Helicobacter pylori (Hp for short) is a spiral, micro-anaerobic, and very demanding bacteria that lives in the stomach and duodenum. It can cause mild chronic inflammation of the gastric mucosa, or even cause gastric and duodenal ulcers and gastric cancer. It is currently the only microbial species known to survive in the human stomach and is classified as a carcinogenic by the International Agency for Research on Cancer of the World Health Organization. Things.
The infection rate is gradually increasing
According to statistics, more than half of people in my country are infected with Helicobacter pylori. Researchers can isolate Helicobacter pylori from the gastrointestinal secretions, saliva, gums and feces of infected people, indicating that it can be transmitted through mouth-to-mouth and feces-to-mouth. Meals and close contact, especially the close contact between parents and children at home, are all ways to get Helicobacter pylori.
And with age, the infection rate of Helicobacter pylori has gradually increased. Studies have shown that the infection rate of Hp in the 25-year-old is close to 50%, the infection rate in the 35-year-old is >60%, and the infection rate in the elderly over 70 is 80%. In addition, living environment and habits, food hygiene, smoking, etc. are also related to Helicobacter pylori infection.
Infection 4 manifestations
Under normal circumstances, infection with Helicobacter pylori does not have any bad symptoms, but in severe cases, the body will have different symptoms, such as:
1. Thinning. Compared with the previous month, the weight suddenly dropped and anemia began to appear.
2. Upset stomach. The abdomen begins to ache, the location is concentrated in the upper abdomen, and there is frequent flatulence.
3. Indigestion. I feel full when I eat a little bit, and I often feel bloated, bowel movements are not formed, and the pulling is not clean.
4. Bad breath. If other problems are excluded, it is most likely that Helicobacter pylori remains in the mouth.
4-step effective screening
At present, there are many methods to detect Hp, mainly including the following:
Gastroscopy biopsy. In addition to seeing the stomach, gastroscopy can also take some tissues for biopsy, and it can detect Helicobacter pylori during the biopsy.
C13, C14 Urea Breath Test Method C13 and C14 are very simple and can be completed by blowing a breath. It has the characteristics of no pain, high sensitivity, high detection rate and high specificity. It is a very popular test for pylorus in recent years. Helicobacter method. The difference between C13 and C14 is that C13 has no radioactivity and has a wider range of applications. It has almost no effect on children, women of childbearing age, and breastfeeding women; C14 has a certain amount of radioactivity and has little effect on adults and the elderly, but children, Choose carefully for women of childbearing age.
The antibody test checks whether there are Hp antibodies in the blood and urine.
The antigen detection method checks whether there is Hp antigen in the stool.
Quadruple therapy of Helicobacter pylori
Currently, oral medications are mainly used for Hp infection. Therapeutic drugs include antibiotics, acid inhibitors and bismuth. Antibiotics mainly include amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin and furazolidone. Acid inhibitors mainly include proton pump inhibitors (PPI) with strong acid suppression ability and slightly weaker histamine H 2 receptor antagonists. The former mainly include esomeprazole, omeprazole, rabeprazole, Lansoprazole, etc.; the latter mainly include ranitidine and famotidine. Acid inhibitors can inhibit the growth of Hp while increasing the sterilization activity of antibiotics. Pectin bismuth and bismuth include bismuth potassium citrate, while protecting the gastric mucosa Hp have significant inhibition effect, and is not affected by gastric acidity
due to the gradual rise in resistance rates of Hp, currently recommended eradication therapy is generally It is a 10-day or 14-day quadruple treatment, including PPI, bismuth and two antibiotics. The combination of two antibiotics is as follows:
(1) Amoxicillin + clarithromycin;
(2) Amoxicillin + levofloxacin;
(3) Amoxicillin + furazolidone;
(4) Tetracycline + metronidazole or furazolidone.
For patients allergic to amoxicillin, the two antibiotic combinations are as follows:
(1) clarithromycin + levofloxacin;
(2) clarithromycin + furazolidone;
(3) tetracycline + metronidazole or furazolidone;
(4) carat Mycin + metronidazole.
The standard dose of PPI in therapy is esomeprazole 20mg, omeprazole 20mg or lansoprazole 30mg/time, 2 times/day, taken 30 minutes before meals; the standard dose of bismuth is bismuth potassium citrate 220mg/time, 2 times/day, take 30 minutes before meals. It should be reminded that the above drugs should be taken under the guidance of a doctor.