Infected with Helicobacter pylori Can I eat with friends?

Lu Hong, chief physician of the gastroenterology department of Renji Hospital, receives a photo by Xu Cheng, a reporter of this newspaper

A while ago, actor Hu Bing's post on the treatment of Helicobacter pylori (HP) rushed to the hot search, and netizens were surprised to find that there were so many people infected with HP around! Infection with HP is not terrible, it is good to treat it, and there is no need to be "socially afraid" because of it. Lu Hong, chief physician of the Department of Gastroenterology at Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, told reporters that about 50% of people in the mainland are infected with HP, and we do not even call it a "disease". Regarding whether to treat, how to treat, whether to relapse, etc., the facts may subvert your cognition.

The cook was expelled after becoming infected

Lu Hong's clinic has many HP infected people who come to visit. Some of them talk about discoloration, worried about developing stomach cancer; some people are about to get married and are forced by their other half to treat them; others have repeatedly failed treatment and are depressed...

Mr. Wang is the head of a company's department, he found HP positive in the physical examination, and many people in the whole department were "recruited", and the company's overall infection rate reached more than 40%. Because the chef himself was also infected and was considered the "culprit", he was dismissed. What's even more shocking is that the company threw away all the cutlery and bought new ones.

Such "arrogance" may also stem from ignorance. In Lu Hong's view, such a thing happens, indicating that ordinary people know very little about it, and some people may think of the story of "Typhoid Mary", but in fact, this is not the same as HP infection and transmission. "It is not surprising that the infection rate of one company is 40%, which is similar to the infection rate of the overall population." Lu Hong told reporters that Helicobacter pylori is the most common chronic bacterial infection in humans, and due to the improvement of socio-economic level and health habits, the infection rate of Helicobacter pylori in the mainland has shown a downward trend in recent years, especially in large cities. However, large-scale screening and treatment are still unrealistic, but examinations during physical examinations are encouraged.

Who must be treated? Lu Hong said that it was previously believed that peptic ulcer, chronic gastritis with indigestion symptoms, gastric mucosa atrophy and erosion, or had done gastric tumor surgery, there is a family history of gastric cancer to be actively treated, but in recent years, the industry recognized that infected people need treatment, unless there is a countervailing factor, because eradication of HP is an effective means of primary prevention of gastric cancer. "Among people with stomach cancer, about 90% of people have or have had HP infection, which is the initiating factor of stomach cancer, but the two are not equal. Infection with HP does not mean that you will definitely get stomach cancer, and its relationship with stomach cancer can be compared to smoking and lung cancer. "In addition, for those who need to take nonsteroidal anti-inflammatory drugs such as aspirin for a long time, hp should also be eradicated first, otherwise it is easy to cause ulcer disease and gastrointestinal bleeding." In the fierce competition of modern society, the incidence of cardio-cerebral diseases is significantly increased, and the opportunity to use these drugs will also be greatly increased.

Children are a vulnerable group

Is it contagious to eat with someone who is infected with HP? This is what a lot of people care about. Lu Hong told them that from a scientific point of view, there was such a possibility, but it was not large.

HP transmission route is inseparable from the "mouth", "feces-mouth" and "mouth-mouth" route is the most likely mode of transmission, if you accidentally eat contaminated food or water directly, it is likely to be infected. But under normal circumstances, it is difficult for adults to be infected, even between couples, which may be related to gastrointestinal immunity. The main susceptible group is children, especially young children. The risk of transmission may be that mothers or other adults chew food in their mouths and feed it to their children, a habit that is still common in some rural older adults. "Or children exposed to HP-contaminated food in their daily lives." Lu Hong said.

Some young parents also came to ask if they were infected with HP, do they want their children to do a test? Lu Hong said that more than half of the global Helicobacter pylori infections occur, most of which occur in childhood. However, considering that children have low tolerance to adverse drug reactions, poor compliance, and few types of antibiotics available, it is not recommended that children under 14 years of age undergo routine HP testing, and it is too late to treat them when they grow up. However, for some special children, such as peptic ulcer patients, it is recommended to test and treat.

