It's time to recognize the seriousness of "bacteria entering the mouth"
Recently, the U.S. Department of Health and Human Services released the 15th edition of the carcinogen report, which added 8 carcinogens, and Helicobacter pylori was listed as a clear carcinogen for the first time. As soon as the news came out, on social media, Helicobacter pylori "panic" hit.
"I seem to be familiar with the name Helicobacter pylori, but I always feel that many people have been infected, so I don't pay much attention to it. I didn't expect it to be a clear carcinogen." Most of the netizens' reactions were a little shocked.
"Many people have been infected with Helicobacter pylori, which doesn't mean it's okay to be infected with this bacteria. On the contrary, we should pay more attention to it, because the infection rate is very high." According to Zhang Zhenyu, director of the Department of Gastroenterology of Nanjing First Hospital, this The attention of Helicobacter pylori is an opportunity to let the public know more about this disease, which has an infection rate of over 40% in my country.
Over 85% of gastric cancers worldwide are attributable to Helicobacter pylori infection
Helicobacter pylori infection and unhealthy lifestyle are closely related
Although many people have heard of Helicobacter pylori, not many people really understand this infectious disease.
This is Zhang Zhenyu's clinical experience for many years. He said that as early as 1994, the International Agency for Research on Cancer (IARC) under the World Health Organization designated Helicobacter pylori as a class I carcinogen of gastric cancer. Bacterial infection has never been an insignificant disease, but the Chinese people have not paid enough attention to it."
"So it is very important to improve people's health literacy." Qiu Haibo, deputy chief physician of gastric surgery of Sun Yat-sen University Cancer Center, said with emotion, "Helicobacter pylori infection is closely related to some unhealthy lifestyles. Many times, we should pay more attention to the infection. The possibility is much smaller." Qiu Haibo will repeatedly explain the cause of infection to patients and family members with related diseases to attract everyone's attention.
For example, he said: "An unhealthy lifestyle leads to a decline in the body's immunity, which may indirectly lead to an increase in the infection rate; in addition, kissing between couples or sharing tableware between family members can also lead to Helicobacter pylori infection."
If Helicobacter pylori is detected, should you worry about cancer?
"More than 85% of gastric cancers worldwide are attributable to Helicobacter pylori infection." Zhang Zhenyu listed this remarkable data and analyzed that Helicobacter pylori infection is the most important controllable risk factor for the prevention of gastric cancer.
A large amount of research evidence shows that the occurrence of intestinal-type gastric cancer (which accounts for the majority of gastric cancer) is the result of the combined effect of Helicobacter pylori infection, environmental factors and genetic factors.
It is estimated that about 90% of non-cardiac gastric cancers are related to Helicobacter pylori infection; the overall role of environmental factors in the development of gastric cancer is second to that of Helicobacter pylori infection; genetic factors are involved in about 1% to 3% of hereditary diffuse gastric cancers. play a decisive role.
"It can be seen that among the many factors that cause gastric cancer, the prevention of Helicobacter pylori infection is the most controllable factor. This is also an important reason why we should pay attention to Helicobacter pylori infection," he concluded.
"We must pay attention to Helicobacter pylori infection, but we don't have to be overly nervous." Qiu Haibo explained that about 90% of Helicobacter pylori infected patients will not show any symptoms, and a small number will have indigestion, stomach pain or bad breath Other symptoms, only a very small number of infected people are diagnosed with gastric cancer.
"Helicobacter pylori infection will first lead to chronic gastritis, then atypical hyperplasia, including mild dysplasia and severe dysplasia, and finally to cancer. The evolutionary process is not necessarily forward, only 1% of The probability will lead to the occurrence of gastric cancer." Qiu Haibo's words made many Helicobacter pylori infected people let go of their excessive anxiety.
But we must pay attention to Helicobacter pylori, Zhang Zhenyu repeated his point again.
"Because my country is a country with a high incidence of Helicobacter pylori infection, and Helicobacter pylori infection is also the main cause of gastric cancer in my country." In Zhang Zhenyu's view, the more the public knows about the harm of gastric cancer, the more helpful it is to promote gastric cancer prevention.
