How to face the positive H. pylori? — Digestive Disease Public Service Science 0551 Post
Original 2016-02-28 Digestive Disease Science Popularization Digestive Disease Science Popularization
With the popularization of health knowledge on the Internet, Helicobacter pylori has become one of the most famous bacteria, especially for friends who usually have a bad stomach and are more concerned about it.
One day, Xiao Wang attended a medical checkup and deliberately added the item “H. pylori test”, the result came out positive: ++++, because he knew that H. pylori infection is closely related to stomach cancer, looking at his test results, frowning and worried, he took the “HP (++++) ” result for medical consultation.
With the popularity of H. pylori testing, there are many examples like Xiao Wang, who was found positive in a simple physical examination, (according to the survey, the positive rate of H. pylori in China reached 60-70%). So, just how harmful is H. pylori, and should it be eliminated or forgotten? In this article, we will briefly talk about how we should face the positive H. pylori?
[Does it really cause cancer?
In the Internet era, the Internet is full of true and false news, and too many times the “wolf is coming” makes us half believe in all kinds of information that can cause cancer, so is it true that “H. pylori can cause cancer”?
This is very clear, as early as 1994, the World Health Organization in the classification of H. pylori as a class I carcinogen, the evidence is conclusive. Of course, this process is long and closely related to individual factors, there is a clear relationship between the two, but there is no inevitability.
[Should we treat it?
However, with a H. pylori positive rate of nearly 60%-70% in China, it is clear that not everyone must be treated to reduce the risk of cancer, which is not very realistic. A large proportion of people who are infected do not develop symptoms or do not cause significant “damage”, but remain latent for a long time, waiting for an opportunity to move. Whether or not the disease develops or causes harm is highly dependent on individual factors.
The risk of H. pylori infection varies greatly from person to person, and the need for treatment is based on factors such as family history of gastric cancer, gastric mucosal lesions (atrophy, erosion, enterosis, ulcers, etc.), presence of symptoms, and psychological burden.
If positive for H. pylori, eradication treatment is recommended for people with high risk of gastric cancer, family history of gastric cancer, gastric ulcer, duodenal ulcer, severe gastric mucosal lesions (e.g., erosion, intestinalization, etc.), dyspepsia (e.g., acid reflux, belching, etc.), long-term use of acid suppressants, need for long-term use of non-steroidal anti-inflammatory drugs, residual stomach, gastric MALT lymphoma, and high psychological burden.
For those who are not in the above range, although they are found to be positive, it does not mean that they must be eradicated or that they will definitely get gastric cancer in the future. Think of it this way, if H. pylori is living peacefully with you, then we don’t have to kill them all, just remember to get a gastroscopy to check if these “little guys” are causing damage to your stomach. (Just observe)
About treatment
Treatment should be standardized, a cure, to reduce recurrence, pay attention to prevent reinfection.
The first treatment should be the use of effective drugs and programs, standardized treatment, as far as possible a thorough treatment to reduce drug resistance. As for the specific treatment plan, you should find a specialist to prescribe, listed here and then someone will go to the pharmacy to buy their own drugs. Because unregulated medication can easily lead to treatment failure and the occurrence of drug resistance, we do not recommend buying your own medication.
The vast majority of people can achieve satisfactory results with the first H. pylori eradication treatment, the efficiency rate can reach about 90%, but some people due to irregular drug use, drug resistance or strain variation, etc., can lead to ineffective treatment, so the treatment should be reviewed to observe whether this time the drug can be eradicated H. pylori.
The time window for review: usually about 1 month after the end of the medication to review, too long apart can not exclude reinfection, too close to exclude the impact of drugs. The effect of H. pylori eradication can be reviewed with a breath test (the best option for the first examination is gastroscopy to clarify whether the gastric mucosa is normal or already diseased).
It is common for family members to infect each other, so if available, family members should be tested and treated for H. pylori at the same time.
[About the test: Breath test is not a substitute for gastroscopy]
Gastroscopy is one of the common methods for H. pylori detection, but since it is known that the C13 breath test can detect H. pylori, the majority of patients choose the breath test. It is important to emphasize that the breath test can accurately determine the presence of H. pylori in the stomach, but it does not mean that the breath test can replace gastroscopy. Some inappropriate propaganda, such as “gently blowing, you can check the stomach disease” mislead many patients. This kind of propaganda and advertising has changed the concept and expanded the function of the breath test, which can only detect the presence of H. pylori infection, and a negative breath test is not the same as the absence of gastric disease.
The breath test is a test for H. pylori only, while gastroscopy can determine inflammation, ulcers, polyps or tumors in the stomach in addition to detecting H. pylori. If you have a “stomach disease”, you can’t tell exactly what kind of stomach disease you have by just doing a breath test, you can only know if you have H. pylori infection or not, whether the pain is caused by an ulcer or a tumor, you need a gastroscopy to be clear. There are many different causes of “gastric disease”, and there is no direct equation between H. pylori infection and “gastric disease”. Therefore, a breath test is not a substitute for gastroscopy, and gastroscopy is required to diagnose what kind of gastric disease is present.
In conclusion: If the test is positive for H. pylori, treatment is recommended for the following groups: people at high risk of gastric cancer, family history of gastric cancer, gastric ulcer, duodenal ulcer, severe gastric mucosal lesions, dyspepsia, long-term use of acid suppressants, long-term use of non-steroidal anti-inflammatory drugs, residual stomach, gastric MALT lymphoma, and people with high psychological burden. If you don’t have these conditions, you don’t have to worry too much and regular observation (gastroscopy) is sufficient.
The next time you encounter someone who asks you, “Should I treat it if I am positive for H. pylori?” Pass this article on to him!