Ten Questions and Answers about Helicobacter pylori

1.Is Helicobacter pylori a bacterium?

Helicobacter pylori (HP) is a unique bacterium that can colonize the human gastric mucosa and cause gastric infection. Because the bacteria are spirally curved, they are called Helicobacter pylori. HP was discovered by Barry Marshall and Robin Warren, who won the 2005 Nobel Prize in Medicine for this research.

2.What are the routes of infection of Helicobacter pylori?

Helicobacter pylori is mainly found in saliva, dental plaque, stomach and feces. Therefore, its main transmission routes are as follows: (1) Oral-oral transmission, such as dinner parties, kissing, feeding, etc., so family members should not share toothbrushes. (2) Fecal-oral transmission: HP can be excreted with feces, so wash your hands frequently after going to the toilet and pay attention to personal hygiene; (3) Gastric-oral transmission: gastric juice will reflux into the mouth and then spread from mouth to mouth.

3.Where does Helicobacter pylori live?

Helicobacter pylori mainly lives in the stomach and duodenum, especially in the gastric antrum and pylorus.

4.What are the symptoms of Helicobacter pylori infection?

Early Helicobacter pylori infection can cause indigestion, such as acid reflux, heartburn, early satiety, belching, bad breath, etc. In more serious cases, there will be abdominal pain, bloating, sudden weight loss, anemia and other symptoms.

5.What are the methods for checking for Helicobacter pylori infection?

There are many methods for checking HP, the most commonly used ones are urea breath test, C13, C14 breath test, and fecal antigen test.

6. What diseases can be caused by infection with Helicobacter pylori?

The World Health Organization's International Agency for Research on Cancer has classified Helicobacter pylori as a Class 1 carcinogen, and believes that 78% of gastric cancer is caused by chronic infection with Helicobacter pylori. Patients infected with Helicobacter pylori are more likely to develop atrophic gastritis, gastric ulcers, and gastric cancer.

7. How to treat Helicobacter pylori infection?

1 proton pump inhibitor + 2 antibiotics + 1 bismuth agent. Treatment course: 7-14 days. After one month of discontinuation of medication, outpatient reexamination is recommended.

8. Will HP be infected again after it is eradicated?

Here we need to distinguish between the concepts of reinfection and recurrence;

Reinfection: refers to the re-infection of a new strain of Helicobacter pylori or a strain homologous to the original strain after complete eradication. What everyone thinks of as "recurrence" is often the result of failure to eradicate the bacteria, such as failure to use medication in a standardized manner or failure to follow up at the prescribed time, which leads patients to believe that the bacteria have been "eradicated" when in fact they have not been eradicated. When such patients test positive for Helicobacter pylori again after a period of "successful" eradication treatment, it is actually the original bacteria that have become active, not a re-infection.

Research on HP reinfection in China: The results of a study published in March 2020 showed that the annual reinfection rate of Helicobacter pylori after eradication was less than 1.5%. A study conducted in Xi'an showed that among the 422 patients who completed follow-up, 12 had recurrence of infection, with an annual recurrence rate of 2.84%.

9. Will I definitely get stomach cancer if I’m infected with HP?

Not necessarily! Helicobacter pylori infection is not the direct cause of gastric cancer, but it is the most obvious and dangerous factor for gastric cancer. The risk of gastric cancer will increase if HP infection is combined with gastric mucosal lesions, such as atrophic gastritis, bad eating habits such as smoking and alcoholism. Therefore, active treatment and regular medication should be used to eradicate Helicobacter pylori and reduce the occurrence of gastric cancer.

10. How to prevent infection with Helicobacter pylori?