In recent years, the word "Helicobacter pylori" has frequently appeared in the public eye, and when going to the hospital for screening, many doctors will recommend doing a Helicobacter pylori breath test, and many units will even list the Helicobacter pylori breath test as a routine physical examination item.
A breath test generally refers to a urea breath test, when there is a Helicobacter pylori infection in the stomach, the patient's exhaled air will have carbon dioxide labeled with carbon dioxide, thus diagnosing whether the patient has a Helicobacter pylori infection.
In addition, the breath test is a non-invasive test method, which has the advantages of non-invasive, no need for oral intubation, and is more comfortable for patients than electronic gastroscopy, so it is more acceptable. Therefore, doctors generally recommend a breath test for screening.
So is this screening really going to be done? How lethal is Helicobacter pylori? Let's talk about the answer first: The doctor asked you to check for Helicobacter pylori, he really wanted to save you!
Stomach after Helicobacter pylori infection
What will it become?
In June 2023, the Institute for Infectious Disease Prevention and Control of the Chinese Center for Disease Control and Prevention and other units released a white paper on "Prevention and Control of Helicobacter Pylori Infection in China", pointing out that the infection rate of Helicobacter pylori in mainland China is nearly 50%, which means that about 700 million people have Helicobacter pylori in their stomachs, and 70% of stomach cancers are related to Helicobacter pylori. Currently, the World Health Organization has included Helicobacter pylori in the list of a group of carcinogens.
Helicobacter pylori (Hp) is a microaerobic gram-negative bacillus parasitic in the human digestive tract that is spiral or S-shaped with flagella at one end, which can survive in a strongly acidic environment in the stomach and cross the mucus layer, reach the epithelial surface, and connect firmly to avoid being emptied by the stomach. I like the pylorus and antrum of the stomach the most, hence the name.
Helicobacter pylori. The stock copyright picture, reprinting and using may cause copyright disputes
It is mainly transmitted from person to person through the oral-oral route or fecal-oral route, and is currently the only known bacterium that can survive in the stomach.
After Helicobacter pylori infection, almost all gastric mucosa will be inflamed, it can survive in a strong acidic environment in the stomach, and through its strong motility, adhesin and urease produced by factors, firmly connected to the surface of the gastric mucosa, especially in the antrum, resulting in chronic gastritis, duodenal ulcer, gastric ulcer and other diseases, and even closely related to the occurrence of gastric cancer and gastric mucosa-related B-cell lymphoma.
In the early stages of infection, people may have no obvious symptoms, but that doesn't mean they're not serious or don't need treatment. However, inflammation of the gastric mucosa may persist even in the absence of symptoms, and some patients may present with a chronic progressive progression of gastric mucosal atrophy, intestinalization, and even cancer.
Stomach after Helicobacter pylori infection, Image Credit: Author
Moreover, there is currently no good indicator or method that can accurately predict which patients will develop serious diseases such as gastric ulcers and gastric cancer, and which patients may carry Helicobacter pylori for a long time without obvious symptoms.
Therefore, according to the "Expert Consensus on Helicobacter Pylori Eradication and Gastric Cancer Prevention and Control in China", doctors recommend treatment for all patients who are found to be positive for Helicobacter pylori to prevent potential risks.
Which groups of people need to proceed
Helicobacter pylori test
So which groups of people are the key screening targets for Helicobacter pylori?
1. People with a history of peptic ulcer: Helicobacter pylori testing should be considered regardless of whether it is active or not, and whether there is a history of complications;
2. Patients with chronic gastritis: especially those in the active phase with gastric mucosal atrophy and erosion, as well as patients with chronic gastritis with symptoms of dyspepsia;
3. People with a previous history of gastric cancer or lymphoma: Since Helicobacter pylori is closely related to the occurrence of malignant tumors such as gastric cancer, these patients should be tested for Helicobacter pylori regularly;
4. People who take specific drugs for a long time: such as patients with long-term oral omeprazole or aspirin, these drugs may affect the gastric mucosa and increase the risk of Helicobacter pylori infection;
5. People with a history of chronic diseases such as other blood diseases: such as unexplained iron deficiency anemia, idiopathic thrombocytopenic purpura, etc., these diseases may be related to Helicobacter pylori infection;
6. People with poor hygiene habits: not washing hands before and after meals, often grabbing food directly with their hands, or not doing good oral hygiene, not brushing their teeth actively, not regularly disinfecting tableware, etc., may also spread and be infected with Helicobacter pylori.
7. People who experience these symptoms are especially alert to Helicobacter pylori infection:
(1) Bad breath. When infected with Helicobacter pylori, it may stimulate gastric acid secretion, which in turn affects the motility of the stomach and esophagus, leading to gastroesophageal reflux. This reflux may not only damage the esophageal mucosa, but it may also produce odorous substances in the mouth, causing bad breath.
(2) Bloating and abdominal pain. When the gastric mucosa is damaged and the gastric function is disturbed, the patient may experience abdominal discomfort, including bloating and abdominal pain, burning pain in the upper right abdomen, cramping, and even nausea and vomiting.
(3) In addition, non-specific symptoms of dyspepsia, such as acid reflux, belching, loss of appetite, and satiety.
How to prevent Helicobacter pylori infection?
Finally, let's talk about what we need to pay attention to in our daily life to prevent Helicobacter pylori infection.
1. The implementation of a separate meal system and the use of chopsticks and spoons are effective means to prevent the spread of Helicobacter pylori. This eating habit can reduce the chance of bacteria being spread through saliva and ensure personal food hygiene.
The stock copyright picture, reprinting and using may cause copyright disputes
2. Maintaining good personal hygiene habits is also crucial. Wash your hands thoroughly with soap or hand sanitizer before eating and after using the toilet to remove germs from your hands and reduce the risk of infection.
3. Oral hygiene should not be neglected either. Changing your toothbrush regularly and keeping your mouth clean can help reduce the growth of H. pylori in your mouth.
4. Cleaning and disinfection of tableware is also an important part of preventing Helicobacter pylori infection. Regular high-temperature disinfection of tableware can effectively kill bacteria and ensure the hygiene of tableware.
5. Avoiding drinking raw water and eating raw food as much as possible is also an important measure to prevent Helicobacter pylori infection. Because it may survive in these unprocessed foods and waters, entering the body through the diet.
6. Children are susceptible to the population, so preparing special tableware for children, ensuring the cleanliness and hygiene of tableware, and eliminating oral feeding and reducing kissing are the key to prevention.
7. Adhere to the concept of health, strengthen exercise, improve the body's immunity, and pay attention to physical examination.
Planning and production
Author丨Li Tian, Chief Physician of the Fifth Affiliated Hospital of Guangzhou Medical University
Review丨Tang Qin, Director of the Science Popularization Department of the Chinese Medical Association, Researcher
Planning丨Yinuo
Editor-in-charge丨Yinuo
Reviewer丨Xu Lai Linlin