Helicobacter pylori is on the rise again. Don’t believe the rumors and take preventive measures as soon as possible.

Recently, the topic #Infection with Helicobacter pylori may induce gastric cancer# has once again become a hot search on Weibo. my country is the country with the largest number of people infected with Helicobacter pylori (HP) in the world, and it is estimated that more than half of the residents are infected with Helicobacter pylori.

A national survey conducted from 2002 to 2004 showed that the overall infection rate of Helicobacter pylori was about 56.2% on average. Gastric cancer-prone areas and economically underdeveloped areas had higher HP infection rates. [1] Another survey conducted from 2005 to 2011 showed that the overall HP infection rate was 49.5%. There were differences in HP infection rates among people of different age groups, but it is worth noting that the HP infection rate among people under 20 years old was still as high as 37.1%. [2]

The picture comes from the Internet

Helicobacter pylori is the only microorganism that can survive in the human stomach. It is highly contagious and can induce gastritis. It is also a risk factor for gastric cancer. If one family member is infected, other family members are at risk of infection. High attention is always a hotbed for rumors. Some claims that dietary therapy such as eating garlic/onions/drinking tea can kill Helicobacter pylori spread like wildfire, making many people believe it.

01

Can eating garlic treat HP?

Garlic supplements are more recommended

Among the many schools of thought on how to treat Helicobacter pylori (HP) with dietary therapy, the idea that "eating garlic can kill HP" is the earliest and most widely spread. Experiments have shown that garlic preparations have a significant inhibitory effect on HP, and the antibacterial mechanism may be related to the effects of allicin, alliin, and allistatin in garlic on HP. However, the concentration of allicin used in the experiment was relatively high, and the inhibitory effect increased with the increase in the concentration of the garlic preparation solution. [3]

In other words, garlic extract does have a significant effect on inhibiting HP, but this does not mean that eating garlic directly in the diet can also kill HP. After all, the concentration of allicin in the experiment cannot be reached by just eating a few cloves of garlic in daily diet, nor can it completely kill Helicobacter pylori. Moreover, these experiments are based on animal experiments and cell experiments, and may not necessarily achieve the same effect on humans.

If you must rely on eating garlic to eliminate HP, the biggest benefit may not be the inhibition of Helicobacter pylori, but a more obvious "garlic breath".

Although eating garlic to treat HP is not highly recommended, there is a 22-year randomized intervention trial on "garlic supplementation and Helicobacter pylori" that studied its effect on gastric cancer. The results showed that garlic supplementation can significantly reduce the risk of death from gastric cancer in people infected with Helicobacter pylori, [4] and Helicobacter pylori is one of the factors that induce gastric cancer. Rather than relying on eating garlic to treat HP, it is recommended to take garlic supplements instead of eating garlic directly to reduce irritation to the gastric mucosa and increase the concentration of active ingredients.

02

Can eating onions and drinking green tea cure HP?

A bit difficult

Onions are a type of vegetable with a very strong pungent smell that can make people cry while cutting them. I don’t know if it is for this reason that, like garlic, they are labeled as “killing bacteria if eaten regularly”, especially against Helicobacter pylori (HP).

The antibacterial ability of onions is mainly attributed to the flavonoid compound quercetin contained in onions. The content of quercetin in red onions is: outer skin (140 mg/100 g) > middle skin (110 mg/100 g) > core (10 mg/100 g). [5]

In one experiment, guinea pigs infected with Helicobacter pylori for 60 days were given 200 mg/kg of quercetin orally every day for 15 days. The results showed that quercetin had a therapeutic effect on guinea pigs infected with Helicobacter pylori, reducing Helicobacter pylori infection in the gastric mucosa, and reducing inflammatory responses and lipid peroxidation. [6]

However, this is still only an animal experiment, and the same effect cannot be extended to humans. There is currently no research on the effect of quercetin intake on the risk of Helicobacter pylori infection or cancer in humans. In addition, the experiment used pure quercetin, which is different from the concentration of quercetin in natural onions. If extrapolated to a 60kg adult, 12,000mg of quercetin would be needed orally every day to produce the corresponding effect. Even if all they eat is the skin of the red onion, they would still need to eat 8.5kg, and this dosage requirement is not practical.

