A. What is H. pylori
It is a kind of curved curved or S-shaped curved microaerobic bacteria found by Australian scholar Marshall in 1983, which is parasitic on the surface of gastric mucosa and deep layer of gastric mucus, because it is mainly parasitic in the pylorus area of the gastric sinus, plus the special shape, so it is successively called Campylobacter pylori, H. pylori, now referred to as HP bacteria.
Second, why is the “culprit” of chronic gastric disease is H. pylori
Since the discovery of HP by Australian scholar Marshall in 1983, there have been countless studies on HP, and it has been confirmed that HP is the culprit of peptic ulcer (gastric ulcer, duodenal ulcer), chronic active gastritis, and research shows that more than 90% of duodenal ulcers and 80% of gastric ulcers are caused by H. pylori infection, and more than 60% of patients with chronic gastritis have HP infection. HP infection. HP infection chronic superficial gastritis atrophic gastritis enterocolitis or atypical hyperplasia gastric cancer. This pathway of development has been clinically proven. Therefore, WHO (World Health Organization) has identified HP as the first category of carcinogenic factor for gastric adenocarcinoma and gastric lymphoma.
What are the clinical implications of H. pylori screening?
The purpose of H. pylori (HP) test is to determine whether HP infection is present and whether HP has been completely eradicated after anti-HP treatment. Because the discovery of HP revolutionized the world’s understanding and treatment of gastric diseases for decades, by eradicating HP, chronic gastric diseases that were considered unlikely to be eradicated in the past can now be said to be cured, or minimize the recurrence rate. Therefore, HP examination is conducive to the clinical development of reasonable treatment methods and beneficial to the complete recovery of patients with chronic gastric disease.
Fourth, there are those main methods to check H. pylori
1, the need to clamp the gastric mucosa tissue through gastroscopy HP examination methods are: isolation of bacteria culture, direct smear staining microscopy, immunohistochemistry, biopsy tissue rapid urease test. The main drawback of such methods is that they are complex, invasive and painful for the patient.
2, through the immunological principle of HP examination methods are: serum HP antibody assay, fecal HP antigen assay. The main disadvantage of these methods is that they can only reflect the history of HP infection and are not very accurate.
3, blowing test (14C – breath test): because of its non-invasive, specificity, high sensitivity, simple operation has gradually become the main method of HP examination.
Five, why blowing test can detect H. pylori it has those advantages
HP has highly active urease properties, which can decompose urea to produce NH3 and CO2. When a certain amount of 14C-urea is taken orally, if the stomach is infected with HP, the isotope-labeled urea is decomposed by the urease produced by HP bacteria and exhaled in the form of 14CO2 through exhalation, 14CO2 can be detected by liquid flash meter, thus diagnosing the presence or absence of HP infection.
Advantages: The 14C-breath test is simple, 20 minutes after taking 14C-urea capsules orally, blow into the breath card for about 2 minutes and test the breath card count to get the result. A count/minute >100 is considered positive. The sensitivity and specificity is over 95%, which is recognized by domestic and foreign scholars as a non-invasive and reliable standard for diagnosis and follow-up of HP effect. Non-invasive and painless.
Six, those who are suitable for blowing test H. pylori examination before precautions
1, dyspepsia initial diagnosis: as long as there are upper gastrointestinal discomfort symptoms such as epigastric pain, bloating, nausea, vomiting, decreased appetite, etc. can be checked for HP;
2, indigestion repeat patients;
3.Those who cannot tolerate gastroscopy or refuse gastroscopy;
4, gastroscopic examination (such as found to be duodenal ulcer, gastric ulcer, active chronic gastritis, etc.) can be further examined for HP to determine the treatment method;
5, HP eradication effect of the review to understand whether the HP eradication to determine the treatment plan.
Caution: fasting (fasting) before the examination, pregnant women and lactating women do not do this examination, HP-sensitive drugs used within a month, 5 days of upper gastrointestinal bleeding, the sensitivity of the examination is relatively reduced.