It has long been believed that the gastric environment is sterileconcerning the dwelling in it of microflora. In the stomach with its internal content - acid, simply not survive a single organism. Detection in the digestive tract Helicobacter Pylori revolutionized the perception of the nature of gastrointestinal diseases: gastritis, duodenitis, gastric and duodenal ulcers, gastrointestinal oncology and their treatment. In this article, we will consider in detail what eradication is. This is a definite method of treatment, which has become very popular lately.
Excursus in the history of Helicobacter pylori
In fact, a bacterium has been detected for a long time, andnot once. For the first time this happened at the end of the century before last. It was in 1886. Professor Jagiellonian University V. Yavorsky discovered a bacterium of characteristic spiral shape in gastric materials. He gave the bacteria the name Vibrio rugula, and suggested that it plays some role in the development of gastric diseases.
However, due attention in medical circlesYavorsky's work did not receive. Seven years later, the Italian scientist D. Bidzodzero extracted a similar microorganism from the digestive tract of the dog. Next, who noted the presence of bacteria in the stomach cells of operated ulcer patients, was Professor I. Morozov from Moscow. This was already the end of the 70s of the last century.
Further attempts to somehow describe,classify, grow in a laboratory and study an unnamed bacterium in 1979 and 1981 by Australians Marshall and Warren. And they succeeded. Marshall conducted a successful experiment on self-contamination of Helicobacter pylori and the cure of acquired Helicobacter pylori by a two-week course of taking Metronidazole and bismuth salts.
This method formed the basis for the modern eradication of Helicobacter pylori. And brave researchers in 2005 received the Nobel Prize in Medicine.
Name Helicobacter pylori microorganismreceived in 1989, as well as a full description and classification. The spiral-shaped bacterium, the habitat chosen by the "gatekeeper" of the stomach ("pylori" - from the Greek "gatekeeper"), infects all areas of the duodenum and gastric. In a significant percentage of all gastritis, duodenitis, ulcers of the intestine and duodenum up to their cancer, this microorganism is guilty.
What is dangerous for Helicobacter pylori infection?
Helicobacter pylori, inhabited in the human gastrointestinal tract oranimal, until about time behaves roughly. At the slightest malfunction in the immune system, or with the accumulation effect of irrational nutrition or bad habits, the bacterium becomes active, becomes aggressive. Than it is dangerous? Inhabited in the mucous membrane of internal organs - the stomach and duodenum - the microorganism pathogenically affects it.
There is an increased secretion of secrets thathas a detrimental effect on the gastrointestinal tract. The mucous membrane becomes loose, collapses, strongly inflamed areas appear with ulceration. Chronic gastritis caused by the pathogenic microorganism of the Helicobacter Pylori group, unlike conventional mechanical gastritis, can not be cured by conventional methods.
Helicobacter pylori penetrates more and moredeep layers of tissues, as a result of which it is not susceptible to the action of most antibiotics (antibiotics are unstable to acidity). Such her vandalism causes irreversible processes in the mucosa, for example, a precancerous condition, and, directly, the development of oncology. To prevent this from happening, Helicobacter eradication is used.
Diagnosis Helicobacter Pylori in the digestive tract
If the patient complains of nausea and indigestion,heartburn, pain, problems with stools, painful discomfort in the epigastric region - this is a direct indication to pass tests for the presence of Helicobacter pylori in the body. Analyzes give the following:
- blood, a general analysis for antibodies, including the presence of Helicobacter pylori;
- feces, analysis for the presence of waste products of bacteria;
- a breath test based on a certain concentration of ammonia in the exhalation;
- cytological analysis.
The most reliable method of diagnosing infection is a biopsy of the tissues of the stomach and duodenal mucosa. The tissue for analysis is taken by endoscopy.
Indications for the use of eradication
As mentioned above, eradication is a method of fighting a gastric bacterium.
Eradication is carried out by the patient with such pathologies:
- Ulcerative manifestations in the stomach and duodenum;
- postresection status (surgery to remove a cancerous tumor);
- precancerous conditions with tissue atrophy of organs;
- lymphoma.
The risk group includes people whose relatives have had oncological diseases. Recommended eradication therapy and patients with gastroesophageal reflux and functional dyspepsia.
Methods of eradication
Эрадикация – это уничтожение, искоренение (англ.eradication). This is a measure designed to destroy Helicobacter pylori in the digestive tract. The method of treatment is indicated in patients with a severe form of a stomach or duodenal ulcer. Its essence lies in the course of taking medications according to a certain scheme.
Before the beginning of the course, an additional study of the tissues of the gastric mucosa on the presence of malignant cells is carried out.
Helicobacter pylori eradication has several types:
- mono, where only one drug is used in treatment, usually drugs based on bismuth salts or antibiotic;
- duo, double therapy (bismuth-containing substance plus antibiotic);
- triplet, as the name implies, this treatment by three agents (bismuth, antibiotic and imidazole group);
- quadruplet, four-component form, where IPN (blockers of hydrochloric acid formation) is added to the triplet therapy complex.
Mono eradication is a practically ineffective method of therapy because of its inefficiency (below 50%). He was on the move at the dawn of discovery and the first experiments on the treatment of helicobacterial infection.
