Helicobacter pylori

　　Helicobacter pylori infection is the main pathogenic factor for chronic active gastritis, peptic ulcers, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer.

　　Helicobacter pylori can cause gastritis. After the patient is infected with Helicobacter pylori, the Helicobacter pylori can destroy the self-protection mechanism of the gastric mucosa, and Helicobacter pylori can break through the protective effects of gastric acid, proteases, and insoluble and soluble mucus layers, destroying the gastric mucosa and causing gastritis.

　　Helicobacter pylori can cause peptic ulcers. Due to the fact that Helicobacter pylori lives in the stomach and destroys the natural protective barrier and repair function of the gastric mucosa, the gastric mucosa, duodenal mucosa, and esophageal mucosa are easily eroded by substances such as gastric acid and bile, but cannot be effectively repaired, thereby causing peptic ulcers.

　　Helicobacter pylori can induce gastric cancer. The metabolic products of Helicobacter pylori directly harm the mucosa, causing inflammatory reactions, and also have genotoxic effects, thereby triggering the malignant transformation of gastric mucosa and the occurrence of gastric cancer.

　　Helicobacter pylori can induce coronary heart disease. Helicobacter pylori can cause disorders in fat metabolism in the blood, leading to an increase in low-density lipoprotein, which is prone to cause atherosclerosis of the coronary arteries. Infection with Helicobacter pylori can lead to an increase in fibrinogen and C-reactive protein in the blood, thereby triggering coronary heart disease.

　　1) The symptoms of Helicobacter pylori infection are mainly acid regurgitation, heartburn, and stomachache, halitosis. This is mainly due to the excessive secretion of gastrin induced by Helicobacter pylori, causing acid and heartburn. For patients with gastric ulcer disease, Helicobacter pylori is the main cause of the main symptom of stomachache. Halitosis is one of the most direct pathogens, which is Helicobacter pylori.

　　2) Helicobacter pylori can cause chronic gastritis. The main clinical manifestations include: discomfort and pain in the upper abdomen, sometimes belching, acid regurgitation, nausea, and vomiting. The course is relatively slow, but it is prone to recurrence.

　　3) After the patient is infected with Helicobacter pylori, various pathogenic factors are produced, causing damage to the gastric mucosa, and the occurrence of clinical diseases presents diversity. Moreover, most patients will have symptoms such as acid regurgitation, belching, fullness, etc., which are many times higher than those without Helicobacter pylori infection.

　　4) Helicobacter pylori infection often does not have particularly obvious symptoms. In this case, it is usually determined through examination to see if there is a Helicobacter pylori infection. Helicobacter pylori, this pathogenic bacterium, is very easy to induce the occurrence of gastrointestinal diseases. The symptoms of Helicobacter pylori include these.

　　Helicobacter pylori has a strong infectious power and can be transmitted through hand, unclean food, unclean tableware, feces, and other routes. Therefore, it is necessary to develop good hygiene habits in daily diet to prevent infection.

　　Items to be checked for Helicobacter pylori infection

　　Bacterial CAMP Test: Direct smear examination, cytological tissue chemical staining, urease test

　　1. Bacterial Culture: The gastric mucosal specimen is directly streaked onto solid culture media or the gastric mucosal specimen is ground into a homogenate and then inoculated. It is incubated under microaerobic conditions, with relative humidity above 90%, at 37℃ for 48-72 hours, and the results are observed. At least based on smear staining microscopic examination, urease, catalase, and oxidase identification.

　　2. Gastric Biopsy Mucosal Smear: The biopsy mucosal surface is directly applied to a clean glass slide, naturally dried, and then Gram stained or counterstained, and observed under an oil immersion lens.

　　3. Tissue Section Staining: The gastric mucosal biopsy specimen (it is advisable to take samples from multiple points) is vertically embedded and sectioned. It is stained with Warthin-Starry and Centa silver staining or HE staining, Giem sa staining, fluorescent acridine orange staining, Methylene blue staining, and unmarked antibody PAP staining, and observed under an oil immersion lens or fluorescence microscope.

　　4. Ureaase Test: Helicobacter pylori has a high urease activity, which can decompose urea to produce NH+4. The presence or absence of H. pylori infection can be indirectly determined by measuring the presence of NH+4. Methods include pH indicator method, analytical chemistry method, and isotope-labeled urea test.

　　5.14C Breath Test: After taking 14C urea orally, if there is a Helicobacter pylori infection, 14CO2 will be present in the exhaled air of the patient 20 minutes later. Without H. pylori infection, there will be no 14CO2 exhaled. This test is safe, accurate, and has good reproducibility, but it is not easy to popularize due to equipment and other reasons.

　　6. Serological examination: ELISA method is used to detect anti-Hp IgG or anti-Hp IgA in serum or saliva, which is a specific and sensitive indicator.

　　7. Polymerase Chain Reaction (PCR) technology: It can detect Hp in gastric juice, gastric mucosa, and saliva, with a higher positive rate than the urease method.

　　8. In situ identification: Monoclonal antibodies can be used for immunohistochemical detection, and Hp specific probes or primers can be used for in situ hybridization and PCR detection.

　　Tissue section staining: The gastric mucosal biopsy specimen (should be taken at multiple points) is vertically embedded and sectioned, and stained with Warthin-Starry and centa silver staining or HE staining, Giemsa staining, acridine orange fluorescence staining, Methyl green staining, and unlabeled antibody PAP staining, etc., under oil immersion or fluorescence microscope.

　　Patients with Helicobacter pylori should pay attention to regular and moderate diet, rich in nutrition, soft and easy to digest, eat in small and frequent meals, chew slowly; avoid overeating, avoid cold, spicy, fried and stimulating foods, avoid smoked and preserved foods. Canned food containing nitrosamines also has a carcinogenic effect, and combined with the positive role of Helicobacter pylori, it will increase the chance of cancer.

　　The most commonly used triple therapy is as follows: Losec + Amoxicillin + Metronidazole. (2) Losec + Erythromycin + Metronidazole. (3) Losec + Amoxicillin + Erythromycin. You can choose any of the above groups of drugs to take, with a course of 7-14 days. The use of drugs should be targeted by local doctors. After the course is over, continue to take Losec alone for another 2 weeks. When using triple therapy, attention should be paid to the toxic and side effects of drugs (especially anti-Hp drugs), such as nausea and pustular tongue with Metronidazole; Amoxicillin, Erythromycin can cause diarrhea, nausea, glossitis, allergic urticaria, rash, and drug fever, etc., so medication should be taken under the guidance and supervision of a doctor. Amoxicillin needs to be skin tested. This program can kill Helicobacter pylori and protect the gastric mucosa. Stick to it to prevent recurrence.