What to do if Helicobacter pylori is weakly positive

When a patient is examined in the hospital and a weak positive Helicobacter pylori test result appears on the test sheet, it generally means that the patient has chronic gastritis or a gastrointestinal ulcer, which is quite harmful to the patient. Of course, the specific situation must be analyzed. At this time, medication should be used in a timely manner. Amoxicillin capsules and clarithromycin can be used for treatment. Attention should be paid to the integrity of the treatment. At ordinary times, emphasis should be placed on diet. Overeating should not be allowed. In addition, avoid catching a cold and get enough rest. Especially for patients, regular observation and re-examination are required. In addition, with good conditioning in daily life, there will generally be no problem.

Helicobacter pylori (Hp) is a Gram-negative microaerophilic bacillus. In 1983, Australian scholars Marshall and Warren isolated Helicobacter pylori for the first time from the gastric antral mucus layer and epithelial cells of patients with chronic gastritis. Hp infection is distributed globally. It colonizes the gastric mucosa of most people and causes chronic inflammation, which is mostly asymptomatic. However, Hp is closely related to the occurrence of some upper gastrointestinal diseases, is an important pathogenic factor of chronic gastritis and gastroduodenal ulcers, and is closely related to the occurrence of gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma.

Helicobacter pylori and related diseases

1. Hp and gastrointestinal diseases

It has been confirmed that Hp is closely related to chronic gastritis, peptic ulcer disease, gastric cancer, and MALT malignant lymphoma. The Hp infection rate in patients with chronic gastritis exceeds 90%. Hp colonizes in the gastric metaplastic epithelium in the duodenum, causing mucosal damage and leading to the formation of duodenal ulcers. WHO (World Health Organization) lists Hp as the first-level carcinogen for gastric cancer and believes that Hp infection is closely related to the occurrence of gastric cancer.

2. Hp and extra-gastrointestinal diseases

Hp is not only closely related to gastrointestinal diseases, but also to multiple system diseases, such as hepatobiliary diseases (hepatic hyperammonemia, fatty liver, chronic cholecystitis and cholelithiasis), nervous system diseases (cerebral infarction), cardiovascular diseases (atherosclerosis, coronary heart disease, arrhythmia), blood system diseases (unexplained iron deficiency anemia, idiopathic thrombocytopenic purpura), etc.

treat

Currently, not all people infected with Helicobacter pylori require treatment. If there are no clinical symptoms, even if Hp is positive, there is no need to eliminate Hp. You can observe regularly and decide how to treat based on the doctor's advice.

Radical treatment is required if the following treatment indications are present: ① peptic ulcer; ② gastric mucosa-associated lymphoid tissue lymphoma; ③ HP-positive chronic gastritis with dyspepsia; ④ chronic gastritis with gastric mucosal atrophy or erosion; ⑤ early gastric tumor that has undergone endoscopic resection or surgical subtotal gastrectomy; ⑥ family history of gastric cancer; ⑦ plan to take non-steroidal anti-inflammatory drugs (including low-dose aspirin) for a long time, etc.

To date, there is no single drug that can eradicate H. pylori, so the combined use of proton pump inhibitors (PPIs) with antibiotics and bismuth is advocated. There are currently a variety of eradication options, including standard triple and quadruple therapy, concomitant therapy, sequential therapy, and mixed therapy.