34-Year-Old Man Diagnosed with Helicobacter Pylori Infection – A Warning Sign of Pre-Cancerous Changes

Summary: A 34-year-old male patient experienced recurring upper abdominal pain and was diagnosed with Helicobacter pylori (H. pylori) infection after an endoscopic biopsy revealed gastric mucosal atrophy and intestinal metaplasia. He underwent endoscopic submucosal dissection to remove the affected tissue, followed by antibiotic therapy. His symptoms resolved within two months, and follow-up tests confirmed the infection had cleared.

Patient Profile: Male, 34 years old
Type of Illness: Helicobacter pylori infection
Treating Hospital: The First Affiliated Hospital of China Medical University
Date of Visit: March 2021
Treatment Plan: Endoscopic submucosal dissection + oral antibiotics (amoxicillin, clarithromycin) + intravenous proton pump inhibitor (pantoprazole sodium)
Treatment Duration: 10-day hospitalization with a follow-up appointment after two months
Outcome: Successful surgery, complete resolution of abdominal pain, and eradication of H. pylori infection

Initial Consultation
The patient, a 34-year-old man, visited the clinic due to persistent upper abdominal discomfort. He had no family history of cancer but worked as a truck driver and frequently dined out. During the physical examination, all vital signs—temperature, pulse, respiration, and blood pressure—were within normal ranges. He was alert, cooperative, and in good general health. Given his symptoms, a gastrointestinal disorder was suspected, prompting an endoscopy that revealed roughened antral mucosa. Biopsy results showed moderate intestinal metaplasia with mild dysplasia and confirmed H. pylori positivity. Based on these findings, he was admitted for further treatment.

Course of Treatment
After discussing the diagnosis with the patient, it became clear that his condition included pre-cancerous changes in the gastric lining—moderate intestinal metaplasia with mild dysplasia. Given the risk of progression to gastric cancer, prompt intervention was crucial. We recommended endoscopic submucosal dissection to remove the abnormal mucosal tissue and prescribed a triple therapy regimen to eradicate the H. pylori infection. The procedure was performed successfully, and post-operative care included intravenous pantoprazole, along with oral amoxicillin and clarithromycin. After a 10-day hospital stay, the patient was discharged with stable health.

Post-Treatment Evaluation
The surgical removal of the affected mucosa was completed without complications such as bleeding, infection, or bowel adhesions. Follow-up endoscopy and biopsies still showed moderate intestinal metaplasia, but after completing a seven-day course of anti-H. pylori medication, the patient reported no discomfort, slept well, and resumed normal eating and bowel habits. His abdominal pain had completely subsided. Two months after discharge, follow-up testing confirmed that the H. pylori infection had turned negative.

Recommendations for Long-Term Health
The patient's recovery was smooth and successful, which is encouraging news. However, to prevent recurrence and further complications, I advised him to take the following precautions:

Maintain strict food hygiene: Avoid raw or undercooked foods, drink only boiled or purified water, and use personal utensils when dining out to reduce the risk of bacterial transmission.

Schedule regular screenings: H. pylori infection is prevalent worldwide, so annual gastroscopy is highly recommended to monitor for reinfection or early signs of gastric abnormalities.

Encourage family members to get tested: Since H. pylori is contagious, close contacts should also undergo screening and receive treatment if necessary.

Clinical Insight and Final Thoughts
This case highlights the importance of vigilance when it comes to dietary habits and gastrointestinal health. As a long-haul truck driver, the patient's frequent consumption of meals outside the home likely contributed to his H. pylori infection. Chronic inflammation caused by this bacterium can lead to serious conditions like intestinal metaplasia—an early sign of potential cancer development. Fortunately, early detection and comprehensive treatment helped reverse his condition. This case serves as a reminder that timely medical attention can make a life-changing difference. If you experience persistent digestive issues, don't delay seeking professional help.