Recently, the male star Hu Bing a vlog record about the treatment of Helicobacter pylori rushed to Weibo hot search, he recorded the whole process of his treatment, and warned all netizens that Helicobacter pylori will bring harm to the stomach, long-term inflammation will have the risk of cancer.
Hu Bing said in the video that he found himself with stomach discomfort during the live broadcast and went to the hospital to check the C14 breath test for Screening Helicobacter pylori. The results showed that the test data was 1107, and the doctor explained that this value was positive as long as it exceeded 100. Because co-feeding is an important reason for the transmission of Helicobacter pylori. So, Hu Bing asked the whole team to do an inspection.
After 14 days of drug treatment, when Hu Bing went to the hospital again to test For Helicobacter pylori, the test result was less than 100, and when he reached the negative range, he was finally relieved.
Judging from the comments, many netizens are mainly worried about whether they are infected with Helicobacter pylori, especially about the relationship between the infection and stomach cancer, and some people will add this item to the annual physical examination to give "bold attention".
In this regard, medical experts said: Helicobacter pylori (commonly known as HP infection) is indeed associated with the occurrence of gastric cancer, but there is no need to panic excessively, early detection, early treatment, and pay attention to "meal sharing" in life, which can prevent problems before they occur.
Doctors introduce that currently, tests for HP infection are divided into invasive and non-invasive tests. The former is tested by gastroscopy to take gastric mucosal specimens, and the latter can be used for 13C breath test, blood HP antibody detection, fecal HP antigen detection, etc.
Dr. Ding Hui of the Department of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, introduced that the eradication of Helicobacter pylori is the first choice of "quadruple therapy":
There are two main methods for eradicating Helicobacter pylori: "triple therapy" and "quadruple therapy". Generally speaking, if the drug can be taken strictly according to the doctor's instructions, the success rate of Helicobacter pylori eradication is very high. However, some patients are still not successfully eradicated due to individual differences and differences in drug resistance.
So how to improve the success rate of Helicobacter pylori eradication? What should I do if the treatment fails?
1. Insist on taking medicine to improve the success rate of eradication
The Consensus on the Management of Helicobacter pylori Infection recommends "quadruple therapy" as the preferred option for the eradication of Helicobacter pylori. In clinical work, doctors will choose the eradication plan according to the specific situation of the patient, the medication time is 10 days or 14 days, if the patient can strictly follow the doctor's instructions to take the drug, the basic can achieve more than 90% of the eradication success rate.
It is worth noting that there are also some side effects of eradication treatment: due to the large dose of antibiotics to be taken, the course of treatment may cause greater stimulation to the digestive tract, resulting in nausea, abdominal pain, loss of appetite and other adverse reactions, some patients may not be able to adapt; taking large doses of antibiotics may cause antibiotic-related diarrhea, many patients will complain of increased "diarrhea" after taking the drug, during the period of taking bismuth, some patients may have black stools, metal taste in the mouth, etc., and a very small number of patients can have elevated transaminases. However, the above conditions can quickly return to normal after discontinuation of the drug.
2. If eradication fails, remedial treatment can be carried out
Patients should have an expiratory test 4 weeks after discontinuation of the drug. Neither serology nor rapid urease test results can be used as criteria. If the breathing test system is re-examined after 4 weeks of discontinuation, and the experimental results are indeed still positive, another "quadruple therapy" can be selected for remedial treatment. In principle, do not reuse the original regimen, if clarithromycin or levofloxacin has been applied in the regimen, re-use should be avoided and the course of treatment should be extended to 14 days as far as possible. The choice of regimen is determined based on local Helicobacter pylori antibiotic resistance rates and individual drug history, weighing efficacy, adverse drug cost effects, and availability.
