As various health knowledge is widely publicized in WeChat circle of friends, microblogs, blogs and health programs, Many people know about Helicobacter pylori. In outpatient clinics, some patients even ask for anti-Helicobacter pylori treatment with a positive report of carbon 14 plus sign. It is certainly good to know about Helicobacter pylori and know that it is related to stomach diseases, but is our understanding sufficient and correct?
First, Helicobacter pylori is what?
Helicobacter pylori lives on the surface of gastric mucosal epithelium, It belongs to gram-negative bacteria, It needs a small amount of oxygen to exist. It can colonize and survive in acidic environment in gastric cavity through various mechanisms. In 1982, Helicobacter pylori was isolated and cultured from gastric mucosa by Australian scientists Marshall and Warren. In 2005, Marshall and Warren won the Nobel Prize in Physiology or Medicine for discovering and proving that Helicobacter pylori can cause chronic gastritis and peptic ulcer. Through this, we can see the importance attached to it by academia.
Second, how to prevent Helicobacter pylori?
The infection rate of Helicobacter pylori is very high, The global infection rate of natural population has reached 50%, The infection rate of Helicobacter pylori in developing countries is higher than that in developed countries. The detection rate of Helicobacter pylori in different ethnic groups in different regions of China is 30% ~ 80%, The infection rate of Helicobacter pylori is affected by race, age, sex, geographical location and living and economic conditions. Good economic conditions, safe drinking water, good eating habits, good living environment, spacious individual space and complete basic medical facilities will greatly reduce the infection rate of Helicobacter pylori.
Spontaneous clearance of Helicobacter pylori infection is very rare, that is to say, it is almost impossible to heal itself. If there is no iatrogenic treatment, it will be infected for life.
The transmission of Helicobacter pylori is mainly through mouth-to-mouth transmission and fecal-to-mouth transmission, with a small number of iatrogenic transmission by gastroscope. Studies have confirmed that Helicobacter pylori has a tendency to gather in the family, that is to say, if there is Helicobacter pylori infection in the family, the probability of infection is greatly increased.
Therefore, washing hands before meals and after defecation, using public chopsticks or sharing food during dinners can indeed reduce Helicobacter pylori infection.
Three, why do you want to eliminate Helicobacter pylori?
Although Helicobacter pylori has not been discovered for a long time, scientists have conducted a large number of studies on Helicobacter pylori in the past 30 years, proving the pathogenicity of Helicobacter pylori to chronic gastritis and peptic ulcer, and finding that it is closely related to gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue lymphoma.
1. Causing gastric mucosal lesions
All Helicobacter pylori infection will develop gastritis, 15% ~ 20% will develop peptic ulcer, and less than 1% will develop gastric cancer. Helicobacter pylori infection is the most common and main cause of chronic gastritis and peptic ulcer.
Helicobacter pylori can produce various toxins and enzymes with toxic effects. Continuous damage to the gastric and duodenal mucosal barrier leads to sustained inflammatory reaction of gastric and duodenal mucosa, resulting in chronic gastritis and peptic ulcer. However, sustained inflammatory reaction of gastric mucosa can lead to changes in gastric mucosa. Under the combined action of congenital genetic immune factors and external environmental damage factors, gastric mucosa can become cancerous.
Therefore, patients with chronic gastritis, peptic ulcer and gastric cancer after operation, if they have evidence of helicobacter pylori infection, must undergo radical cure of helicobacter pylori. Popular point of view, helicobacter pylori is a common cause of chronic gastritis, peptic ulcer and gastric cancer. If there is evidence of infection, radical cure must be carried out to avoid recurrence of the disease caused by it.
2. Lead to [gastric mucosa-associated lymphoid tissue lymphoma]
After persistent infection with Helicobacter pylori, Gastric mucosal lymphocytes proliferate and spread into the mucosal layer. And infection leads to persistent inflammatory reactions. It can stimulate the hyperplastic lymphoid tissue, Cancer of lymphocytes can occur. Helicobacter pylori is the most dangerous cause of [gastric mucosa-associated lymphoid tissue lymphoma]. Radical treatment of Helicobacter pylori can even cure early [gastric mucosa-associated lymphoid tissue lymphoma]. Therefore, once [gastric mucosa-associated lymphoid tissue lymphoma] is diagnosed, radical treatment of Helicobacter pylori must be carried out.
3. Extragastrointestinal damage
Helicobacter pylori can also cause diseases other than gastrointestinal system.
Helicobacter pylori infection, It can lead to iron deficiency anemia and thrombocytopenic purpura of unknown causes. Simply put, In fact, after the body is infected with Helicobacter pylori, because Helicobacter pylori has antigens similar to blood cells and blood vessel cells, the immune system of the body misrecognizes blood and blood vessel cells as foreign risk factors, produces antibodies to attack, injures blood cells and blood vessel cells by mistake, and leads to the onset of the disease. If the above situation occurs, it is also necessary to eradicate Helicobacter pylori.
4. Should Helicobacter pylori be removed when symptoms of stomach trouble occur?
We know that Helicobacter pylori infection is closely related to gastropathy, so is it necessary to use antibacterial drugs to cure Helicobacter pylori if there are gastropathy symptoms such as abdominal distension, anorexia and loss of appetite?
The answer is no.
Gastropathy symptoms such as abdominal distension, anorexia and loss of appetite are not necessarily related to Helicobacter pylori. Helicobacter pylori is not the only cause of gastropathy.
For example, acute gastritis can also cause gastropathy symptoms, However, Helicobacter pylori is not the pathogenic factor of acute gastritis and does not need anti-Helicobacter pylori therapy. Even if there is chronic gastritis, but Helicobacter pylori detection is negative, and there is no atrophy of gastric mucosa, metaplasia, it is necessary to consider that the cause of chronic gastritis is not Helicobacter pylori, and antibacterial therapy is also not needed.
Five, Helicobacter pylori test only low positive does antibacterial therapy need?
If the Helicobacter pylori test is only low positive, And there are no warning symptoms such as bloody stool, black stool, anemia, emaciation, When there are no gastritis symptoms such as abdominal distension, abdominal pain, anorexia, loss of appetite, etc., considering the adverse reactions of drugs, drug resistance of abuse of antibiotics and the ratio of economic benefits, radical treatment of Helicobacter pylori is not recommended. Of course, if some patients have obvious anxiety and strong desire to radical cure Helicobacter pylori, radical treatment is also possible.
VI. Summary
To sum up, Helicobacter pylori is closely related to gastropathy, but not all gastropathy is caused by it, and Helicobacter pylori can also lead to diseases other than gastrointestinal system. Not all gastropathy needs radical cure of Helicobacter pylori, which requires individual selection and individualized treatment.
Author: Huang Xian