Infecting at least 700 million Chinese people! This bacteria is listed as a "clear carcinogen", how to cure it?

" One person's infection can infect the whole family ." I believe many people have heard of Helicobacter pylori but do not know how dangerous it is.

When these words appear on one's physical examination report, the lucky mentality of "feeling no symptoms" usually prevails, and many people choose to ignore this indicator.

It is worth noting that in the 15th edition of the carcinogen report newly released by the U.S. Department of Health and Human Services, 8 new compounds were added, and chronic infection with Helicobacter pylori was listed as a clear human carcinogen. Last year, the authoritative medical journal The Lancet also published an article pointing out that 70% of new gastric cancer patients in China were positive for Helicobacter pylori infection .

How common is Helicobacter pylori in real life? To what extent does it threaten human health, and how can it be prevented scientifically? We combine authoritative research and expert summaries to help you uncover its dangerous true face.

01

Helicobacter pylori

How common is it in our country?

Our stomachs continuously secrete gastric acid, which kills bacteria in food and helps digest food. However, there is a bacteria in the stomach cavity called Helicobacter pylori that can repeatedly infect the stomach .

It can decompose urea to produce ammonia to neutralize stomach acid , creating a comfortable living environment for itself and becoming a pathogen that parasitizes in the human stomach for a long time.

Helicobacter pylori is the only bacterium discovered so far that can survive for a long time in the strong acid environment of the stomach, and its range of infection is very wide .

According to conservative estimates by the World Gastroenterology Organization (WGO), at least half of the world's population is infected with Helicobacter pylori. China is the country with the largest number of people infected with Helicobacter pylori, with an infection rate of 59%, or nearly 700 million people infected.

Behind these shocking figures is the reality that Helicobacter pylori is closely related to many stomach diseases.

The "Sixth National Consensus Report on the Treatment of Helicobacter pylori Infection (Non-Eradication Treatment Part)" officially published in the "Chinese Journal of Digestion" in May this year pointed out that Helicobacter pylori infection is the cause of more than 90% of duodenal ulcers and 70%~80% of gastric ulcers , and its harm cannot be underestimated.

But this is not the worst. A research report published in The Lancet at the end of 2021 found that Helicobacter pylori is one of the main sources of infection for gastric cancer, which can increase the risk of non-cardia gastric cancer by 6 times and cardiac gastric cancer by 3 times .

This is a large-scale gastric cancer risk study conducted in collaboration with research centers including the University of Oxford in the UK, Peking University, and the Chinese Academy of Medical Sciences.

The study included 512,715 adults aged 30-79 years from ten different geographical regions in China recruited between 2004 and 2008. After ten years of follow-up using a case-cohort study design, the results showed:

The Helicobacter pylori positivity rates in non-cardia gastric cancer and cardiac gastric cancer cases and sub-cohort subjects were 94.4%, 92.2%, and 75.6%, respectively.

According to risk assessment, Helicobacter pylori causes 78.5% of non-cardia gastric cancer and 62.1% of cardia gastric cancer cases. Combined with the 2018 Chinese cancer statistics, Helicobacter pylori causes about 340,000 new cases of gastric cancer in China each year .

The ubiquitous Helicobacter pylori is undoubtedly a killer that threatens health, but there is no way to deal with it.

The above-mentioned "Sixth National Consensus Report on the Treatment of Helicobacter pylori Infection (Non-Eradication Treatment Part)" points out that eradication of Helicobacter pylori can permanently cure the vast majority of peptic ulcers and can also effectively reduce the risk of gastric cancer .

Raising public awareness that eradication of Helicobacter pylori can prevent gastric cancer and conducting large-scale screening and eradication of Helicobacter pylori on a population basis will be key strategies for preventing gastric cancer.

02

How to determine whether you are infected?

It is well known that Helicobacter pylori is contagious. When a person carries Helicobacter pylori, the whole family may be affected, especially children and adolescents .

Since Helicobacter pylori can be detected in the patient's saliva, feces, and vomit, it means that tableware, toilets, and even food and water used in daily life may become sources of infection.

However, Helicobacter pylori is very cunning, and even if infected, about 70% of people do not feel obvious discomfort. Even if they actively seek medical treatment, it is because of symptoms related to chronic gastritis, peptic ulcer, etc.

Therefore, in daily life, if the body has obvious symptoms such as the following, we should be extra careful, as it may indicate the possibility of Helicobacter pylori infection: nausea, poor appetite (reduced food intake), acid reflux, heartburn, belching, abdominal pain and bloating, indigestion, bad breath, etc.

