"Dr. Zhang, is Helicobacter pylori really a carcinogen?"
When I went to the round today, a patient told me that when he was browsing the web before, he saw a doctor say that "Helicobacter pylori is a carcinogen." Considering that he had also been found to be infected with this bacterium during his previous physical examination, since he could not judge whether the doctor's statement was exaggerated, he was more worried, so he asked me the question at the beginning of the article.
According to the survey, the infection rate of Helicobacter pylori in China is relatively high, with an average infection rate of up to 59%, and Helicobacter pylori is one of the main causes of stomach cancer. In order to let everyone know more about Helicobacter pylori and understand, I will share the relevant knowledge.
1. Why is the infection rate of Helicobacter pylori in China relatively high?
According to the study, it was found that the infection route of Helicobacter pylori is mainly divided into three major pathways, namely the fecal-oral pathway and the mouth-mouth pathway.
The fecal-oral route, as the name suggests, is when feces with Helicobacter pylori contaminate food, which others become infected after eating it. You may not understand this route of infection, but here I will explain. If a chef is infected with Helicobacter pylori, he may have Helicobacter pylori on his hand when he wipes his butt after defecating in the toilet. If the chef does not wash his hands after defecation or does not wash his hands thoroughly, he may contaminate the dishes when cooking, and when people eat this dish, they may be infected.
The mouth-to-mouth route mainly refers to the fact that the saliva of an infected person contaminates food or utensils, and others may become infected after eating this food or using such utensils. The mouth-mouth route is the most dominant mode of infection for Helicobacter pylori.
When Chinese people gather for dinner, most of them adopt a shared meal system. When a group of people are eating together, if one person is infected with Helicobacter pylori, then when the person eats with chopsticks or spoons, it is possible to contaminate the food through tableware. When a person eats this food that is infected with Helicobacter pylori, they may become infected.
Some people go to the restaurant to eat, if the tableware is not thoroughly disinfected, the tableware may also have Helicobacter pylori on the tableware. When people use this dishware that is not thoroughly disinfected, they may be infected. In addition, some parents of children like to chew food to feed their children, kissing, etc. are also mouth-to-mouth transmission.
Iatrogenic infection mainly refers to a mode of transmission of Helicobacter pylori infection caused by incomplete sterilization of medical devices in the process of diagnosing or treating patients. However, among the three infection routes of Helicobacter pylori, iatrogenic transmission is the least of the infection routes.
In fact, the reason why the infection rate of Helicobacter pylori in China is relatively high is mainly related to some living habits, such as not washing hands or washing hands incompletely after defecation, not taking the meal sharing system, incomplete disinfection of tableware, kissing, feeding infants and young children with their mouths, etc.
2. The acidity of stomach acid is so high, why can't it kill all the Helicobacter pylori that enters the stomach? How does Helicobacter pylori cause stomach cancer?
In real life, some people usually prefer to smoke, drink, stay up late, eat hot pot, etc., and these bad living habits will reduce the resistance of the stomach, thus giving Helicobacter pylori an opportunity.
In addition, long-term evolution has made Helicobacter pylori prefer an acidic environment. Although the acidity of stomach acid is relatively high, Helicobacter pylori can cope with some measures. Helicobacter pylori can produce acid inhibition proteins, which in turn inhibit the secretion of gastric acid; produce urease, decompose urea in food to produce ammonia, ammonia can isolate Helicobacter pylori and gastric acid, but also can neutralize gastric acid, so that the lethality of gastric acid is greatly reduced.
Helicobacter pylori causing stomach cancer is not an overnight thing, but a long-term process. After a person is infected with Helicobacter pylori, he or she needs to experience superficial gastritis→ atrophic gastritis→ intestinal metaplasia → atypical hyperplasia → stomach cancer. In general, it takes decades for a person to go from being infected with Helicobacter pylori to developing stomach cancer.
It is estimated that many friends see what I wrote, and their hearts are more panicked, in fact, there is really no need. After infection with Helicobacter pylori, only 1% of people will develop gastric malignancy, about 75% of people will develop chronic gastritis, and 15% to 20% will develop peptic ulcer.
3. How can we tell if we have Helicobacter pylori? Since Helicobacter pylori is so tenacious, is it difficult for us to eliminate them? #养老知识大赛 #
To determine whether we are infected with Helicobacter pylori, we can judge from the symptoms and examination. However, it should be noted that after infection with Helicobacter pylori, its symptoms are lack of specificity, and many people have no symptoms at all in the early stages of infection. Therefore, it is a bit unrealistic to rely on symptoms to determine whether you are infected with Helicobacter pylori.
Clinically judging whether there is helicobacter pylori infection is mainly a urea breath test, which only requires exhalation. The urea breath test is not only fast and painless, but also has a relatively high accuracy. However, this test also has limitations, and in general, pregnant women and children are not suitable for use because it has a certain degree of radioactivity. In addition, before doing this test, it is necessary to meet the requirements of drugs that have not been used for less than 14 days without using proton pump inhibitors, antibiotics, etc.
Although Helicobacter pylori is more powerful, it is also easy to kill if a formal treatment plan is adopted. At present, the killing of Helicobacter pylori is mostly a 4-part protocol, that is, 2 antibiotics + 1 proton pump inhibitor + bismuth.
At present, there are 7 main combinations of antibiotics, namely amoxicillin + clarithromycin, amoxicillin + levofloxacin, amoxicillin + furazolidone, amoxicillin + metronidazole, amoxicillin + tetracycline, tetracycline + metronidazole, tetracycline + furazolidone. #健康明星计划 #
Commonly used proton pump inhibitors mainly include omeprazole, pantoprazole, lansoprazole, esomeprazole, rabeprazole and the like. Bismuth i.e. agents mainly include bismuth potassium citrate, pectin bismuth and so on.
The specific choice of treatment plan needs to be selected under the guidance of a professional pharmacist or doctor, because drug resistance varies from place to place, and different people may have certain contraindications to certain drugs.
In general, the duration of the 4-in-one regimen is 14 days. Testing is required two weeks after the end of treatment to completely kill Helicobacter pylori, and acid suppressants and antibiotics cannot be used before 2 weeks of examination, otherwise the results of the examination will be affected. #健康科普大赛 #
Although we can take some measures to kill Helicobacter pylori, if we do not pay attention to some things, we will still be infected again. Usually, when eating together, the meal sharing system and the public chopstick system should be adopted. Pay attention to quit smoking and alcohol, do not stay up late, do not eat spicy and irritating foods, do not eat undercooked foods, pay attention to washing hands before eating and after going to the toilet, and parents should not feed their children with their mouths.