Our previous article introduced H. pylori, and readers’ feedback wanted to know the specific measures to prevent and treat H. pylori. This article introduces the diagnostic and preventive measures for H. pylori.
Detection
Diagnostic methods for H. pylori infection include invasive methods that rely on gastroscopic biopsy and non-invasive methods that do not rely on gastroscopic biopsy. The main non-invasive methods are serological tests and breath tests.
The scientific name for the “breath test” to detect H. pylori is the carbon 13 (or carbon 14) urea breath test, hereafter referred to as the breath test. It is based on the principle of using carbon isotopes (carbon 14 or carbon 13) as markers to label carbon atoms in urea and to determine the presence of H. pylori by using its ability to break down urea.
After oral administration of the labeled urea capsule, if H. pylori is present in the stomach, the urease produced by it will break down the labeled urea into carbon dioxide and ammonia, the carbon atoms in the urea that are labeled move to carbon dioxide, and the carbon dioxide is expelled from the body via blood circulation from the lungs, and the expelled carbon dioxide is collected (blowing or exhaling). The level of carbon dioxide produced by the breakdown of H. pylori is measured by a specific instrument to determine the presence of H. pylori infection in the stomach.
The breath test is a convenient and accurate way to detect the presence of H. pylori infection, but it is a single test, and a negative breath test is not the same as the absence of “gastric disease”.
When do I need to eradicate H. pylori?
1. Peptic ulcer: the most important indication for H. pylori eradication. Eradication of H. pylori leads to complete cure of chronic, recurrent disease.
2, gastric MALT lymphoma, about 80% or more H. pylori positive, early eradication of Hp can be obtained after a complete response. Hp eradication has become the first-line treatment for early gastric MALT lymphoma.
3, H. pylori-positive chronic gastritis with dyspepsia: eradication of H. pylori can provide long-term relief of symptoms in 8%-20% of patients with H. pylori-positive functional dyspepsia (FD), and the efficacy is better than any other treatment.
4, H. pylori infection with chronic gastritis or gastric mucosa atrophy or erosion, atrophy and intestinal metaplasia are important lesion stages in the evolution from non-atrophic gastritis to gastric cancer.
5.Family history of gastric cancer, the genetic susceptibility of first-degree relatives of gastric cancer patients is high. Although genetic susceptibility is difficult to change, eradication of H. pylori can eliminate important factors in the development of gastric cancer, thus improving the prevention effect.
6.Personal request for treatment, endoscopy is recommended before treatment.
7.Plan to take long-term non-steroidal anti-inflammatory drugs, referred to as NSAIDs, including low-dose aspirin.
Treatment
Treatment of H. pylori infection is mainly carried out by anti-H. pylori drugs. The reduced activity of most antibacterial drugs in the acidic environment of the stomach makes H. pylori infection less likely to be eradicated. There is no single drug that can effectively eradicate H. pylori, and single drugs are ineffective and can easily induce drug resistance. The most commonly used combination therapy is to eradicate H. pylori with a combination of an acid inhibitor, an antibacterial drug or a synergistic colloidal bismuth agent.
Treatment considerations
The vast majority of people have ideal treatment results, but attention must be paid to strict indications for H. pylori eradication, standardization of treatment, emphasis on combination of drugs, do not stop the drugs when symptoms improve; oral cavity as the second aggregation site of Hp may be one of the reasons for eradication failure; antibiotic therapy requires attention to allergy history and liver damage.
Prevention
H. pylori enters the body mainly through the oral cavity. The bacteria are often found in the tartar and saliva of carriers and are transmitted through shared eating. Therefore, simultaneous treatment of family members, sterilization of dishes, meal sharing, oral hygiene, and regular toothbrush changes are the most critical measures to prevent infection with this bacterium. In addition, adults should not use mouth-to-mouth feeding or give chewed food to infants and children, which can easily transmit H. pylori to children.
”Stomach disease” is not as simple as sterilization
Most patients with gastric or duodenal ulcers can have good results with the eradication of H. pylori, as described in an earlier article, H. pylori does not develop in every infected stomach, which means that the causes of the “stomach” are complex and multiple, H. pylori is only one of the causes, the loss of gastric mucosa is also related to diet The loss of gastric mucosa is also closely related to diet, lifestyle habits, emotions, side effects of drugs, etc. The loss of gastric mucosa is also closely related to diet, lifestyle, emotions, and side effects of medications. Moreover, your “stomach pain” may not really be a problem of the stomach, so it should be diagnosed before treatment.