So let's not count on treating HP by eating onions. Similarly, although the quercetin content in green tea is also high, the little tea leaves used to make tea each time are far from enough to affect Helicobacter pylori.

03

Can using "Helicobacter pylori toothpaste" kill HP?

It's a bit beautiful

We often see advertisements for "toothpaste that eradicates Helicobacter pylori" on the Internet. Although the price is almost two or three times that of ordinary toothpaste, it sells very well. Does this toothpaste really have the effect of killing Helicobacter pylori as it claims?

Helicobacter pylori (HP) is a recognized pathogen of chronic active gastritis, and it mainly colonizes the gastric mucosa. People with HP also have a high detection rate of Helicobacter pylori in their oral cavity, and it mainly exists in dental plaque. In particular, for patients with chronic gastritis, the HP positive rate in dental plaque culture is as high as over 80%. [7]

HP toothpaste can only act on HP in the mouth, and has little sterilization effect on HP in the stomach. Currently, no research has shown that brushing your teeth with a certain toothpaste every day can cure HP.

However, it is right to pay attention to oral hygiene when treating HP-related gastric diseases. Controlling dental plaque has a positive effect on the eradication of HP.

HP is highly resistant to drugs, and the eradication rate of traditional triple therapy is decreasing. A meta-analysis showed that before 2004, the eradication rate of HP with standard triple therapy in my country was 88.5%; from 2005 to 2009, it dropped to 77.66%; and after 2010, it was only 71.13%. [8] Traditional triple therapy is no longer suitable as a first-line HP eradication regimen. Currently, the "Fifth National Consensus Report on the Treatment of Helicobacter pylori Infection" recommends that bismuth quadruple therapy be used as the main empirical treatment regimen. [9]

Therefore, eradicating HP is not an easy task in clinical practice. It is a bit of a "pipe dream" to completely eliminate Helicobacter pylori with just a toothpaste. If you have friends who have been infected with Helicobacter pylori, you must remind them not to imagine that any food or daily necessities can cure the disease. Taking medicine and receiving treatment is the right way.

04

Food cures HP is just empty talk

Preventing infection starts with details of life

Although food cannot cure Helicobacter pylori (HP), we can prevent HP infection by paying attention to small details in life. Specifically, we can pay attention to the following aspects:

A. Eat less pickled food

Although there is no food that can remove HP, there are foods that can become accomplices of HP.

Researchers conducted a survey on the relationship between dietary habits and Helicobacter pylori infection in a certain area of ​​Anhui Province. The results showed that high salt intake (≥9g/d) and high frequency of pickled food intake (≥1 time/d) were risk factors for Helicobacter pylori infection in female residents aged 40-69 in a certain area of ​​Anhui Province. [10]

The usual eating habits are heavy in flavor, salty in food, and pickled vegetables, pickled meat and other foods. These will aggravate the damage of Helicobacter pylori to the gastric mucosa, so try to develop the habit of a light diet and eat less pickled products and processed foods.

Let me emphasize again: According to the recommendations of the "Dietary Guidelines for Chinese Residents", each person's daily salt intake should be less than 6g, which is about the amount of one beer bottle cap.

B. Try not to eat raw food

Eating raw or undercooked food can lead to infection with Helicobacter pylori, and high-temperature cooking can kill Helicobacter pylori. Generally, heating at 100°C for 1 minute can kill Helicobacter pylori in food.

So I suggest again that you try to eat thoroughly cooked food and clean and disinfect tableware thoroughly after use.

C. Implementing the separate dining system

Since Helicobacter pylori is contagious, it is recommended that families eat separately. Everyone needs to prepare their own set of bowls and chopsticks, and use public spoons and chopsticks when eating in a restaurant to avoid cross infection.