"Eradication of Helicobacter pylori can reduce the incidence of gastric cancer, especially early eradication." This is the conclusion of Zhang Zhenyu's many years of clinical and research, and it is also the consensus of domestic experts.
"In our country, most gastric cancer patients are already in the advanced stage when they are found to have cancer, and the prognosis is poor. If it is detected early, it can be treated in time and the prognosis is good." Zhang Zhenyu said, but early gastric cancer is generally asymptomatic or the symptoms lack specificity, so it is difficult to timely Find.
"So once we find out that we have cancer, it is very troublesome. If we can treat Helicobacter pylori in time to reduce the risk of cancer, our health will of course be more secure."
Helicobacter pylori infection does not go away on its own unless proactive intervention is taken
How to detect Helicobacter pylori infection
Detected Helicobacter pylori infection, must be treated?
"We recommend early treatment. The sooner you treat Helicobacter pylori infection, the better your health will be." Zhang Zhenyu said, "In the past, many people thought that if there were no serious symptoms, they could die, but now most domestic experts believe that it should be treated as soon as possible." Because If not treated, it is easy to infect people around you, and it will also increase the possibility of gastrointestinal diseases.
"There was a point of view before, that after treatment, reinfection will occur, so you can ignore it if there are no obvious symptoms. But according to our current research, the reinfection rate after Helicobacter pylori treatment is very low, and the reinfection rate of the general population is about Only about 1.5%." In Zhang Zhenyu's view, early treatment of Helicobacter pylori can maximize benefits.
"For people with a family history of gastric cancer, eradication of Helicobacter pylori can reduce the risk of gastric cancer by 73%." Zhang Zhenyu once again used research data to prove the importance of early treatment of Helicobacter pylori.
What symptoms can Helicobacter pylori infection cause if left untreated?
Li Lei, director of the General Medicine Department of the Affiliated Hospital of Xuzhou Medical University, concluded that about 25% to 30% of Helicobacter pylori-infected patients will develop gastrointestinal diseases of varying degrees, such as indigestion, chronic gastritis, and peptic ulcers. , gastric cancer, etc.
"In fact, not only gastrointestinal diseases, Helicobacter pylori infection is also closely related to a variety of extra-gastrointestinal diseases, such as iron deficiency anemia, cardiovascular disease, cerebrovascular disease, etc." Li Lei said.
Zhang Zhenyu also emphasized: "For some special populations, it is more important to eradicate Helicobacter pylori infection, such as the elderly." The elderly population has a higher infection rate of Helicobacter pylori, and eradication of Helicobacter pylori can improve the gastrointestinal symptoms of elderly patients. It can be improved, and to some extent prevent or delay the occurrence of gastric mucosal atrophy and intestinal metaplasia, and even reverse some gastric mucosal atrophy or intestinal metaplasia.
"It's just that elderly patients with Helicobacter pylori infection often suffer from cardiovascular, cerebrovascular, renal and other systemic diseases. Therefore, before the treatment of Helicobacter pylori, the patient's previous drug use, physiological characteristics, diseases and adverse drug reactions should be considered. Wait, choose an individualized and standardized treatment plan." Zhang Zhenyu said.
"We also need to be clear that unless active intervention measures are taken, Helicobacter pylori infection will not disappear on its own." Zhang Zhenyu reminded that Helicobacter pylori-related diseases not only endanger human health, but also cause a great burden to the health care of society and families.
"Therefore, in all aspects, it is very urgent to eradicate Helicobacter pylori to reduce the occurrence of related diseases." It is understood that his point of view is also the consensus of domestic experts in related fields.
According to the "Expert Consensus on the Prevention, Control and Management of Helicobacter pylori Infection in Chinese Residents' Families" released in 2021, there are currently two main strategies for the diagnosis, treatment and management of Helicobacter pylori infection in my country: detection and treatment in areas with low infection rates, and high infection rates. area for screening and treatment.
"That is to say, in areas with low infection rates, if you have indigestion symptoms, it is recommended to do relevant inspections yourself, and if infection with Helicobacter pylori is found, then treatment; and for areas with high infection rates, my country is striving for large-scale For the screening of Helicobacter pylori, for example, in the community, community doctors and community staff can conduct relevant popularization and examinations on the masses, and those who are found to be infected with Helicobacter pylori are recommended to be treated, unless the patient has a counteracting factor in his own body.” He also reminded that people with a family history of gastric cancer and other related diseases should be tested regularly.
