Helicobacter pylori (abbreviated as HP), this name, I believe everyone is no stranger.
It is a major cause of stomach cancer and is a known carcinogen [1,2].
In China, about 30 to 50 percent of people have been infected with Helicobacter pylori. This means that 400 to 700 million people have this dangerous carcinogen in their stomachs for a long time [3].
How do I know if I'm infected?
If an infection is detected, should it be treated?
The answers to these questions can be found in a newly published authoritative paper [4].
We finished reading this informative paper and found some of the conclusions that are most closely related to your health.
Please read this article, it can really help you and your family!
The following 4 things are related to you and me.
1. Helicobacter pylori can be transmitted from person to person, especially prone to family transmission [5-13]
If the parent has a Helicobacter pylori infection, the child's infection rate will be significantly higher.
There is also transmission between spouses and siblings [5-12].
Why is that?
The main reason is the "shared meal system" that we Chinese.
Everyone is on the same plate, "exchanging" saliva, it is easy to "one person is recruited, the whole family is infected.".
(Dian Ge did not mean to criticize traditional culture, but for health reasons, it is still recommended to use public chopsticks.) ）
2. The transmission route of Helicobacter pylori, mainly mouth-to-mouth and fecal-oral transmission [11,14-16]
This is where the way to prevent infection is hidden.
Mouth-to-mouth transmission
The main way: do not use chopsticks to pick vegetables, chew up food to feed children, etc.
Preventive measures: it is recommended to use chopsticks or a meal sharing system, one serving per person, how much to eat, and how much to waste.
Even if you want to eat together, you must use chopsticks, spoons, etc., don't be troublesome.
Parents should not chew up food and feed it to their babies.
Fecal-oral transmission
Main route: Eating/drinking food or water contaminated with excreta, and untreated water such as well water. (Because Helicobacter pylori can be excreted from the body through feces)
Precautions: Food should be washed or cooked before eating, drink boiled water.
Freshly picked fruits and vegetables in the field should be washed and eaten.
Shared utensils spread
Main routes: sharing of utensils or undemanderated dental equipment, etc.
Precautions: The tableware should be washed, and if you have the conditions, you can buy a disinfection cabinet.
Family members do not use toothbrushes; to see and wash teeth, go to the stomatology department or stomatological hospital of a regular hospital.
3. Family members infected with Helicobacter pylori are always a potential source of infection and may continue to spread to others [5-12]
This is because Helicobacter pylori infection is not treated and rarely resolves on its own.
Coupled with eating the same dish, drinking the same bowl of soup, and sharing utensils, it is easy to have continuous transmission and cross-infection.
But don't worry too much, it doesn't mean that other family members will necessarily be infected. Because whether or not you are infected with Helicobacter pylori is related to the amount of bacteria you are exposed to, the person's immunity and other factors.
4. Most infections occur in childhood and adolescence, and can also be infected in adulthood
The vast majority of infection routes in children and adolescents are transmitted from home to child, mainly from parents (especially mothers).
The most common route is:
Feed your baby chewed food;
Sharing of cutlery and food;
Kiss the baby;
Eat/drink water and food contaminated with bacteria, etc.
The rate of Helicobacter pylori infection in children increases with age. Especially between the ages of 10 and 19, the risk of infection is the highest [14], and parents must pay attention!
How can I help my child prevent Helicobacter pylori infection?
Smart you, you must have summed it up. Let us know in the comments section.~
The answer is simple – go to the hospital and take a breath to measure it.
The scientific name of this test is the "carbon 14/13 breath test" (also called the "14C/13C-urea breath test"). This method does not harm the body.
However, it also has some limitations, such as taking antibiotics, acid-suppressing drugs, certain Chinese medicines before the test, or suffering from severe gastric mucosal atrophy, stomach bleeding and other diseases, and the results may be inaccurate.
If you have these conditions, you can tell the doctor. Doctors also have serum antibody testing, fecal antigen detection and other methods [1,17-18].
What conditions do I need to test for [1,17,19-21]?
