China is a high incidence of Helicobacter pylori (Hp) infection, 25% to 30% of hp infection will have different degrees of gastrointestinal diseases, such as dyspepsia, chronic gastritis, peptic ulcer, etc., and Hp infection is also one of the causes of stomach cancer in China.
How do I find out if I have an Hp infection and how do I treat it?
Conventional methods for diagnosing Hp infection
The diagnostic test methods of Hp infection mainly include: 13C, 14C urea breath test, fecal antigen detection, biopsy and other methods (Table 1), of which the 13C and 14C urea breath test has the advantages of non-invasive, high acceptance and easy operation, and is listed as the "gold standard" for the diagnosis of Hp infection in the clinical guidelines of many countries.
Table 1 Helicobacter pylori examination methods
Note: *Proton pump inhibitors should be discontinued for 2 weeks and antibiotics for 4 weeks before testing
How are the drugs used after diagnosis? How long does it take?
As an infectious disease, Hp gastritis is necessary for hp-positive patients. According to the Fifth National Consensus Report on the Management of Helicobacter pylori Infection, an empiric bismuth quadruple treatment regimen (bismuth + PPI + antibacterial) is recommended for a duration of 14 days, with a minimum of not less than 10 days.
Due to the upward trend in resistance rates (including multi-drug resistance rates) of clarithromycin, metronidazole, and levofloxacin, treatment requires special attention, in which, when levofloxacin is used after the first hp treatment but the treatment is not effective, the second treatment should avoid the selection of previously used antimicrobials. The use of antibacterial drugs can be referred to Table 2.
Table 2 Dosage, usage and evaluation of antimicrobial combinations in tetragrammetry (click for larger view; source: References[6])
When to eat? What are the precautions?
Many people with Hp infections have a lot of doubts, such as: When should we take these drugs? What should I pay attention to during taking medicine?
Proton pump inhibitor (PPI): eat 30 minutes before meals, reduce the acidity in the stomach, do not let the stomach acid "digest" the antibacterial drug;
Antibacterial drugs: take 30 minutes after meals to reduce the stimulation of the stomach by the drug, and also wait for the stomach medicine to reduce the acidity in the stomach.
At the same time, when taking the drug, you need to pay special attention to the following 3 points:
1. During the treatment, alcohol should not be consumed.
2. Since hp eradication fails, the main reason is family transmission, so family members can be considered for treatment together (children under 14 years old can not be treated).
3. When there are adverse reactions in the treatment of Hp patients, the medication should be stopped. However, discontinuation of the drug is not required when the patient can tolerate it.