Helicobacter pylori, abbreviated as Hp, Helicobacter pylori, is a pathogenic bacterium that can cause stomach cancer, and more than 50% of the world's population has been infected with Helicobacter pylori. At present, the first-line clinical drugs mainly use amoxicillin, metronidazole, clarithromycin antibiotics and proton pump inhibitors, as well as bismuth agent combination methods to inhibit the growth and infection of the bacteria (commonly known as triple or quadruple methods). In recent years, Helicobacter pylori has become highly resistant to these known antibiotics, making eradication of Helicobacter pylori a thorny issue in clinical practice.
Recently, the U.S. Department of Health and Human Services released the 15th edition of the Carcinogen Report, which added 8 new carcinogens. Of particular note is the fact that Helicobacter pylori, which is extremely common in daily life, is classified as a definitive carcinogen.
The data shows that the infection rate of Helicobacter pylori in natural populations worldwide exceeds 50%. In China, there are regional differences in the probability of infection with Helicobacter pylori, with an average infection rate of nearly 60%.
Helicobacter pylori was first isolated from gastric mucosal biopsy tissue in patients with chronic active gastritis in 1983 and is the only microbial species known to survive in the human stomach. The World Health Organization reports that half of stomach cancers are linked to Helicobacter pylori.
Helicobacter pylori can cause chronic inflammation of the mucous membrane through bacteriology, cytotoxin and immune activation, over time, it is manifested as epithelial damage in the anatomy, repeated damage causes the gland to wither, which in turn leads to atrophy of the gastric mucosa, over time or repeated infection with H.pylori, the probability and severity of mucosal atrophy increases, the mucosa thins, and the new epithelial enteration. Intestinal metaplasia is considered to be an adaptive response of the gastric mucosa to a long-term unfavorable environment, and in the process of regeneration, heterogeneous proliferation of the intestinal epithelium further abnormal development, the formation of atypical hyperplasia, manifested as cellular atypical and glandular structure disorders, at present, "chronic superficial gastritis - atrophic gastritis - intestinal metaplasia - atypical hyperplasia - gastric cancer" model has been recognized by most clinical scholars.
Not all Patients with Helicobacter pylori end up with stomach cancer. At the genetic level, the most important gene involved in the oncogenicity of H. pylori is the cag gene, and only H. pylori has cag island. Pylori will further promote the secretion of some inflammatory factors by gastric epithelial cells, activate tumor signals and eventually develop into cancer. Individual genetic sensitivity, physique, living habits, etc. will affect the progression of the disease.
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At present, the methods of detecting Helicobacter pylori are mainly divided into: invasive detection and non-invasive detection. Invasive testing, which uses gastroscopic clamping of gastric mucosal tissue for slice microscopy, is one of the gold standards for the detection of Helicobacter pylori. Non-invasive testing refers to a C-13 (or C-14 urea) breath test. The principle is that C13 or C14-labeled urea is broken down into ammonia and C-13 (or C-14) labeled carbon dioxide by helicobacter pylori urease, and the presence of Helicobacter pylori infection can be diagnosed by analyzing the proportion of carbon dioxide labeled in the exhaled air, which can initially reflect the status of Helicobacter pylori infection. Non-invasive testing is also a widely developed Helicobacter pylori test, which can be done in most hospitals and the steps are very simple.
Helicobacter pylori is contagious! The main routes of transmission are oral transmission, fecal-oral transmission, close contact transmission and iatrogenic transmission. One person in the family may be infected, others may also be infected, and kissing between couples and parents chewing food and feeding children can spread Helicobacter pylori.
Therefore, anyone in the family who is infected with Helicobacter pylori will cross-infect when eating together because of the sharing of chopsticks and saliva.
Living in a crowded environment, not paying attention to hygiene, or not having a reliable and clean water source are all risk factors for Helicobacter pylori infection in daily life.
Therefore, the following measures need to be adhered to by our efforts:
Share meals with your family or use chopsticks and spoons to serve rice and vegetables, do not sandwich dishes with each other.
It is forbidden to feed children food with their mouths, and before making love between couples, they should fully clean their mouths.
Wash your hands before eating and after using the toilet, and wash or peel vegetables, melons and fruits.
Do not eat irritating foods, do not drink raw cold water, do not eat things that are too hot.
Cutlery should be boiled regularly for 20 minutes.
In particular, the use of public chopsticks has not been effectively popularized in most households or restaurants. From a scientific point of view, the saliva and droplets of the human respiratory tract are the main transmission routes of many infectious diseases. For Helicobacter pylori infection and other germs and infectious diseases, the chopsticks are an effective barrier. Including in the current COVID-19 pandemic, it is crucial to adhere to this principle.
A study published in the Journal of Nursing by Jia Mingfang and others of Zhongnan Hospital of Wuhan University analyzed the current status and risk factors of Helicobacter pylori infection in 2180 residents and concluded that household meals with public chopsticks are one of the effective measures to reduce Helicobacter pylori infection.
doi:10.16460/j.issn1008-9969.2016.18.048
Therefore, the Healthy China Action (2019-2030) issued by the National Health Commission in 2019 advocated the use of public tableware and meal sharing system by families and society.
Healthy China Initiative (2019-2030)
http://www.nhc.gov.cn/wsxf/zcfg/201907/2a771d89e00e4b228028335d4fcf1a7d.shtml
Eradicating Helicobacter pylori is a long and arduous task. In addition to promoting healthy eating habits such as public chopsticks and spoons, improving the level of primary care and screening investment are the most critical measures. The domestic academic community has formed a relatively clear understanding of this, and it is expected that these academic consensuses can be written into relevant policies as soon as possible.
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