Antibiotics kill Helicobacter. Treatment of Helicobacter: treatment regimen, recommendations. Proton pump inhibitors

The treatment regimen for Helicobacter pylori always includes several drugs. Only A complex approach can give the desired result, since the bacterium has high degree survivability. This microorganism is able to resist both acidic environment stomach, and many modern antibiotics. A correctly selected treatment regimen is when high eradication of Helicobacter pylori is ensured.

What is a bacterium

Helicobacter pylori is a spiral-shaped bacterium that thrives even in an acidic stomach environment, because it secretes substances that neutralize this acid. Bacteria multiply very quickly, causing inflammation of the gastric mucosa. It is difficult to destroy them, since antibiotics for Helicobacter pylori are often powerless. And all because people use antibiotics so often, when necessary and not necessary, that many bacteria, including Helicobacter, have perfectly adapted to them, becoming insensitive to the action of many antibiotics.

The bacterium was first discovered in the 19th century by German scientists. But at that time it was not yet possible to study this microbe and its effect on the human body. It was only in 1980 that American and Australian scientists gave an accurate description of the bacterium. Research scientist Barry Marshall had to drink the contents of a Petri dish to go from infection to recovery. With the help of this experiment, it was possible to prove that it is these microorganisms, and not errors in nutrition, that in 70% of cases are the culprits of gastritis and stomach ulcers and duodenum.

After research by scientists, the search for diagnostic and treatment tools began. Finally, they began to wonder: how to treat Helicobacter pylori - associated gastritis and other stomach diseases, where the cause of their occurrence was Helicobacter. And it turned out that traditional methods it is impossible to defeat the bacteria. Universal medicine Helicobacter pylori still does not exist. Therefore, a multicomponent treatment regimen for Helicobacter pylori with antibiotics and antibacterial drugs is necessary.

If a person is inattentive to his health and does not seek treatment medical care at the first problems with the stomach, then later you may face serious consequences from exposure to Helicobacter. The problem will become expressed as superficial antral, erosive, then mixed gastritis. The development of an ulcerative process is possible. Prolonged course inflammatory processes in the mucosa caused by Helicobacter pylori, leads to dystrophic changes and epithelial restructuring of the gastric mucosa. Foci of atrophic mucosa appear, then with intestinal metaplasia, and then the development of an oncological process is possible.

Under no circumstances should you self-medicate, much less take self-prescribed pills. It can only make things worse. Tell us what antibiotics to fight the bacteria, and also choose correct scheme Treatment of Helicobacter pylori can only be done by the attending physician.

How does infection occur?

It is very easy to become infected with this pathogenic microorganism. Helicobacter, having entered the body, immediately strives for the digestive organ and digs into the mucous membrane, thanks to its special structure. Over time, a colony of bacteria is created, which, multiplying, causes inflammation of the gastric mucosa, further increasing acidity gastric juice. The walls of the stomach under the influence of microbial activity and increased of hydrochloric acid begin to deteriorate, which leads to the formation of ulcers.

The route of transmission of Helicobacter pylori is through contact and household contact:

• through kisses;
• Children become infected through utensils: spoons, glasses, plates, as well as through pacifiers.

Important! It is difficult to choose against Helicobacter pylori necessary antibiotics and overcome with medication, but this tenacious microorganism quickly dies in the open air.

How to suspect an infection

• epigastric discomfort;
• nausea, belching air or sour;
• pain in the digestive organ before eating, subsiding or intensifying after eating;
• regular heartburn.

If at least one of the above symptoms is gastrointestinal tract repeats regularly, you should definitely visit a doctor, get examined and, if necessary, undergo eradication therapy.

Systematic approach to treatment

For many years, scientists around the world have been trying to find universal remedy fight against dangerous bacteria. Treating Helicobacter pylori infection in the stomach, both in adults and children, is very difficult, since it is resistant to many modern antibiotics. A breakthrough in this matter occurred in 1996 after successful testing of new methods that many world scientists and pharmaceutical giants worked on. These methods were called lines of eradication therapy. It is now much easier for gastroenterologists to identify rather than treat patients because the approach to eradication therapy has become systemic. If not cured using the first line, a second line is prescribed. Each line has several options.

First line: treatment option

• proton pump inhibitor (PPI) twice a day (Omez, Omeprazole, Rabeprazole - 40 mg each);
• Clarithromycin (0.5 g twice a day) or Josamycin (dose twice as much), or Nifuratel (0.4 g twice a day);
• Amoxicillin in doses of 0.5 g four times a day or 1 g twice a day.

Second line: treatment option

If treatment does not help, the option of the second line of eradication is selected:

• Bismuth tripotassium dicitrate;
• Metronidazole;

To the complex drug therapy often include De-Nol. This is a bismuth-containing drug that affects Helicobacter and prevents it from multiplying. Together with antimicrobial drug De-Nol leaves no chance for pathological microorganisms to survive. In addition, it protects the gastric mucosa, thereby promoting healing.

The Helicobacter pylori eradication scheme is developed taking into account individual characteristics the patient and the sensitivity of the bacteria themselves.

