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Comment by lkrubner | Hacker News Reader

Sad to say, the fecal-oral cycle of infection remains common in the USA, with the most common areas of spread being restaurants although hospitals were sadly guilty of this until recently. And for any gastrointestinal illness in the USA, the single most common cause is Helicobacter pylori. Back in the 1980s and 1990s researchers mostly associated Helicobacter pylori with ulcers, but since then the research has expanded to show it produces a wide range of symptoms. It is a serious illness, even if you never develop an ulcer. And it so contagious that you can get it simply by kissing someone. And it is shockingly prevalent, with more than 20% of the public having it. It is always the first thing that should be checked when someone has weird gastrointestinal issues. The good news is that it is easy to cure: 14 days of antibiotics cures the disease in 96% of patients.

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The one thing that shocked me after moving to the States was how no one washed their hands before meals. It's just not a thing.

weird, I've lived in the US most of my life and I think pretty much everyone washes their hands?

When people walk into a restaurant - fast food, slow food - especially before COVID, do you see people go to the bathroom to wash their hands before the meal? That never happens.

I've never seen it happen either - and I live in Poland, though I haven't seen it in my various visits to China, Germany and the UK either. Who actually does go into the restaurant bathroom specifically to wash their hands before the meal?

I do - it just makes sense if you are riding public transport or touching stuff that isn’t as clean as you’d think. Like your phone, wallet, keys, backpack, shoe laces, pant pockets, etc. Not obsessively, but if I haven’t washed my hands in a few hours or feel they are dirty I wash them before eating.

Spanish here. I do it all the time. I even carry a small bottle of alcohol in case I go to a place where I can't wash my hands first.

I would say most people do wash their hands here, however I have seen everything. From people not washing them to people using the toilet, not washing them, and then sitting on the table for lunch.

I'm Polish and I do - so do some of my friends. Typically right after ordering, before even the beverages have a chance to arrive.

My father would wash hands after petting a dog even, so I guess it's his germophobia that set the standard in my household.

my wife is Polish and makes sure everyone washes they hands before eating. This isn't common in the USA.

I usually go wash my hands once I’ve ordered at a sit down restaurant.

Three simple habits that have (anecdotally) cut down on colds for me:

* wear a mask in crowded environments where showing my face doesn't buy me anything (I don't wear one at work, but do at the grocery store or airport)

* wash hands before eating (or at least use hand sanitizer)

* grip the exit handle of the bathroom with a paper towel and dispose of it on exit

Not exactly double blind demonstrated but low cost and this year has been much better than last (which may also be due to my immune system having caught back up, too, so YMMV)

I usually carry a bottle of hand sanitizer to clean my hands before meals. I started doing this even before the pandemic, to avoid getting sick with the common cold.

A good number of people do this in my city: when I go on public transit, I see a fair number of commuters with a hand sanitizer bottle clipped to their bag with a carabiner. Many people also have a bottle in their pockets or purse.

After COVID, yes, that is true. People take it more seriously now (although things seem to be snapping back).

I would go out to lunch with mu coworkers and I would give out everyone wet wipes because I was the only one who had them, specifically for this.

> When people walk into a restaurant

No, we order first and then do it.

Especially after touching menus - which are almost never washed!

It's nominally a thing, but a lot of people don't do it.

I was certainly raised to do it.

So true. The thing that always shocked me outside of the US was the inverse. The habit to clean hands soap or just a moist towel but then the lack of soap and sanitation in the restrooms.

It's a thing in our household. Everyone washes hands before eating. When we go to restaurants, we order, then take turns washing hands. I guess it depends on where in the U.S.

That sounds pretty gross really. :(

Unfortunately, antibiotics can fuck up your gut in other ways.

Most people can take 14 days of an oral antibiotic without significant long-term adverse consequences.

As of 15 years ago, according to my doctor, while on the antibiotic, sacchromyces boulardi is the best probiotic to take to try to minimize the risk of adverse consequences.

Both can be true, antibiotics can cause substantial side effects in some people and most people will be fine. Still sucks if you are not one of those most people.

Yes, it still sucks, but so do uncontrolled chronic bacterial infections.

I have never been given a probiotic while getting an antibiotic.

Seems like a good idea. Is that a common thing? Does the evidence support this?

Studies say dunno: https://www.bbc.com/future/article/20190124-is-it-worth-taki...

Personally I try to take some biotic food - yoghurt and the like

When this happened (again about 15 years ago) I was taking a very long course of antibiotics.

Antibiotics seem to be underused for GI issues, anecdotally I’ve experienced a dramatic reduction (even elimination) of some GI issues when using antibiotics (Z-pack) for unrelated infections (a course followed by quality probiotics like Visibiome).

The positive changes seem sticky!

On the other hand, we're discovering that certain antibiotics can be very useful in treating specific GI conditions.

Rifaximin, and antibiotic designed to stay in your gut, has been approved for treating specific types of IBS. When it works it can induce remission for months or longer.

Story time: I went through a dark and stressful period of my life when I was in my teens. After I mostly got over the issues, I went on a vacation with a friend and his family. At one point in the vacation, I ended getting some kind of food poisoning from shellfish that apparently no one else who at the same meal got. Anyway, I eventually recovered in a few days, but it seemed as though I never fully recovered. I had frequent GI issues for literal years.

I sometimes wonder if the intense stress and whatnot that I had experienced prior some how made me more susceptible to whatever illness I happened to succumb to? No way to truly know, I suppose.

After various specialists and unhelpful treatments for what was later deemed to be "IBS", I was recommended to try something by my GP. He gave me some antibiotic (this was 15 years or so ago) it may have been that one -- Rifaximin -- I know it started with an "R." Anyway, my GP warned me that he came across it in some research, and would be willing to give a try, but I was not to get my hopes up.

I took the antibiotics for 14 days. Towards the end of the regiment, I was starting to have symptoms far worse than normal, but I pushed through. 15 years or so later, I basically have no issues at all. Whatever the drug was it was like a freaking miracle cure.

If you have medical records (ie at the doctors office, etc), then maybe you can ask them about it the next time you visit the doctor?

Have a family member being treated for Helicobacter pylori right now! He was very worried it was cancer as the symptoms seemed to align. Interestingly he is allergic to penicillin which is complicating the treatment.

What’s to stop you from Just getting it again two days later?

Just like respiratory infections, some people get it multiple times, and have to be treated multiple times.

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