Recently, the U.S. Department of Health and Human Services released the latest edition, the 15th edition of the Carcinogen Report, adding 8 new compounds. In this latest report, chronic H. pylori infection is listed as a definitive human carcinogen.
Source: NTP Magazine
Subsequently, "the United States listed Helicobacter pylori as a clear carcinogen" on the hot search list of major platforms.
Before the official popularization of science, first make a small science popularization of the name of the disease: the canonical writing of this term should be "Helicobacter pylori", not a spiral Oh ~ ~
1. What is Helicobacter pylori?
Helicobacter pylori disease is a spiral-shaped, microaerobic bacterium that generally grows in the stomach.
Almost all infected patients develop chronic active gastritis, on the basis of which some patients can develop dyspepsia, peptic ulcer, and a very small number of patients can develop gastric malignancy (gastric cancer, gastric MALT lymphoma). Helicobacter pylori gastritis has been defined as an infectious disease.
Helicobacter pylori is the most common chronic bacterial infection in humans and is extremely common in everyday life. According to the "Fifth National Consensus Report on the Treatment of Helicobacter pylori Infection", the infection rate of Helicobacter pylori infection in China is about 50%, that is to say: almost every 2 people, 1 person may be infected with Helicobacter pylori.
Second, is it terrible to be listed as a carcinogen?
In fact, this is not the first time that Helicobacter pylori has been listed as a carcinogen, as early as 1994, the International Agency for Research on Cancer (IARC) under the World Health Organization (WHO) has identified Helicobacter pylori as a Class I carcinogen.
However, to clarify some concepts, the World Health Organization lists Class I carcinogens, which means that the strength of the evidence is Class I, not the intensity of carcinogenic effects, so Class I carcinogens ≠ certain carcinogenic. In fact, alcohol is the first class I carcinogen, Helicobacter pylori is the fortieth, and common carcinogens include salted fish, solar radiation, soot and so on.
Because Helicobacter pylori is considered one of the culprits of stomach cancer and is listed as a clear carcinogen, many people will feel that if infected, it is terrible.
It should be emphasized here that ≠ infected with Helicobacter pylori will definitely get stomach cancer, not to mention that they have already had stomach cancer, so there is no need to panic if they are infected with Helicobacter pylori. Regular physical examination screening, if it is positive for Helicobacter pylori, then early treatment and eradication can reduce the risk of stomach cancer.
3. What are the symptoms of infection with Helicobacter pylori?
Many people have Helicobacter pylori infection, but generally do not cause symptoms or other problems, so if infected with Helicobacter pylori, it is not easy to find in daily life.
However, sometimes infection can cause lesions and symptoms, such as chronic gastritis, ulceration of the stomach or duodenum (the starting part of the small intestine), stomach cancer.
If an ulcer develops after infection, common symptoms are:
- Pain or discomfort in the epigastric region;
- A feeling of fullness occurs after eating a small amount;
- Nausea, vomiting, loss of appetite;
- Dark or black stools may appear.
If the above symptoms occur, you should go to the hospital in time.
Source: Little Dutch Medical Code
4. If you are infected with Helicobacter pylori, will it infect your family?
Helicobacter pylori may be transmitted to the family.
Helicobacter pylori is mainly transmitted through the mouth-to-mouth or fecal-oral route between people, and may also be infected in the following ways:
- If the dishes are not cleaned and there is Helicobacter pylori left, it may become infected.
- It can spread when infected patients kiss other people.
- Do not wash your hands before meals and after going to the toilet, and you can easily infect Helicobacter pylori.
- People infected with Helicobacter pylori can contaminate daily necessities such as pillows, towels, cups and other daily necessities through saliva and breathing, causing infection, so daily necessities should be used separately as much as possible.
5. Are there any tests for Helicobacter pylori infection?
Yes. Currently, tests for Helicobacter pylori infection include:
- Blood tests
- Stool detection
- Biopsy: A small amount of gastric mucosal tissue is endoscopically taken for testing.
- Breath test: That is, the subject is asked to drink a special liquid and then detect the exhaled gas. It is also a common test at present.
Note that at present, Helicobacter pylori cannot complete the self-test at home, and no matter what kind of test, it needs to be completed in a hospital or professional institution.
6. Infected but without symptoms, do I need treatment?
For the general population, if there are no symptoms, depending on the individual's wishes, it is also possible to choose not to treat it temporarily.
However, for some high-risk groups, even if there are no symptoms, they should be treated, such as: peptic ulcer, chronic atrophic gastritis, family history of gastric cancer, bad lifestyle habits such as alcoholism, smoking; long-term use of nonsteroidal drugs.
But from the perspective of preventing stomach cancer, even if there are no symptoms, it must be treated. Because:
- Eradication before the occurrence of atrophic gastritis, almost completely blocking the development path of intestinal gastric cancer;
- No symptoms do not mean no harm, once infected, 100% will have gastric mucosal damage;
- Many stomach diseases have no obvious symptoms, including pre-cancer and no specific symptoms; eradication of Helicobacter pylori can be effectively prevented.
Guidelines related to gastric cancer screening in recent years recommend:
Over 35 years of age, People with Helicobacter pylori infection, regardless of whether they have symptoms or not, should have a gastroscopy;
Over 40 years of age, regardless of whether there are symptoms, it is recommended to have a gastroscopy;
Subsequently, the time for gastroscopy review is determined according to the gastroscopy and biopsy pathology.
We should neither exaggerate the harm of Helicobacter pylori, nor ignore its carcinogenic risk, even if it is 1% risk, put on a person, that is, 100%! Therefore, for stomach cancer, Helicobacter pylori infection is the only factor that can be confirmed and controlled at present. If treated early in the course of infection, the risk of stomach cancer can be greatly reduced. It is generally believed that eradication at the age of 18-40 will yield the greatest benefits.
Image source: Figureworm creative
7. In daily life, how to prevent Helicobacter pylori infection?
Theoretically simple, as long as this bacteria is not allowed to enter the mouth, it can be prevented. However, in daily life, we need to do regular disinfection of tableware, the implementation of meal sharing, pay attention to oral hygiene, change toothbrushes regularly, exercise more to enhance immunity, avoid eating contaminated food and drinking contaminated water, which are the key measures to prevent the infection of the bacterium.
In addition, parents and children's tableware should also be used separately, and the habit of feeding infants and young children in a mouth-to-mouth manner or giving chewed food to children should be abandoned.
After eradication, patients should also pay attention to prevent re-infection caused by daily intimate contact, so family treatment together is the key to avoid mutual infection and re-infection.
bibliography:
[1] National Clinical Research Center for Digestive Diseases (Shanghai), National Alliance of Early Cancer Prevention and Control Centers of the Digestive Tract, Helicobacter pylori and Peptic Ulcerology Group of Gastroenterology Branch of Chinese Medical Association, et al. Expert consensus on prevention, control and management of Helicobacter pylori infection in Chinese households (2021) [J] . Chinese Journal of Digestion, 2021, 41(4): 221-233.
Helicobacter pylori and peptic ulcer group of Gastroenterology Branch of Chinese Medical Association, National Helicobacter pylori Research Collaborative Group, Liu Wenzhong, et al. Fifth National Consensus Report on the Treatment of Helicobacter pylori Infection[J] . Chin J Digest,2017,37 (06): 364-378.
Medical Editor: Gao Jinong
Content Planner: Duffy
Medical Review: Li Xingxing
Content exhibit: Kogari Medical Clinic