[Fat Bear Science] One person gets sick and the whole family is infected! Half of the Chinese people have this disease

“Why did you get this disease?”

"Do you want treatment?"

"Some people say this disease can turn into stomach cancer. Is that true?"

…

Let's see what Chen Weiqing, director of the gastroenterology department and chief physician of our hospital, has to say.

Experts of this issue

Chen Weiqing

Chen Weiqing: Director of the Department of Gastroenterology, Chongqing Cancer Hospital, chief physician, doctor of medicine, and master's supervisor. He has in-depth research on the clinical diagnosis and treatment of gastrointestinal bleeding, severe pancreatitis, cirrhosis and its complications, inflammatory bowel disease, etc. He is particularly good at gastrointestinal, hepatopancreatic and other diseases and endoscopic diagnosis and interventional treatment. Clinic hours: Monday morning

Because my country does not have the system of separate meals and the habit of using serving chopsticks, many people are infected with this disease - Helicobacter pylori. (The main source of infection comes directly from family members.)

Once you are found to be infected with Helicobacter pylori, there is no need to be afraid or worried. As long as standardized treatment is provided, more than 90% of patients can be eradicated.

What is Helicobacter pylori

"Clinically, most Helicobacter pylori patients are found during physical examinations. They may have no clinical symptoms, or they may have clinical symptoms but have not received attention." Chen Weiqing said that Helicobacter pylori is a spiral-shaped bacillus that colonizes the human gastric mucosa. Humans are its only host and source of infection. Relevant data show that 70% of people infected with Helicobacter pylori have no symptoms, 10% may have indigestion, and 10%-20% may have peptic ulcers.

Although the symptoms are not obvious, once the human body is infected with Helicobacter pylori, the normal gastric mucosa will produce histological inflammation, namely chronic superficial gastritis and chronic atrophic gastritis. Data show that more than 90% of chronic gastritis is caused by Helicobacter pylori.

"At this point, as long as standardized treatment is given, it can be reversed." Chen Weiqing said, but if there is no intervention treatment, during the process of repeated infection and repair of chronic inflammation, the stomach cannot use gastric mucosal cells to repair, but uses intestinal cells to repair, which is the so-called intestinal metaplasia, but this is not in line with the normal process of human evolution. At this time, if the inflammation is still not controlled and persists, it will lead to gastric mucosal dysplasia, that is, precancerous lesions such as low-grade lesions and high-grade lesions will occur, and finally malignant lesions will turn into cancer.

There is no direct causal relationship between Helicobacter pylori and gastric cancer

"After infection with Helicobacter pylori, gastric mucosal cells undergo a series of changes: normal gastric mucosa → chronic superficial gastritis → chronic atrophic gastritis → intestinal metaplasia → dysplasia → gastric cancer." Chen Weiqing said that this process is recognized by the international academic community and most gastric cancers evolve in this way. However, it has been confirmed that only 1% of Helicobacter pylori have a direct causal relationship with gastric cancer patients.

This is because Helicobacter pylori is mainly involved in the two processes of chronic superficial gastritis and chronic atrophic gastritis. These two processes are also the basis of gastric intestinal metaplasia and dysplasia. However, in many patients, due to other changes in the internal environment or because of doctor intervention and treatment, Helicobacter pylori is eliminated before chronic gastritis develops into intestinal metaplasia. Because the chain of evidence of "normal gastric mucosa → chronic superficial gastritis → chronic atrophic gastritis → intestinal metaplasia → dysplasia → gastric cancer" is broken in the middle, it cannot be said that Helicobacter pylori and gastric cancer have a direct causal relationship.

"The data of 1% seems very low, but because the bacteria Helicobacter pylori can directly cause inflammation of the gastric mucosa, it is an infectious disease." Chen Weiqing said that the current international consensus is that Helicobacter pylori infectious gastritis is an infectious disease regardless of whether there are symptoms and complications.

The current situation of Helicobacter pylori treatment in my country is grim

"Since Helicobacter pylori is an infectious disease with great harm, it needs treatment." Chen Weiqing said that according to statistics, there are about 4.4 billion people infected with Helicobacter pylori in the world. In China, this number has reached an astonishing 768 million. The infection rate of Helicobacter pylori in the population is as high as 50% to 60%, which means that more than half of the people are infected.

There are several problems with the current status of Helicobacter pylori treatment.

First, the number of people infected with Helicobacter pylori is large, but not all positive patients need to be treated. Moreover, it is not feasible to carry out eradication treatment on all positive people, and it is not in line with national conditions. At present, the cost of treating a person infected with Helicobacter pylori is about 700 to 1,000 yuan per time, and only 90% of the infected people are effective, and 10% are not effective.

