In recent years, the term "Helicobacter pylori" has frequently appeared in the public eye. When visiting hospitals for screenings, many doctors recommend undergoing a Helicobacter pylori breath test. In fact, many institutions even include the detection of Helicobacter pylori in breath as a routine health check item.
The breath test usually refers to the urea breath test. When the stomach is infected with Helicobacter pylori, the patient's exhaled breath will contain carbon-labeled carbon dioxide, thereby diagnosing whether the patient has a Helicobacter pylori infection.
Furthermore, the breath test is a non-invasive examination method. Compared to an electronic gastroscopy, it has the advantages of being non-invasive and not requiring oral intubation, making it more comfortable for patients and thus easier to accept. Therefore, doctors generally recommend undergoing a breath test for screening.
But is this screening really necessary? And just how harmful is Helicobacter pylori? Here's the answer: When doctors advise you to check for Helicobacter pylori, they really want to save you!
What happens to the stomach after Helicobacter pylori infection?
In June 2023, the Chinese Center for Disease Control and Prevention and other units released the "Chinese Helicobacter pylori Infection Prevention and Control" white paper, pointing out that the infection rate of Helicobacter pylori in the Chinese population is nearly 50%, meaning that approximately 700 million people have Helicobacter pylori in their stomachs, and 70% of stomach cancers are related to Helicobacter pylori.
Currently, the World Health Organization has listed Helicobacter pylori in a list of carcinogens.
Helicobacter pylori (Hp) is a microaerophilic gram-negative bacillus parasitic in the human digestive tract, appearing as a spiral or S-shaped bacterium with flagella at one end. It can survive in the highly acidic environment of the stomach, penetrate the mucous layer, reach the epithelial surface, and firmly attach to it, avoiding being emptied from the stomach. It is most fond of the pylorus and gastric antrum, hence its name.
It mainly spreads through oral-oral or fecal-oral routes among humans and is the only bacterium known to survive in the stomach.
After Helicobacter pylori infection, the gastric mucosa almost always becomes inflamed. It can survive in the acidic environment of the stomach and firmly attach to the gastric mucosa surface through its strong motility, adhesins, and factors such as urease production, especially in the gastric antrum, leading to diseases such as chronic gastritis, duodenal ulcers, gastric ulcers, and even closely related to the occurrence of gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma.
In the early stages of infection, patients may not have obvious symptoms, but that does not mean the condition is not serious or does not require treatment. However, even without symptoms, inflammation of the gastric mucosa may still exist, and some patients may exhibit a chronic progressive development process, gradually leading to gastric mucosal atrophy, intestinal metaplasia, and even carcinogenesis.
Gastric mucosa after Helicobacter pylori infection, image source: author
Furthermore, currently there isn't a reliable marker or method to accurately predict which patients will develop serious conditions like gastric ulcers or gastric cancer, and which patients may carry H. pylori long-term without noticeable symptoms.
Therefore, according to the "Expert Consensus on H. pylori Eradication and Gastric Cancer Prevention in China," doctors recommend treating all patients who test positive for H. pylori to prevent potential risks.
Who needs H. pylori testing?
So, who are the key target groups for H. pylori screening? They mainly include the following:
Individuals with a history of peptic ulcer disease: Regardless of whether they are in the active phase or have a history of complications, H. pylori testing should be considered.
Patients with chronic gastritis: Especially those in the active phase with gastric mucosal atrophy and erosion, and those with dyspeptic symptoms.
Individuals with a history of gastric cancer or lymphoma: Since H. pylori is closely associated with the development of malignant tumors like gastric cancer, these patients should undergo regular H. pylori testing.
Individuals on long-term medication: Such as those taking long-term proton pump inhibitors or aspirin, as these medications may affect the gastric mucosa and increase the risk of H. pylori infection.
Individuals with a history of other chronic diseases such as unexplained iron-deficiency anemia, idiopathic thrombocytopenic purpura, which may be related to H. pylori infection.
Individuals with poor hygiene habits: Those who don't wash hands before meals or after using the restroom, frequently handle food with their hands, or neglect oral hygiene by not brushing teeth regularly or disinfecting utensils.
People exhibiting these symptoms should be particularly vigilant about H. pylori infection:
Bad breath: H. pylori infection may stimulate gastric acid secretion, affecting the function of the stomach and esophagus, leading to gastroesophageal reflux. This reflux may not only damage the esophageal mucosa but also produce malodorous substances in the mouth, causing bad breath.
Abdominal bloating and pain: When the gastric mucosa is damaged and gastric function is disrupted, patients may experience abdominal discomfort, including bloating and pain, burning or cramping in the upper right abdomen, and possibly nausea and vomiting.
Additionally, nonspecific digestive symptoms such as heartburn, belching, loss of appetite, and feeling full easily.
How to prevent H. pylori infection?
Finally, let's discuss how to prevent H. pylori infection and what to pay attention to in daily life.
Implementing separate dining and using communal chopsticks and spoons are effective measures to prevent the spread of H. pylori. This dietary habit can reduce the chance of bacterial transmission through saliva and ensure personal food hygiene.
Maintaining good personal hygiene habits is also crucial. Thoroughly washing hands with soap or hand sanitizer before meals and after using the restroom can remove bacteria from hands and reduce the risk of infection.
Oral hygiene is equally important. Regularly replacing toothbrushes and keeping the mouth clean can help reduce the proliferation of H. pylori in the oral cavity.
Cleaning and disinfecting tableware are also important steps in preventing H. pylori infection. Regular high-temperature disinfection of tableware can effectively kill bacteria and ensure their hygiene.
Avoiding drinking untreated water and eating raw food is also an important measure to prevent H. pylori infection, as it may survive in these untreated foods and water and enter the body through diet.
Children are susceptible, so providing them with dedicated tableware, ensuring its cleanliness and hygiene, and avoiding mouth-to-mouth feeding and reducing kissing are key preventive measures.
Upholding a healthy lifestyle, exercising regularly, boosting immune system, and prioritizing regular check-ups are essential.
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Planning and Production
Author: Li Tian, Chief Physician, The Fifth Affiliated Hospital of Guangzhou Medical University
Reviewed by: Tang Qin, Director and Researcher, Department of Scientific Popularization, Chinese Medical Association
Planned by: Yino
Editor: Yino
Proofreader: Xu Lai, Lin Lin