For the diagnosis of Helicobacter pylori infection, the commonly used detection methods in clinical practice are roughly divided into two categories: invasive and non-invasive. Invasive detection includes rapid urease test, gastric mucosal tissue section staining microscopy, etc.

The most common non-invasive detection methods are the C13 and C14 breath tests , which are also internationally recognized as the "gold standard" for Helicobacter pylori testing with an accuracy rate of over 95%. Not only does it have no risk of cross-infection, it is also convenient and fast, and only requires two breaths to complete the test.

03

Eradicating Helicobacter pylori

Pay attention to these points

The "Epidemiological Survey on Helicobacter pylori Infection in the Natural Population of China" shows that most Helicobacter pylori infections within a few years can only cause mild superficial gastritis; but long-term chronic infection for decades can easily lead to erosion, verrucous gastritis, atrophic gastritis and even gastric cancer.

Therefore, although Helicobacter pylori infection is a high-risk factor for gastric cancer, there is still a certain period of prevention and treatment before it becomes a cancer promoter.

Simply put, the sooner the Helicobacter pylori infection is cured, the more secure your health will be. When the following people have tested positive for Helicobacter pylori, timely cure should be put on the agenda:

Patients with peptic ulcer disease , such as gastric ulcer and duodenal ulcer.

Patients with precancerous lesions such as chronic atrophic gastritis or gastric mucosal erosion .

If there are stomach cancer patients in the family , such as parents or great-grandfathers, great-grandmothers, etc., then treatment is needed after infection with Helicobacter pylori.

For patients with gastric mucosa-associated lymphoma , Helicobacter pylori infection can easily aggravate the tumor condition, so timely treatment is required.

It is worth noting that no matter which family member is infected with Helicobacter pylori, other family members are likely to be infected. If one person tests positive, it is best for family members to be tested and treated together .

For adults, after successful eradication of Helicobacter pylori, the annual recurrence rate does not exceed 1%, and it is difficult to be infected again. This can block the spread of Helicobacter pylori in the family and help reduce reinfection after eradication.

For children and elderly people infected with Helicobacter pylori, individualized management strategies should be formulated based on relevant disease status and benefit-risk.

04

How to prevent it

“One person is infected, the whole family is affected”?

Like all methods of preventing the spread of infection, to effectively prevent Helicobacter pylori, we can start from three aspects: eliminating the source of infection, cutting off the transmission route and protecting susceptible populations:

1. Eliminate the source of infection

That is, family members should have regular physical examinations to know their Helicobacter pylori infection status, and once infected, they should receive timely eradication treatment. This is not only to reduce the risk of disease, but also to cut off the source of transmission within the family in a timely manner.

2. Cut off the transmission route

That is, pay attention to the hygiene habits that cause fecal-oral and oral-oral transmission. Clean up feces and vomit in time and fully wash the ground, tabletops, tableware, etc. that may be contaminated, and develop a good habit of washing hands before and after meals.

Eliminate the bad habit of feeding children with mouth, and do not touch baby nipples and various foods with your mouth; if someone in the family is infected with Helicobacter pylori, you must adopt the family dining system, use public chopsticks and spoons to serve rice and dishes, and do not pick up dishes for each other.

3. Protect vulnerable groups , that is, protect children and adolescents with underdeveloped immune systems. Let children use independent tableware as much as possible to help them develop good personal hygiene habits in the long run.

Only by correctly understanding Helicobacter pylori and preventing and treating it with scientific methods can we avoid panicking in the face of the disease and embrace every day of life with a healthy attitude.

References:

[1] Helicobacter pylori Study Group, Chinese Society of Gastroenterology. Report on the Sixth National Consensus on the Management of Helicobacter pylori Infection (Non-Eradication Therapy Part)[J]. Chinese Journal of Gastroenterology, 2022, 42(5): 289-303.

[2] Chinese Helicobacter pylori Research Collaboration Group. Epidemiological survey of Helicobacter pylori infection in the Chinese natural population[J]. Modern Digestion and Interventional Diagnosis and Treatment, 2010, 15(5): 265-270.

[3] Jin Qiuyu, Zhang Yang, Li Zhexuan, et al. Epidemiological study on the association between Helicobacter pylori infection and gastric cancer[J]. Electronic Journal of Comprehensive Oncology Treatment, 2022, 8(2): 5-10.

Author: jting

Review | Sun Hao, Chief Physician, Gastrointestinal Tumor Center, Affiliated Cancer Hospital of Chongqing University