The following 7 types of people pay attention:
Family history of gastric cancer in first-degree relatives (parents, children, siblings);
History of gastric cancer;
Peptic ulcer;
Chronic gastritis with erosion or atrophy;
Chronic gastritis dyspepsia symptoms;
The need for long-term use of nonsteroidal anti-inflammatory drugs;
Unexplained iron deficiency anemia, etc.
In fact, many people can insist on regular physical examinations once a year. During the physical examination, it is recommended to add a breath test to the package.
This problem is still quite complicated, we briefly summarize from the three aspects of adults, children, and the elderly:
1. Adults
As soon as the infection is identified, "eradication therapy" of Helicobacter pylori is recommended. There are 2 benefits:
Eliminate the source of infection and reduce the risk of infecting family members;
Prevent serious complications from persistent infection, especially by reducing the risk of stomach cancer.
But the paper also mentions that if there are countervailing factors (such as kidney failure), it is best to communicate with the doctor whether to treat it.
2. Children (< 14 years old)
It takes a doctor to weigh the pros and cons. Remember the most important 3 points [1,21]:
Helicobacter pylori-infected children with peptic ulcer and gastric malignant lymphoma must be eradicated;
Chronic gastritis, family history of stomach cancer, unexplained refractory iron deficiency anemia, etc., can be eradicated;
Testing and treatment is generally not recommended for children without gastrointestinal symptoms (e.g., abdominal pain, bloating, acid reflux, hiccups, etc.).
3. Elderly
The incidence of Helicobacter pylori infection is higher in the elderly population, and eradication therapy is recommended to improve gastrointestinal symptoms and, to some extent, prevent stomach cancer.
However, it should be noted that the elderly may have other diseases (such as heart, lung, cerebrovascular, kidney disease) and may take some drugs on a daily basis (such as nonsteroidal anti-inflammatory drugs), so they need to be treated under the guidance of a doctor.
Eradication regimen for Helicobacter pylori, preferably with a bismuth quadruple regimen. As for how to take it, just listen to the doctor.
Here's the point!
Prevention and treatment of Helicobacter pylori infection, now advocating "family-based prevention and control".
This is because the bacteria have the potential to re-infect and recur.
The epidemiological survey data of the mainland show that the recurrence rates of Helicobacter pylori at 1 and 3 years are 1.75% and 4.61%, respectively.
Simultaneous eradication therapy by family members reduces the risk of cross-infection and family transmission, as well as reduces recurrence rates and cure rates.
Read more medical codes: can net red toothpaste kill Helicobacter pylori?
Poke the video to see the truth
Unfortunately, not yet.
The vaccine against Helicobacter pylori is still in the research and development stage and cannot be clinically applied in the short term.
Therefore, preventing new infections and eradicating existing infections are the most effective prevention and control strategies at present.
The method of preventing Helicobacter pylori, in fact, was mentioned earlier, and here is to help you summarize it:
It is recommended to divide meals or use public chopsticks.
Do not feed your child mouth-to-mouth, and do not chew up food to feed your child.
Don't let strangers kiss children casually, and neither can they kiss their faces.
Food is cooked or washed before eating, especially freshly picked fruits and vegetables, do not eat without washing.
Wash your hands before and after meals.
Dental appliances should not be shared, it is best to change them every 3 months.
Finally, to give you relief —
Helicobacter pylori can induce stomach ulcers and stomach cancer, but the majority of the population is carriers without pathological response [22].
That is to say, in case of positive Helicobacter pylori, do not panic too much, listen to the doctor's words, the treatment should be treated, and the prevention should be prevented.
Forward to the circle of friends, tell more people about it~
bibliography
LIU Wenzhong. Fifth National Consensus Report on the Treatment of Helicobacter pylori Infection[J]. Gastroenterology, 2017, 22(6):15.
Helicobacter pylori Group, Gastroenterology Branch of Chinese Medical Association. Proceedings of the Kyoto Global Consensus Symposium on Helicobacter pylori gastritis[J]. Chinese Journal of Digestion, 2016, 36(1):5.
[3] Xie C, Lu NH. Review: clinical management of Helicobacter pylori infection in China. Helicobacter.2015;20(1):1-10.