Second, because Helicobacter pylori is generally transmitted through oral transmission, close contact, eating contaminated food and drinking water, etc. Therefore, in many cases, the main source of Helicobacter pylori infection comes directly from family members. For example, if patients are used to using chopsticks and do not have a separate dining system, they will be repeatedly infected, resulting in unsatisfactory results after treatment and increased treatment costs.

Third, the drug resistance of Helicobacter pylori in my country is serious. In the past, only three drugs were used, but now four drugs are used, and none of them can achieve 100% ideal results. Moreover, the treatment used to be controlled for 7 days, but now it takes at least 14 days. Although the prolonged use of antibiotics kills Helicobacter pylori, it will also cause other problems such as drug resistance. In addition, once Helicobacter pylori adapts to the current antibiotic drug environment, it may no longer be effective after a period of time.

Helicobacter pylori infection can be treated

So which Helicobacter pylori patients need treatment? Chen Weiqing said that the fifth national consensus on Helicobacter pylori eradication indications released this year has been specially revised.

Specifically, if the test result is positive for Helicobacter pylori, doctors strongly recommend treatment for the following: peptic ulcer (regardless of whether it is active or not and with or without a history of complications); gastric mucosa-associated lymphoid tissue lymphoma.

Recommended treatments include: chronic gastritis with dyspepsia symptoms; chronic gastritis with gastric mucosal atrophy and erosion; early gastric tumors that have undergone endoscopic resection or surgical subtotal gastrectomy; long-term use of proton pump inhibitors; family history of gastric cancer; plans to take NSAIDs (including low-dose aspirin) for a long time; unexplained iron deficiency anemia; idiopathic thrombocytopenic purpura; other Helicobacter pylori-related diseases (such as lymphocytic gastritis, hyperplastic gastric polyps, Menetrier's disease); and confirmed Helicobacter pylori infection.

"The fifth national consensus on Helicobacter pylori eradication indications is a modification based on the fourth national consensus on Helicobacter pylori in 2012, which is based on evidence-based medicine. It not only conforms to China's national conditions, but also aligns with international consensus." Chen Weiqing said, for example, changing "individual request for treatment" to "confirmed Helicobacter pylori infection" means that people who are infected with Helicobacter pylori but do not have the above indications can also be treated.

If infected, treatment should be standardized and meals should be shared with family members

"Although the current situation of Helicobacter pylori in our country is very serious, people do not have to worry too much." Chen Weiqing said, because Helicobacter pylori is the only bacterium in the human stomach that can produce a large amount of urease, urease decomposes urea in the stomach to produce ammonia and carbon dioxide, which reduces the concentration of urea and increases the concentration of ammonia. Therefore, Helicobacter pylori infection can be diagnosed by detecting urease through breath tests represented by C13 and C14.

Chen Weiqing said, "At the same time, current studies have shown that traditional Chinese medicine preparations and biological preparations can help improve the eradication rate of Helicobacter pylori. Next, we will also carry out corresponding clinical research and strive to improve the eradication rate of Helicobacter pylori."

In addition, for patients infected with Helicobacter pylori or with a history of infection, regular check-ups and, if necessary, gastroscopy are very meaningful.

In addition, for most people, Helicobacter pylori should be taken seriously. For example, if you or someone in your family is infected with Helicobacter pylori, you should receive standardized treatment under the guidance of a doctor and pay attention to protection. It is best to separate meals from your family, or use public chopsticks and spoons to serve rice and vegetables, do not pick up vegetables for each other, and avoid feeding children with your mouth. The bowls and chopsticks should be cleaned and sterilized at high temperature. Kissing between lovers can also directly infect.

We should also develop good hygiene habits, wash hands before and after meals, wash or peel vegetables, fruits, and try to cook them well, do not eat half-cooked steaks and other foods, do not drink raw or cold water, do not eat too hot things, especially hot pot, barbecue, alcohol, coffee and spicy food, which will irritate the gastric mucosa and reduce its resistance, thus creating conditions for the invasion of Helicobacter pylori; try to reduce eating out. In addition, the diet should be nutritious, the food should be soft and easy to digest, eat small meals frequently, chew slowly, and maintain a good attitude and a happy mood every day to avoid the occurrence of gastric diseases.

Text/ Fat Bear Picture/ Online Reviewer/ Chen Weiqing

Original article, no reproduction without authorization

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