Helicobacter pylori eradication: protect stomach health and stay away from the threat of gastric cancer

Helicobacter pylori (Hp) infection is an important risk factor for gastric cancer. In recent years, the resistance rate of Hp to clarithromycin, levofloxacin and metronidazole has continued to rise, making the prevention and treatment of gastric cancer more complicated. This article will give you a detailed introduction to the impact of Hp eradication on the risk of gastric cancer and the current treatment options.

1. Relationship between Hp and gastric cancer

Hp infection can lead to chronic gastritis and further develop into gastric mucosal atrophy and intestinal metaplasia, which are precancerous lesions of gastric cancer. Eradication of Hp can significantly improve gastric mucosal inflammation in patients, delay or prevent the occurrence and development of gastric mucosal atrophy and intestinal metaplasia. In some patients, gastric mucosal atrophy may even be reversed. In addition, eradication of Hp can also reduce the risk of gastric cancer.

2. Hp infection and gastric hyperplastic polyps

After Hp-positive gastric hyperplastic polyps are treated with Hp eradication therapy, the polyps may shrink or disappear. Therefore, Hp eradication is the preferred treatment for gastric hyperplastic polyps.

III. Treatment recommendations for patients with Hp-positive early gastric cancer

For Hp-positive early gastric cancer patients, there is still a risk of developing metachronous gastric cancer after endoscopic resection (ESD). Therefore, these patients should receive Hp eradication therapy as early as possible to reduce the risk.

Current treatment options

With the increasing resistance of Hp to clarithromycin, levofloxacin and metronidazole, the classic triple therapy has been eliminated. Currently, the bismuth quadruple therapy has become the main eradication regimen. This regimen can overcome Hp's resistance to these antibiotics to a large extent. my country recommends the bismuth quadruple therapy as the first and second treatment option for Hp infected patients.

In addition to proton pump inhibitors (PPIs) and bismuth agents, there are other antimicrobial drug combinations available, such as amoxicillin combined with clarithromycin, amoxicillin combined with levofloxacin, tetracycline combined with metronidazole, amoxicillin combined with metronidazole, amoxicillin combined with tetracycline, etc.

In addition, a high-dose dual therapy is also a viable option. This regimen includes a double dose of PPI and no less than 3 grams of amoxicillin per day for 14 days. Compared with quadruple therapy, dual therapy has significantly lower adverse reactions, but because it requires a higher acid suppression intensity, acid-suppressing drugs with a higher acid suppression effect should be selected for this regimen.

For patients who fail treatment, an individualized eradication therapy regimen guided by drug sensitivity testing is recommended.

The prevention and treatment of gastric cancer requires comprehensive consideration of multiple factors. Eradication of Hp is an important means to reduce the risk of gastric cancer. With the increase in Hp resistance, it is particularly important to choose a suitable eradication treatment plan. Through effective eradication treatment, the risk of gastric cancer can be reduced and the health of patients can be protected.