Helicobacter pylori is listed as a clear carcinogen, and the ultra-total eradication program is here!

*For medical professionals, the infection rate of Helicobacter pylori is high, and the family's prevention and control and management procedures should be known
.

Recently, the U.
S.
Department of Health and Human Services released the 15th edition of the carcinogen report, and chronic infection of Helicobacter pylori (Hp) was listed as a clear carcinogen
.

Hp is a kind of pathogenic bacteria that can parasitize in the human stomach.
It is not only a carcinogen that causes gastric cancer, but also the main pathogenic factor of gastritis and gastric ulcer
.

Figure 1 The screenshot data of Weibo hot search shows that about 1 in 2 people in China carries H.
pylori, and the infection rate is as high as 40%-60%
.

In recent years, the infection rate of H.
pylori has continued to rise, and there is a phenomenon of family gathering and transmission.
If one person is detected, the whole family must be screened
.

Therefore, it is very important to effectively prevent and control Hp infection in the family
.

H.
pylori transmission routes and preventive measures "Expert Consensus on the Prevention, Control and Management of Helicobacter pylori Infection in Chinese Residents' Families" (hereinafter referred to as the "Consensus") points out that there are 4 main transmission routes of H.
easily spread to each other
.

Figure 2 H.
pylori transmission route Therefore, family prevention measures for H.
pylori mainly include: 1.
Avoid eating the same plate of food, recommend a divided meal system, and use public chopsticks, spoons, etc.
; 2.
Eat healthy and safe food, and avoid chewing and feeding infants and young children; 3.
, Clean food containers in time; 4.
Avoid close contact with Helicobacter pylori infected persons and suspicious equipment, and thoroughly disinfect medical equipment
.

The H.
pylori management and control strategy consensus points out that "prevention and control of H.
pylori infection by family unit" is an important strategy to block H.
pylori infection and transmission, that is, screening, treatment and follow-up of infected family members (the Hp screening process is shown in Figure 3) , in order to improve family members' awareness of prevention, prevent or reduce the spread of H.
pylori, reduce the risk of gastric mucosal lesions and gastric cancer, and save later medical expenses
.

Figure 3 Flow chart of Hp screening.
Currently, the most suitable methods for Hp screening of family members are non-invasive Hp tests, including urea breath test, serum antibody test and stool antigen test
.

Figure 4.
Hp detection method Hp eradication treatment For adults in the family, Hp infection should be treated as soon as it is found
.

In 2017, China's "Fifth National Consensus Report on the Treatment of Helicobacter pylori Infection" proposed quadruple therapy containing bismuth (PPI + bismuth + two antibiotics) as the main empirical therapy for eradication of Helicobacter pylori.
The course of treatment is 10.
days or 14 days
.

Family members can choose a quadruple regimen with good curative effect and low adverse drug reaction rate for Hp eradication treatment according to the following 7 major programs (Figure 5)
.

Figure 5 Hp eradication treatment regimen
.

If a child Hp infection is found in the family, it needs to be treated according to the risk-benefit assessment and related disease status
.

For children 5 years of age or older with active infection, H.
pylori eradication therapy is available when the possibility of reinfection is considered
.

H.
pylori eradication therapy is recommended for children with active gastritis, gastroscopy due to abdominal symptoms, a family history of gastric cancer in first- or second-degree relatives, and active H.
pylori infection
.

Hp eradication therapy for chronic primary urticaria is not recommended
.

Testing and treatment of asymptomatic children is not recommended
.

For elderly members of the family, strategies for treating H.
pylori infection should be tailored to individual circumstances
.

Although the prevalence of H.
pylori infection is higher in the elderly population (60-65 years or older), they usually have one or more diseases, such as heart, lung, cerebrovascular and kidney disease, or long-term use of non-steroidal anti-inflammatory drugs
.

Therefore, caution and risk-benefit assessment should be performed before H.
pylori eradication, and individualized or individualized treatment options should be selected based on the patient's medication history, pathophysiological status, disease state, and adverse drug reactions
.

References: [1] National Clinical Research Center for Digestive Diseases (Shanghai), National Alliance of Early Gastrointestinal Cancer Prevention and Control Centers, Helicobacter pylori and Peptic Ulcer Group of Digestive Disease Branch of Chinese Medical Association, etc.
Chinese resident family pylori Expert consensus on the prevention, control and management of Helicobacter infection (2021) [J].
Chinese Digestive Journal.
2021, 41(4): 221-233.
[2] Liu Wenzhong, Xie Yong, Lu Hong, et al.
Consensus report on the treatment of Helicobacter pylori infection [J].
Chinese Digestive Journal.
2017;37:364-378.
Source of this article: Digestive and Liver Disease Channel of the Medical Community Editor: Yuan Xueqing Zhangli Copyright Statement This article is reproduced,