D. Quit smoking as soon as possible

The harm of smoking is common knowledge. For example, it increases the risk of respiratory diseases, cardiovascular diseases, breast diseases, and even increases the incidence of lung cancer. However, few people know that smoking behavior is also related to Helicobacter pylori infection.

A study investigated 2,186 patients with gastric diseases and tested them for Helicobacter pylori (HP). The results showed that the HP detection rate in the group with smoking and drinking habits was 62.32%, while the HP detection rate in the group without smoking and drinking habits was 46.62%. If smoking and drinking are examined separately, the effect of drinking and non-drinking behaviors on HP is not obvious, while smoking has a greater impact on HP infection rate. [11]

That is to say, although smoking cannot directly cause HP, it is one of the negative factors that increase the infection rate of gastric mucosal HP and also affect the treatment effect of HP. Quitting smoking can not only reduce the risk of respiratory diseases, but also has a positive effect on the control and treatment of HP.

So, quit smoking as soon as possible!

Summarize:

Helicobacter pylori is a relatively stubborn "little bad guy". For healthy people, they must pay attention to small details in life to prevent infection. In addition to the suggestions mentioned above, they must also pay attention to personal hygiene and wash their hands before meals and after defecation.

If someone in your family has been infected with Helicobacter pylori, you must screen the whole family for early detection and early treatment. Do not believe any rumors that a certain food can cure the disease. Following the doctor's advice and cooperating with the treatment is the only correct way to deal with it!

References:

[1] Zhang Wandai. Epidemiological survey of Helicobacter pylori infection in the Chinese natural population[C]// Guangdong Provincial Traditional Chinese Medicine, Traditional Chinese and Western Medicine Academic Conference on Spleen and Stomach Digestive Diseases. 2006.

[2] Zheng Yansong, Chen Zhilai, Sai Xiaoyong, et al. Cross-sectional analysis of Helicobacter pylori infection in the physical examination population[J]. Chinese Journal of Clinical Physicians (Electronic Edition), 2013, 7(022):10044-10047.

[3]O'Gara, EA, Hill, et al. Activities of Garlic Oil, Garlic Powder, and Their Dially Constituents against Helicopter pylori.[J]. Applied & Environmental Microbiology, 2000.

[4]Effects of Helicobacter pylori treatment and vitamin and garlic supplementation on gastric cancer incidence and mortality: follow-up of a randomized intervention trial

[5] Gao Jinhong. Determination of quercetin content in different parts of red onion[J]. Chinese Condiment, 2014, 39(9):108-108.

[6]Gonzalez-Segovia R, Quintanar JL, Salinas E, et al. Effect

of the flavonoid quercetin on inflammation and lipid peroxidation

induced by Helicobacter pylori in gastric mucosa of guinea pig

[J]. J Gastroenterol, 2008, 43(6): 441-447.

[7] Ye Guoqin. Current status and prospects of oral Helicobacter pylori infection and its detection technology[J]. Chinese Journal of Clinical Infectious Diseases, 2014: 371.

[8] Wang Ben. Meta-analysis of the efficacy of my country's standard triple therapy for eradication of Helicobacter pylori and in vitro study of the anti-Helicobacter pylori effect of the new antibacterial drug TNP-2092[D]. Nanchang University.

[9] Guidelines for diagnosis and treatment of Helicobacter pylori infection at the primary care level (2019)

[10] Wu Hanhan, Wang Chen, Wang Guangjun, et al. Investigation and analysis of salt and pickled food intake and Helicobacter pylori infection status among residents aged 40-69 years in a high-incidence gastric cancer county in Anhui Province[J]. Chinese Journal of Disease Control, 2020, v.24(02):46-51.

[11] Yu Haijing. Effects of smoking and drinking on Helicobacter pylori infection in gastric diseases[J]. Journal of Regional Anatomy and Surgery, 2011(01):90.

Author | Xue Qingxin, member of Chinese Nutrition Society, registered dietitian, registered nutrition technician, health manager, public nutritionist

Review | Song Shuang, Associate Researcher, Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention

This article was first published on Science Refutes Rumors