Helicobacter pylori, or HP for short, is a bacterium that resides primarily in the human stomach. HP infection has been found to be associated with chronic gastritis, peptic ulcers (including gastric ulcers and duodenal ulcers), and gastric cancer. Therefore, HP infection should be taken seriously.
The current global HP infection rate is over 50%, and in some areas of China it reaches 80%, and most people have no symptoms. The treatment of HP infection is usually called “anti-HP therapy”, which contains two kinds of antibacterial drugs, and random anti-HP therapy can easily lead to bacterial resistance and adverse drug reactions. Therefore, anti-HP therapy should be administered under the guidance of a physician and should be indicated.
At present, patients in the outpatient clinic mainly know HP infection through the following ways.
1.Gastroscopy with HP examination;
2, health check: there are two cases, one is to check the blood and find positive HP antibody in the blood; the other is to do a breath test and find that there is HP infection.
Can a breath test or blood test for HP be a substitute for gastroscopy or barium meal?
No, it cannot. The breath test or blood test can only indicate whether there is HP infection, but not whether there is a lesion or what kind of lesion in the stomach. Therefore, only a gastroscopy with HP can give a more comprehensive picture of the condition of the stomach and HP infection.
If you have stomach discomfort, will a HP test tell you what kind of disease you have?
No. To see whether there is gastritis or other problems in the stomach, there are only two types of tests: gastroscopy and barium meal.
If you have stomach discomfort, can you do an HP test first and then do a gastroscopy or barium meal?
This is not recommended. You should go for a gastroscopy or barium meal first (the doctor needs to choose according to the situation). It is important to remember that the HP test is not a substitute for a gastroscopy or barium meal.
Can HP be transmitted by eating together?
It is possible. The oral-oral route of transmission between people is the main way HP is transmitted.
Can HP be transmitted from one family member to another?
Yes, there are family clusters of HP infection, but the causes are complex. In addition to the oral-oral transmission route provided by sharing meals among family members, there may be other ways, such as shared genetic susceptibility to HP infection, exposure of family members to a common source of Hp infection, and similar childhood socioeconomic status between spouses.
Do all HP infections cause disease?
HP is a genetically polymorphic bacterium, and its ability to cause disease is related to the expression of some genes; the pathogenicity of HP is also related to the body’s resistance and immunity; whether HP causes disease depends on the interaction between the bacterium and the body.
Do all patients with HP infection need treatment?
Let’s look at the current national and international consensus opinion.
Anti-HP therapy is necessary in the following conditions: peptic ulcer, early postoperative gastric cancer, gastric MALT lymphoma and chronic gastritis with significant abnormalities.
Some other conditions can be treated with anti-HP: patients who plan to use NSAID drugs for a long time, some patients with functional dyspepsia, patients with gastroesophageal reflux disease and those with a family history of gastric cancer.
From the above mentioned, it is very important to know if there are lesions in the stomach and what they are before treating HP infection. Therefore, it can be known that.
1. If HP infection is found by gastroscopy and at the same time there is indeed gastritis, ulcer, etc., it should be treated.
2, if no gastroscopy or barium meal is done, and HP infection is found by simple examination, it becomes more tricky whether anti-HP treatment is given.
First of all, if the blood is positive for HP antibodies, it does not indicate whether there is HP infection now. Because of previous HP infection, antibodies may appear inside the blood and will last for a long time. Therefore a positive blood HP antibody alone is not a basis for having to treat HP. Secondly, a breath test with HP infection, if asymptomatic and found only by physical examination, is also not a basis for the necessity of treatment. In both cases, from a cautious point of view, it is best to do a gastroscopy or barium meal before deciding whether or not anti-HP treatment.
3.If there are symptoms of stomach, just doing a breath test is not enough, you must complete a gastroscopy or barium meal before deciding whether anti-HP treatment according to the situation.
When to review after anti-HP treatment?
After standard anti-HP treatment, it is necessary to stop the drug for 4 weeks and then perform a breath test or review HP at the same time if a gastroscopy is needed.
HP infection is a common problem, and its association with a number of lesions makes it important to take HP infection and treatment seriously. However, it is important to choose carefully before proceeding with treatment and to strictly control the indications so that the patient benefits from it more than the risks. Research on HP is also constantly moving forward, and therefore the range of indications and the choice of treatment options are constantly updated. This requires patients to consult their doctors at regular medical institutions when in doubt to obtain the latest information.