Many people are troubled by stomach problems for many years, so what is the reason? Bad habits and mental stress were once considered to be major factors, but there is another reason that must be mentioned, that is, Helicobacter pylori.
I. Discovery of Helicobacter pylori
In 1982, Australian scientists Robin Warren and Barry Marshall succeeded in developing a Campylobacter strain closely related to gastritis and gastric ulcer, named Helicobacter pylori (Hp). It has been proven that Helicobacter pylori is the causative agent of gastritis and gastric ulcer. About 90% of duodenal ulcers and 80% of gastric ulcers are caused by Helicobacter pylori infection. This discovery has made the ulcer disease a chronic disease that is difficult to cure and recurrent, and it has become a disease that can be cured by short-course medical treatment. It breaks the traditional concept of many years of epidemic and is known as a milestone revolution in the field of digestive diseases research. The scientists won the 2005 Nobel Prize in Medicine or Physiology for this discovery and subsequent research.
II. What is the cause of Helicobacter pylori?
How does Helicobacter pylori survive in a high acidity stomach? This pathogen produces a large amount of urease, which breaks down urea into ammonia and carbon dioxide, forming an alkaline protective layer around it. Based on this principle, Marshall invented a non-invasive respiratory diagnostic method: the patient only needs to take a small amount of carbon isotope-labeled urea. If the patient is infected with Helicobacter pylori, it can decompose it and exhale the isotope-labeled carbon dioxide. After several years of clinical validation, this method has become a universal and accurate method for diagnosing H. pylori infection.
Studies have shown that smoking, alcohol abuse, excessive salt intake and non-steroidal anti-inflammatory drugs (both cold medicines and antipyretics) can cause damage to the stomach tissue. Helicobacter pylori can quickly identify and colonize slightly injured parts of the stomach. Interfere with the healing of damage and promote the progression of the disease.
III. Is this bacterial infection?
Hp has a certain infectivity and can be popular in a small range. Most scholars believe that “mouth-mouth” and “fecal-mouth” are the main modes of transmission, and can also be transmitted through endoscopes that are not thoroughly disinfected. Hp infection can be caused by obvious aggregation in the family. Drinking contaminated water, intimate contact with people who have already infected and eating together, eating unclean food on the roadside can cause the spread of Hp.
IV. Is Helicobacter pylori carcinogenic? Is it harmful to the body after infection?
Recent studies have found that Hp infection is not only an important cause of chronic gastritis and peptic ulcer, but also closely related to the pathogenesis of gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. To this end, the World Health Organization has designated Hp as a Class I carcinogen.
According to the World Epidemiological Survey, people infected with Hp are four times more likely to develop gastric cancer than uninfected people. But it doesn’t have to be too nervous, because only strains with strong virulence and high cancer-causing rate may lead to gastric cancer, and the occurrence of gastric cancer is a long-term, multi-stage, multi-stage process, and Hp is not the only cause. If you are diagnosed with a Helicobacter pylori infection, don’t worry too much, why? Because it is not symptomatic in 80% of carriers. More than half of the world’s people carry this bacterium. In developing countries, Helicobacter pylori infection is very common, and not all people with Helicobacter pylori need to be eradicated.
Please note that the indications for eradication therapy that are strongly recommended by the expert consensus are: peptic ulcer, gastric mucosa-associated lymphoid tissue lymphoma, atrophic gastritis, postoperative patients with gastric cancer, first-degree relatives of gastric cancer patients, indigestion, and patient willingness.
V. How to diagnose and treat Helicobacter pylori infection?
The most commonly used diagnostic method at present is the non-invasive and convenient C13 breath test.
Anti-Hp drugs mainly include proton pump inhibitors (omeprazole, pantoprazole, etc.), expectorants (colloidal pectin), antibacterial drugs such as: metronidazole, amoxicillin, clarithromycin, furazolidone, levofloxacin And tetracycline and so on. With the emergence of drug resistance, standard triple therapy has been unsatisfactory. The current eradication program recommends a four-way therapy consisting of a proton pump inhibitor + a tincture + two antibacterial drugs. The antibacterial drug composition schemes are: 1. Amo Xilin + clarithromycin 2, amoxicillin + levofloxacin 3, amoxicillin + furazolidone 4, tetracycline + metronidazole or furazolidone, recommended for allergic to penicillin: 1, clarithromycin + levofloxacin 2, clarithromycin + furazolidone 3 , tetracycline + metronidazole or furazolidone 4, clarithromycin + metronidazole, this program based on the combination of probiotics or prebiotics can reduce side effects. The recommended course of treatment is 10 days or 14 days. Need to remind everyone is, after taking the drug for 1 month, go to the hospital to review the breath test to avoid false negatives.
VI. Why is the failure to eradicate Helicobacter pylori?
1. Hp is resistant to antimicrobial agents. In areas where a certain antibiotic drug is widely resistant, the antibacterial drug should be avoided. When conditions permit, sensitive drugs can be selected according to the drug sensitivity test. At the same time, the Hp vaccine is being developed and developed to make the desire to prevent Hp infection a reality.
2. Poor patient compliance, irregular medication, not only will lead to treatment failure, but also easily lead to Hp resistance, making future treatment more difficult. Therefore, everyone must take the medicine according to the doctor’s law.
3. Differences in host genotypes (genetic factors) are also important causes of eradication failure.