Eradication with the use of two medicines hasthe effectiveness of getting rid of Helicobacteria is about 60%, and also in modern realities is little practiced. What is used today eradication? Treatment schemes are used such.
The triplet therapy includes a bismuth compound, an antibiotic (amoxicillin and claritomycin are often used), and imidazoles (these are fungicides).
Курс из четырех лекарств - это все the above drugs plus Proton pump inhibitors (an antiulcer group of drugs aimed at reducing stomach production of acid). The methods have efficiency indicators of 90% and 95%, respectively. This is how Helicobacter eradication can be effective.
Medical products used for eradication
In view of the fact that the acidic environment nullifies the effect of most antibiotics, the list of medicines for eradication is rather short:
- antibiotics;
- anti-infectious agents;
- bismuth preparations;
- proton pump inhibitors;
- probiotics and prebiotics.
Antibiotics most commonly used in eradication therapy
How does eradication begin? Antibiotics are prescribed as follows:
- "Amoxicillin" or "Flemoxin Solutab" - penicillin group, suitable for most patients, not recommended for use in pregnancy, renal failure.
- "Amoxiclav" - a combination of amoxicillin andcavulonic acid, a broad-spectrum antibiotic, it is recommended that it be used cautiously with the patient's renal pathologies, this pregnancy causes serious dysbacteriosis during pregnancy.
- "Clarithromycin" or "Klacid" - low toxicThe broad spectrum erythromycin group antibiotic, most popular for eradication, is contraindicated in infants up to half a year, pregnant, and should be used with caution in patients with renal and hepatic insufficiency.
- Azithromycin is an alternative to Claritomycin with minimal side effects, although it is less effective than Helicobacter Pylori.
Antibiotics "Tetracycline" and "Levofloxacin"used less frequently and in cases where the above drugs have not had the desired result. Preparations of the tetracycline group have an aggressive effect in terms of side effects after Helicobacter eradication, therefore, they are used less frequently.
Antibacterial and anti-infective eradication drugs
Metronidazole is an anti-infective chemotherapeutic agent of the nitromidazole group, very toxic, strictly incompatible with alcohol and prohibited during pregnancy.
"McMiror" or "Nufuratel" is an antibacterial drug, it is used in case of the ineffectiveness of Metronidazole.
Bismuth preparations
"De-Nol" - this is the medicine that showed the highestthe degree of neutralizing effects on helicobacter. "De-Nol" dissolves and penetrates into the bile mucus into the deepest layers of the affected organ. There are practically no negative side effects, as well as contraindications (except, traditionally, pregnancy).
Less commonly used in the treatment of helicobacter salts are bismuth compounds:
- bismuth subsalicylate;
- bismuth subnitrate.
Preparations based on bismuth salts usedfor the treatment of gastrointestinal diseases even before the discovery of Helicobacter pylori. These compounds are resistant to the acidic environment of the stomach. On the damaged surface of the mucous membrane, bismuth compounds form a protective film from an aggressive environment, reduce acidity and contribute to the rapid scarring of the affected surfaces.
When opening Helicobacter Pylori, bismuth compounds showed a stunning effect on the inhibition and destruction of this particular bacterium.
IpN drugs used for eradication
Proton pump inhibitors (PPI) are indispensable incomplex effects on Helicobacter pylori. Injection preparations have a peculiar antacid effect, which reduces the aggressiveness of the acidic environment. Bacteria research has shown that it dies outside the acidic environment. Consequently, PITs create intolerable conditions for the comfortable existence of a bacterium, which, in combination with bismuth, Metronidazole and an antibiotic, increases the success of Helicobacter pylori eradication to 95% and more. These drugs include:
- Omez (Omeprazole);
- Nolpaz;
- Rabeprazol;
- Pantoprazole, etc.
Most often appointed precisely "Omez". Proton pump blockers or PPIs slow down the secretion of the digestive glands.
Normalization of the gastrointestinal microflora after eradication of Helicobacter
The effects of antibiotics in most casesdetrimental to the intestines and stomach. Therefore, after the eradication procedure, it is necessary to minimize the damage caused to the body. For this there are such useful products as probiotics or prebiotics, shown in dysbacteriosis, flatulence, diarrhea, etc. These include:
- "Lactoferon";
- Linex;
- Hilak Forte;
- "Bifidumbacterin";
- "Atsipol" and so on.
Probiotics and prebiotics - fundamentally differentcultures that harmoniously complement each other’s work. Both groups have a beneficial effect on the body by normalizing the intestinal microflora. The difference between them is that probiotics are a living culture of beneficial microorganisms. Prebiotics are organic chemical compounds. The first directly "grow up" the killed microflora, the second - create favorable conditions for this. They must be taken after eradication.
Disease prevention
Each latent carrier of Helicobacter pylori can be. The microorganism lives in the stomach, intestines and mouth of a person or animal and for years does not manifest itself.
Activation of bacteria occurs due toimmune failure, stress, bad habits (alcohol, smoking), unbalanced diet and manifests itself epigastric pain. Some types of Helicobacter pylori are able to infect the liver.
Conclusion
Infection from the carrier of infection occursby contact or through household items. You should carefully follow the rules of personal hygiene in order to minimize third-party infection. Then the eradication of Helicobacter Pylori is not required.