The standard "triple therapy" is mainly composed of PPI (proton pump inhibitor) + clarithromycin + amoxicillin or metronidazole. This regimen has been widely used in clinical first-line treatment due to the low number of drugs and low adverse reactions. However, due to the long-term use of the regimen, the rate of resistance to clarithromycin or metronidazole in Pylori has increased significantly, and the eradication rate has gradually decreased, with eradication rates below 80 per cent in many regions.
The classic "quadruple therapy" consists of four drugs containing bismuth, PPI + bismuth + two antibiotics, and the eradication rate can reach 85%-94%. Bismuth agents are mainly targeted at Helicobacter pylori-resistant strains, which can increase the eradication rate by an additional 30%-40%. Bismuth agents are not resistant and have high safety in short-term use. Therefore, unless there is a region where the use is contraindicated or known to belong to the drug resistance rate, doctors should apply a very bismuth tetralogy whenever possible.
In addition, it is worth noting that only adults are "recruited", and children will also have Helicobacter pylori infection.
Dr. Zhang Weiqi of the Department of Pediatrics of Renji Hospital said that in the pediatric department, outpatient doctors often encounter children with repeated abdominal pain and symptoms of dyspepsia such as anorexia, nausea and vomiting, in addition to the intestinal dysfunction caused by psychological factors, common diseases that can cause repeated abdominal pain in children are gastritis, peptic ulcer, constipation, diarrhea, intestinal parasitic diseases, allergies and connective tissue diseases, and rare liver, gallbladder, pancreatic diseases, Crohn's disease, cysts and tumors. In recent years, with the extensive study of Helicobacter pylori infection in children, it has been found that a considerable proportion of children with recurrent abdominal pain and upper gastrointestinal symptoms are caused by stomach and duodenal inflammation and ulcers caused by Helicobacter pylori infection.
"Helicobacter pylori infection is not only the main cause of chronic gastritis and peptic ulcer in adults, but also the most important factor in chronic gastritis and peptic ulcer in children. Clinical data show that the incidence of chronic gastritis and peptic ulcer in children in China is significantly higher than that of developed countries in Europe and the United States. Some scholars believe that it is mainly related to diet and Helicobacter pylori infection, so cultivate good eating habits to avoid abnormal gastric acid secretion, while preventing and treating Helicobacter pylori infection can reduce the incidence and keep your child away from 'stomach disease'. Dr. Zhang Weiqi said.
How to prevent it? Dr. Zhang Weiqi reminded that Helicobacter pylori (HP) infection has a certain phenomenon of family aggregation. When there are infected people in the family, it is best to implement a "meal sharing system" to reduce the chance of cross-infection among family members.
In addition, HP infection in children is also closely related to feeding patterns in infancy and early childhood. For example, adults feed to their children after chewing food, this seemingly "care" for children is actually a bad feeding method, allowing HP to "take advantage of" and increasing the chance of HP infection in infancy and childhood.
Plaque is the main site of HP retention, which can cause self-infection or transmission between each other. Therefore, cultivate good hygiene habits of brushing teeth morning and evening and gargling after meals, eliminate plaque in time, and do not give HP a "hiding place". In addition, children are taught to pay attention to dietary hygiene, do not eat raw and cold, unwashed, heated and disinfected food, and must wash their hands before eating to prevent hp transmission and infection through hands and food.
【Extended reading】Helicobacter pylori and Nobel Prize
In 1983, two Australian physicians took a sample from the gastric mucosa of chronic gastritis and isolated and cultured Helicobacter Pylori (HP) under micro-aerobic conditions, which is recognized as an important causative factor in chronic gastritis and peptic ulcer, and believes that long-term infection of Helicobacter pylori is also associated with gastric adenocarcinoma and gastric mucosal associated tissue (MALT) lymphoma. Twenty years later, the two physicians were awarded the Nobel Prize in Medicine for their discovery of Helicobacter pylori.
Author: Tang Wenjia
Editor: Tang Wenjia
Editor-in-Charge: Jiang Peng
Source: Renji Hospital
*Wenhui exclusive manuscript, please indicate the source when reprinting.