"In recent years, Japan and South Korea have begun to implement nationwide Helicobacter pylori eradication programs to reduce the incidence of gastric cancer and Helicobacter pylori infection-related diseases, thereby saving later medical expenses." In Zhang Zhenyu's view, the nationwide eradication program It is necessary, and his suggestion is to "step by step, with the efforts of the government and all levels of society, we must realize the national Helicobacter pylori eradication plan as soon as possible".
About 64% of families in my country have at least one family member infected with Helicobacter pylori
To prevent "bacteria from entering the mouth", the most important thing is to advocate a divided meal system
Talking about the way to prevent Helicobacter pylori, Zhang Zhenyu believes that as an infectious disease, using vaccines to prevent infection is of course the best choice.
"But there is no clinical vaccine yet." He said that there have been many attempts at home and abroad for the development of Helicobacter pylori vaccine over the years, but due to the complexity of its antigen preparation and the body's response, the current vaccine research is still In the laboratory and clinical development stage.
"In addition, some toothpastes claim to be anti-Helicobacter pylori, which also lacks scientific basis." Zhang Zhenyu said, "In the absence of vaccines, the most important thing to prevent Helicobacter pylori is to cultivate healthy living habits."
"Human-to-human transmission is an important way of Helicobacter pylori transmission, and Helicobacter pylori infection has obvious family aggregation. Intra-family transmission is an important way of Helicobacter pylori transmission. According to current research, there are about 64 % of families have at least one family member infected with Helicobacter pylori." Zhang Zhenyu reminded that since Helicobacter pylori infection rarely recovers without treatment, family members infected with Helicobacter pylori are always a potential source of infection, and there is the possibility of continuous transmission sex.
In Zhang Zhenyu's view, the most important thing to reduce the possibility of family infection with Helicobacter pylori is to advocate a divided meal system, because this can greatly reduce the possibility of "bacteria entering through the mouth".
"The meal-sharing system is not a question of willingness or not, but a must." Zhang Zhenyu said that the so-called meal-sharing system means that the utensils are separated and reserved for special persons.
"We Chinese think that it is lively for us to eat together, and it seems that we are warm to each other, but if one of the people eating together carries germs, then the tableware he has used may contain germs, and others use the tableware he has used or eat He is very likely to be infected when his tableware has been moved." Not only Helicobacter pylori, but also hepatitis B virus, pneumonia virus, anaerobic streptococcus, oral coccus, and new coronary pneumonia virus and other viruses, regardless of meal, Zhang Zhenyu introduced.
"So when having a meal, it's best to divide the dishes and eat your own. At least you need to use public chopsticks, which is a must."
And for families with children, it is even more necessary to advocate a divided meal system. Li Lei reminded: "Many elderly people bring children and like to chew food before feeding them. This feeding method is actually very easy to prevent Helicobacter pylori and other The virus is passed on to children. And H. pylori infection mainly occurs in children and adolescents, so it must be more careful.”
In Li Lei's view, it is indeed difficult to implement a meal-sharing system in my country because of the many traditional and emotional factors involved.
"This also reflects the importance of improving people's health literacy. If everyone understands the dangers of mixed eating, they will not feel that people who share meals are not in the group." Li Lei suggested that not only when dinner parties, but also family members usually eat together, Also, separate meals, cutlery, chopsticks, etc. should not be mixed together.
"Chopsticks are not easy to distinguish. You can use different colors for each person, so that you will not use them wrong." This is Li Lei's "little trick".
"The Spring Festival is approaching, and it is the peak of the year for dinner parties. Everyone can remind each other that meal sharing does not reduce the atmosphere, does not reduce feelings, and sharing meals is a healthier and more fashionable way of life." Zhang Zhenyu said with emotion, when meal sharing has become the daily routine of dinner gatherings , the infection rate of many viruses has naturally decreased.
(Reporter Zou Xiaojing of this newspaper)