How much does H. pylori have to do with stomach cancer?
Do you know these about H. pylori?
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 may even lead to gastric and duodenal ulcers and gastric cancer. In recent years, with the increase in health awareness and the improvement of welfare in many units, the screening of 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 in order to prevent stomach cancer, and a positive test does not mean that it must be cured, nor does it mean that they 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 infection, 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 in the population with chronic gastritis are positive for H. pylori, much higher than the rest of the population. Also if gastroscopy is performed on H. pylori-positive people, they all suffer from gastritis of varying degrees. In addition, H. pylori is also 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 is a link between the two. Epidemiological surveys in China have shown that regions with a high rate of positive H. pylori detection also have a high incidence of gastric cancer. In animal experiments, mice were infected with H. pylori in their gastric mucosa, and when observed again after a period of time, they also had a higher incidence of gastric cancer than the control animals. C.R. Tseng cautioned that gastric cancer has a long progression time, so all of 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 gastric cancer development, human factors and environmental factors are also crucial.
Screening for H. pylori is recommended for those with a family history of gastric cancer
Since the rate of H. pylori infection is so high in China, shouldn’t we all get checked for this item? People with a family history of gastric cancer are at high risk of developing gastric cancer, so it makes sense 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 gastric 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. The first choice of gastroscopy can avoid the missed diagnosis of gastric cancer, cardia cancer and other malignant diseases of the digestive tract. While doing the endoscopy, the doctor can take the gastric mucosa under the microscope for H. pylori testing.
How do I get infected with H. pylori?
In most cases, the first H. pylori infections occur in infancy and childhood (mostly before the age of 10), and infections after adulthood are relatively uncommon (but do exist). The main source of infection may come from family members, such as parents, siblings, etc. The transmission route is generally oral-oral and fecal-oral, and intimate contact, consumption of contaminated food and drinking water are all possible routes of transmission. Foreign studies have found that the detection rate of H. pylori in urban drinking water is 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 mentioned here contains two cases, the first one is because the eradication is not complete, and the small amount of bacteria remaining in the body resurfaces, which happens mostly within one year after the successful treatment; the second case is the re-infection with new H. pylori. Both conditions exist, with the former predominating in developed countries and the latter usually dominating in less developed regions.
How to prevent infection and recurrence?
How to prevent infection and recurrence? The fundamental solution is to improve the living and sanitary conditions of the whole society, but this is a long process. There are several things that can be done at present.
First, as mentioned earlier, 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.
Second, use effective drugs and protocols for initial treatment and try to treat as thoroughly as possible.
Third, studies have shown that H. pylori also exists in the human oral cavity, so H. pylori infection in the stomach should be tested and treated at the same time as H. pylori infection in the oral cavity (rinsing with mouthwash is sufficient).
Fourthly, after treatment, H. pylori should be rechecked regularly and if it recurs, it 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 body. If a range of conditions such as peptic ulcers or stomach cancer develop, then treatment is necessary. For a normal person, to treat or not to treat, that is the question.
Reminder
Influenced by the Chinese food culture, many people are not used to using communal chopsticks around meals, etc., are potential infection factors. It can be said that H. pylori is actually the bacteria that is eaten. It is difficult for many families to adopt meal sharing or to use communal chopsticks in the family. However, H. pylori has a weakness, is not heat-resistant, if there is a high-temperature sterilization function of the cupboard can be killed H. pylori, or wash dishes in a pot with boiling water for a while can also be. In addition, the elderly at home to chew or bite down on food and then feed the children, which is a very bad habit, the family should also pay attention to avoid each other pinch dishes to avoid mutual transmission of H. pylori.