. After reaching the epithelial surface, H. pylori is firmly attached to the epithelial cells through adhesions to avoid being expelled with food by the stomach. It also secretes peroxide dismutase (SOD) and catalase to protect it from the killing effect of neutrophils. H. pylori is rich in urease, through the urease hydrolysis of urea to produce ammonia, forming a protective layer of “ammonia cloud” around the bacterium to resist the killing effect of gastric acid.
5.H. pylori is mainly related to what diseases?
H. pylori infection is a major causative factor in chronic active gastritis, peptic ulcers, mucosa-associated lymphoid tissue (MALT) lymphoma and gastric cancer.
In 1994, the World Health Organization/International Agency for Research on Cancer designated H. pylori as a class I carcinogen.
6.What are the diagnostic methods of H. pylori?
Diagnostic methods for H. pylori infection are divided into two categories: invasive and non-invasive.
The invasive method mainly refers to the method that requires taking biopsy specimens for examination through gastroscopy. These include bacterial isolation and culture, direct smear, rapid urease test, and drug sensitivity test.
Non-invasive methods mainly refer to methods that do not diagnose H. pylori specimen infection by taking biopsy specimens through gastroscopy. These include antibody testing, antigen testing, and urea 13C/14C breath testing. The urea 13C/14C breath test is currently the most widely used method, and the entire testing process takes only 30 minutes without any other discomfort, enabling many patients with high blood pressure, heart disease and contraindications to gastroscopy to undergo H. pylori testing without difficulty. Even some medical examination institutions will include it in the routine program.
7.How is the treatment of H. pylori infection?
Because H. pylori is mainly parasitized under the mucus layer, so that the efficacy of the drug is limited, coupled with the side effects or drug-resistant strains that some drugs, especially antibiotics, are prone to produce in the long-term application, the treatment effect is actually not very satisfactory.
The principles for the selection of treatment options are: ① the use of a combined drug approach; ② the eradication rate of H. pylori > 80%, preferably above 90%; ③ no significant side effects and good patient tolerance; ④ the economic affordability of patients.
The effectiveness of treatment of H. pylori infection should be judged by the eradication rate of H. pylori, which refers to the absence of bacterial growth confirmed by bacteriological, pathological histological or isotopic tracing methods at least one month after the termination of treatment.
It is currently believed that more than 90% of duodenal ulcers and about 80% of gastric ulcers are caused by H. pylori infection. The discovery of H. pylori and its role has transformed ulcer disease from a chronic condition that was previously incurable with recurrent attacks to a disease that can be cured with a short course of antibiotics and acid suppressants.
H. pylori has been symbiotic with humans for millions of years, and there must be an aspect of necessity. The ulcers are caused by the fact that H. pylori proliferates because the inherent stability of the entire digestive system is disrupted. Therefore, without restoring the stability of the entire digestive system, the full pursuit of eliminating H. pylori is inevitably putting the cart before the horse.
8, how to correctly understand the H. pylori?
Just as everything has its two sides, due to differences in understanding or one-sided, some people are afraid of H. pylori to the extent of “bacteria”, it is necessary to properly educate the issues related to H. pylori.
(1) The correct understanding of the impact of H. pylori on humans: the infection rate of H. pylori in China is about 60%, while the incidence of gastritis is about 20%, and the incidence of gastric cancer is even lower, not all people infected with H. pylori will lead to gastritis or gastric cancer. So don’t be too panic when you find the manifestation of H. pylori infection, especially when you are found positive for H. pylori in some medical check-ups. It is best to go to a specialist hospital for further consultation.
(2) The correct treatment of H. pylori infection: general specialist hospitals have a relatively complete set of diagnosis and treatment process for H. pylori infection, not indiscriminately first check H. pylori, followed by unprincipled eradication treatment. The current domestic and foreign consensus opinions on H. pylori infection clearly put forward the scope of treatment and the course of treatment and precautions to avoid the waste of medical resources and the occurrence of antibiotic resistance.
(3) Proper prevention of H. pylori infection: H. pylori enters the body mainly through the oral cavity, and the development of good hygiene habits is an important measure to prevent H. pylori infection.