[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):13.
[5] Drumm B,Perez-Perez G I,Blaser M J ,et al. Intrafamilial clustering of Helicobacter pylori infection. [J] . N Engl J Med, 1990, 322: 359-63.
[6] Georgopoulos S D,Mentis A F,Spiliadis CA ,et al. Helicobacter pylori infection in spouses of patients with duodenal ulcers and comparison of ribosomal RNA gene patterns. [J] . Gut, 1996, 39: 634-8.
[7] Rothenbacher Dietrich,Winkler Markus,Gonser Theodor, et al. Role of infected parents in transmission of helicobacter pylori to their children. [J] . Pediatr Infect Dis J, 2002, 21: 674-9.
[8] Perry Sharon,de la Luz Sanchez Maria,Yang Shufang, et al. Gastroenteritis and transmission of Helicobacter pylori infection in households. [J] . Emerg Infect Dis, 2006, 12: 1701-8.
[9] Garg P K,Perry S,Sanchez L, et al. Concordance of Helicobacter pylori infection among children in extended-family homes. [J] . Epidemiol Infect, 2006, 134: 450-9.
[10] Nahar S,Kibria K M K,Hossain Md E, et al. Evidence of intra-familial transmission of Helicobacter pylori by PCR-based RAPD fingerprinting in Bangladesh. [J] . Eur J Clin Microbiol Infect Dis, 2009, 28: 767-73.
[11] Osaki Takako,Konno Mutsuko,Yonezawa Hideo ,et al. Analysis of intra-familial transmission of Helicobacter pylori in Japanese families. [J] . J Med Microbiol, 2015, 64: 67-73.
Yang Liang, Liu Gaifang, Zhu Xinying, et al. Investigation and analysis of family cluster status of Helicobacter pylori infection[J]. Gastroenterology, 2019, 24(7):4.
[13] Blecker U,Lanciers S,Mehta D I ,et al. Familial clustering of Helicobacter pylori infection. [J] . Clin Pediatr (Phila), 1994, 33: 307-8.
Liu Wei, Xu Chundi, Xi Rongping, et al. Epidemiology of Helicobacter pylori infection in children in different family environments in Shanghai[J]. CJPP, 2006, 21(1):3.
[15] Parsonnet J,Shmuely H,Haggerty T,Fecal and oral shedding of Helicobacter pylori from healthy infected adults. [J] . JAMA, 1999, 282: 2240-5.
[16] Dore M P,Sepulveda A R,El-Zimaity H, et al. Isolation of Helicobacter pylori from sheep-implications for transmission to humans. [J] . Am J Gastroenterol, 2001, 96: 1396-401.
[17] Sugano Kentaro,Tack Jan,Kuipers Ernst J, et al. Kyoto global consensus report on Helicobacter pylori gastritis. [J] . Gut, 2015, 64: 1353-67.
[18] Malfertheiner P, Megraud F, O'Morain CA, et al. European Helicobacter and Microbiota Study Group and Consensus panel. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017 Jan;66(1):6-30.
[19] Mahachai V, Vilaichone RK, Pittayanon R,et al. Helicobacter pylori management in ASEAN: The Bangkok consensus report. J Gastroenterol Hepatol. 2018 Jan;33(1):37-56.
Ding Songze. Focusing on the diagnosis and treatment management of Helicobacter pylori infection and related gastric mucosal precancerous changes in the whole family[J]. Chinese Medical Journal,2019,99(19):1446-1448.
[21] Ding SZ. Global whole family based-Helicobacter pylori eradication strategy to prevent its related diseases and gastric cancer. World J Gastroenterol. 2020 Mar 14;26(10):995-1004.
[22] Linz B, Balloux F, Moodley Y, et al. An African origin for the intimate association between humans and Helicobacter pylori[J]. Nature, 2007,445:915-918.
Editors: Zhang Jie, Wu Jiaxiang, Zhang Liang
Typesetting: Han Ningning | Proofreader: Wu Yihe
Operations: Li Yongmin | Coordinator: Ye Zhengxing