30-year-old Xiaoling is still breastfeeding, and the physical examination shows hp infection, whether to treat it or not, has become a matter of her mind. If treated, antibiotics are taken and breastfeeding is interrupted; if not treated, she is worried about passing on to her children. Lu Hong said that HP will not be transmitted through milk, as long as the mother does not feed the child mouth-to-mouth, the usual general life contact will not infect the baby. At present, Xiaoling does not have any symptoms and has no family history of stomach cancer, and can consider postponing treatment.

Interestingly, Lu Hong once encountered a husband and wife "quarrel" in the outpatient clinic, and it had to be said that the other party had infected himself; one party insisted on sharing meals, and the other party did not agree; there was also a strong request for treatment, and the other party did not want to take medicine for the time being. After explanation, the patient finally understands that re-infection in adulthood is very rare, one party is infected, the other party is not necessarily infected; even if the infected person, does not mean that they are infected by the other party, often know that everyone is positive before; and one party temporarily does not take medicine, does not affect the treatment of the other party. However, developing a good habit of using male chopsticks is certainly good for preventing HP infection, especially in families with children.

Standardized treatment can be eradicated

How can I tell if I have HP? Lu Hong said that self-judgment based on symptoms alone is unreliable, and most people have no symptoms and can only be confirmed by doing special examinations. Currently, the breath test is the easiest and most commonly used method clinically to detect Helicobacter pylori infection. For people at high risk of stomach cancer, doctors should also recommend gastroscopy.

For the treatment of HP, it is necessary to take medicine strictly according to the doctor's instructions, and through the "quadruple therapy", it is often possible to eradicate, and it is almost impossible to eliminate spontaneously. Some of the so-called "cure" products that are popular on the Internet are basically unreliable.

Lu Hong met a young man who called himself a "recurring relapse". A question, it turned out that he was infected two years ago, but did not take the medicine seriously, and did a breath review as soon as he stopped the drug, which seemed good, but it was actually a "false negative". "Generally after four weeks of stopping the drug, rechecking the exhalation, turning the yin indicates that the treatment is successful, and the discontinuation of the drug not only refers to the suspension of the quad drug against Helicobacter pylori, but also the cessation of acid suppressants, antibiotics and chinese medicines with anti-inflammatory effects." Lu Hong said that some patients went to test immediately after stopping the drug, tested negative, and soon turned positive, so it was blamed on "recurrence", which is unscientific. In Lu Hong's view, this young man was not cured at all, nor could he talk about "recurrence".

"There is a characteristic of treating HP, when you don't beat the bacteria with a bang, the bacteria become 'strong' and resistant, and it is not so easy for you to destroy it." Lu Hong often told patients, "If you want to be successful in treatment, you must standardize the medicine under the guidance of a doctor." Otherwise, taking medicine intermittently or stopping the drug without authorization is worse than not eating. "In the choice of treatment or non-treatment, most of them depend on the patient himself; but for how to treat, you must listen to the doctor' words." If treatment fails, some antibiotics can no longer be used.

At the same time, Lu Hong also found that smoking may lead to treatment failure. At this time, because smoking can reduce the blood flow of the gastric mucosa and reduce the secretion of gastric mucus, thereby reducing the amount of antibacterial drugs reaching the gastric mucosa; smoking can also stimulate gastric acid secretion and reduce the efficacy of acid-sensitive antibiotics such as amoxicillin and clarithromycin.

For people who have been confirmed to be infected but have not yet been treated, although they do not necessarily infect their families, it is also recommended to pay attention to the hygiene of meals at home, give special tableware to children, do not chew up things to feed children; it is best to use a shared meal system when eating together. But infection and re-infection in adults is rare, even if they live together.

Chief reporter Zuo Yan

Source: Xinmin Evening News