幽门螺杆菌感染

定义

幽门螺杆菌 (H幽门) is a type of bacteria that infects the stomach. It is very common, affecting about two thirds of the world's population. H幽门 感染是最常见的原因 消化性溃疡. However, the infection does not cause problems for most people.

选择的名字

幽门螺杆菌感染

原因

H幽门 bacteria are most likely passed directly from person to person. 这往往发生在儿童时期. The infection remains throughout life if not treated.

It's not clear how the bacteria are passed from one person to another. 细菌可从以下途径传播:

• 口对口联系
• GI tract illness (particularly when vomiting occurs)
• 接触粪便(粪便物质)
• 受污染的食物和水

The bacteria may trigger ulcers in the following way:

• H幽门 enters the mucus layer of the stomach and attaches to the stomach lining.
• H幽门 cause the stomach to produce more stomach acid. This damages the stomach lining, leading to ulcers in some people.

除了溃疡, H幽门 bacteria can also cause a chronic inflammation in the stomach (gastritis) or the upper part of the small intestine (duodenitis).

H幽门 can also sometimes lead to stomach cancer or a rare type of stomach lymphoma.

症状

大约有10%到15%的人感染 H幽门 发展消化性溃疡疾病. 小溃疡可能不会引起任何症状. 有些溃疡会导致严重出血.

An aching or burning pain in your abdomen is a common symptom. 空腹时疼痛可能更严重. The pain can differ from person to person, and some people have no pain.

其他症状包括:

• Feeling of fullness or bloating and problems drinking as much fluid as usual
• Hunger and an empty feeling in the stomach, often 1 to 3 hours after a meal
• 轻度恶心，可能随呕吐而消失
• 食欲不振
• 不劳而获的减肥
• 打嗝
• 带血或黑色，带有柏油的大便 或者流血呕吐物

考试和测试

你的十大赌博平台排行榜会给你做测试 H幽门 如果你:

• 有消化性溃疡或溃疡史
• Have discomfort and pain in the stomach lasting more than a month

Tell your provider about the medicines you take. The nonsteroidal anti-inflammatory drugs (NSAIDs) can also cause ulcers. If you show the symptoms of infection, the provider may perform following tests for H幽门. 这些包括:

• Breath test -- urea breath test (Carbon Isotope-urea Breath Test, or UBT). Your provider will make you swallow a special substance that has urea. If H幽门 are present, the bacteria turn the urea into carbon dioxide. This is detected and recorded in your exhaled breath after 10 minutes.
• 血液测试——测量抗体 H幽门 在你的血液里.
• Stool test -- detects the presence of bacteria in the stool.
• Biopsy -- tests a tissue sample taken from the stomach lining using 内窥镜检查. 检查样品是否有细菌感染.

治疗

In order for your ulcer to heal and to reduce the chance it will come back, 十大赌博平台排行榜会给你开以下药物:

• 杀死 H幽门 细菌(如有)
• 减少胃里的酸

Take all of your medicines as you have been told. 其他 生活方式的改变 也有帮助.

如果你有消化性溃疡和 H幽门 感染，建议治疗. The standard treatment involves different combinations of the following medicines for 10 to 14 days:

• 抗生素致死 H幽门
• Proton pump inhibitors to help lower acid levels in the stomach
• Bismuth (the main ingredient in Pepto-Bismol) may be added to help kill the bacteria

Taking all of these medicines for up to 14 days is not easy. But doing so gives you the best chance for getting rid of the H幽门 防止将来出现溃疡.

前景(预测)

If you take your medicines, there is a good chance that the H幽门 感染会被治愈. You will be much less likely to get another ulcer.

有时, H幽门 能不能完全治愈. Repeated courses of different treatments may be needed. A stomach biopsy will sometimes be done to test the germ to see which antibiotic might work best. 这有助于指导未来的治疗. 在某些情况下， H幽门 can't be cured with any therapy, though the symptoms may be able to be reduced.

If cured, reinfection may occur in areas where sanitary conditions are poor.

Posssible并发症

长期(慢性)感染 H幽门 可能导致:

• 消化性溃疡
• 慢性炎症
• 胃溃疡和上肠溃疡
• 胃癌
• Gastric mucosa-associated lymphoid tissue (MALT) lymphoma

其他并发症可能包括:

• 严重失血
• Scarring from an ulcer may make it harder for the stomach to empty
• Perforation or hole of the stomach and intestines

何时联系医疗专业人员

Severe symptoms that begin suddenly may indicate a blockage in the intestine, 穿孔, 或出血, 这些都是紧急情况. 症状可能包括:

• 大便呈柏油状、黑色或带血
• 严重的呕吐, which may include blood or a substance with the appearance of coffee grounds (a sign of a serious hemorrhage) or the entire stomach contents (a sign of intestinal obstruction)
• Severe abdominal pain, with or without vomiting or evidence of blood

Anyone who has any of these symptoms should go to the emergency room right away.

参考文献

陈福良，刘志伟. 消化性溃疡. 见:Feldman M, Friedman LS, Brandt LJ编. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11日艾德. Philadelphia, PA: Elsevier; 2021:chap 53.

掩护TL，激光MJ. 幽门螺杆菌 and other gastric Helicobacter species. In: Bennett JE, Dolin R, Blaser MJ，编辑. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9日艾德. Philadelphia, PA: Elsevier; 2020:chap 217.

Ku GY, Ilson DH. 胃癌. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff临床肿瘤学. 6日艾德. Philadelphia, PA: Elsevier; 2020:chap 72.