Gastroenterologists have a clear algorithm of actions when antibiotic treatment is really necessary:

• when an ulcer is discovered upper section Gastrointestinal tract;
• surgery was performed due to cancer digestive organ;
• gastritis, including with atrophy of the gastric mucosa;
• gastric cancer as a hereditary factor;
• functional dyspepsia.

Patients with diseases that require long-term therapy with non-steroidal anti-inflammatory drugs, with gastroesophageal reflux, are tested for the presence of Helicobacter pylori.

In a word, eradication is always carried out when Helicobacter is detected and its obvious damaging effect on the stomach, that is, when there are signs of inflammation of the gastric mucosa.

A treatment regimen for gastritis with Helicobacter has also been developed.

For gastritis with increased acidity:

• eradication anti-Helicobacter regimen;
• prokinetics (Motilium, Metoproclamide, Itopride and their analogues) – in case of impaired motor function of the stomach (in the clinic, heartburn as a result of reflux);
• antispasmodics (Drotaverine, No-Shpa, Duspatalin) - to relieve pain;
• cytoprotectors (Venter).

For gastritis with low acidity:

• eradication anti-Helicobacter pylori regimen without antisecretory drugs PPI (Omeprozole, Rabeprozole and their analogues) - with severe achylia (decreased acidity level);
• drugs that increase acidity (Plantaglucid, Limontar) or replacement therapy(Abomin, Pepsidil, gastric juice, Acidin-pepsin);
• Otherwise, the treatment regimen does not differ from the treatment of gastritis with normal or high acidity (antispasmodics, prokinetics, cytoprotectors) - as necessary.

In order not to treat Helicobacter pylori, it is better to prevent it from entering the body. First of all, of course, you need personal hygiene. Although the routes of infection are not always directly related to personal hygiene. That is, the risk of acquiring a microorganism is quite high for any person at any age.

Thus, personal hygiene and healthy image life.

The bacterium Helicobacter pylori is the causative agent of a large number of inflammatory diseases Gastrointestinal tract. A correctly prescribed treatment regimen gives a chance for a complete recovery and relief from unpleasant symptoms, which often interferes with living and working. If you experience pain, stinging, heartburn or frequent belching It is important to go to the doctor to prescribe therapy.

How is Helicobacter pylori treated?

If a Helicobacter pylori infection has been detected, a photo of which clearly shows its structure, then therapy can occur in two directions: using drugs whose action is aimed at regulating the level of gastric juice, and also unconventional methods. The treatment regimen for Helicobacter pylori still causes some controversy among doctors, because the infection has developed a strong immunity to specific drugs. The patient may be in the hospital or at home during therapy.

Folk remedies

When treating a disease in unconventional ways emphasis should be placed on long-term use herbal decoctions, freshly squeezed juices, which have an enveloping effect, relieve pain syndrome, help get rid of acne and other signs of illness. The doctor also selects combinations of herbs that will allow you to quickly remove pathogenic microbes and fight inflammation. The treatment regimen for Helicobacter pylori includes the following recipes: traditional medicine:

1. Take the following herbs in equal quantities: elecampane root, St. John's wort, yarrow. Pour liters of boiling water over the weight. Wrap the container with the broth and keep it there for 30 minutes. Filter with gauze, take a glass before meals 3 times a day.
2. Combine three herbs in equal proportions - calendula, St. John's wort and yarrow leaves. Prepare boiling water, pour 3 tablespoons of the dry mixture into two glasses. Set aside for an hour and then filter. The dosage for administration is half a glass, drink three times a day. This remedy not only fights bacteria, but also has an analgesic effect.
3. In equal proportions you need pear, apple, strawberry inflorescences, and lingonberry leaves. For 1 tbsp. l. 4 liters of boiling water goes into the dry part of the mixture. Wait 5 minutes, strain. The general daily dose will be 300 ml, consumed 3 times.

Eradication therapy scheme

Based on ongoing research, world luminaries have come to the conclusion that none of the eradication treatment regimens for bacteria gives a 100% guarantee that this virus will be defeated. Therefore, the standard of therapy includes several options. If the patient does not get the desired result from the first regimen, then after additional examination he is prescribed a second one. But any medications can be prescribed only after a blood test has been taken, which shows that antibodies to Helicobacter pylori are positive.

Antibiotics

The goal of the eradication therapy regimen is to prevent recurrence of ulcers and reduce the risk of gastric cancer. When prescribing treatment, it is necessary to take into account the cost of drugs, the presence of allergies and adverse reactions. The doctor may prescribe the following course of antibiotic therapy:

1. Amoxicillin. This anti-Helicobacter drug has a wide range of effects. It consists of the first and second lines of the eradication scheme. May have a bactericidal effect, but only affects reproducing pathogenic microorganisms. Used to treat adults and children.
2. Amoxiclav. These antibacterial tablets are capable of killing the most stubborn bacteria. Combination drug consists of two active components: amoxicillin and clavulanic acid.
3. Klacid. Modern drug enjoys its effectiveness in treating bacteria. An antibiotic is used in many first-line eradication therapy regimens; it is guaranteed to prevent infection for a long time.

Drugs

Macmiror is an antibacterial drug. It has both a bacteriostatic and bactericidal effect. Its active components connect nucleic acids and prevent organisms from reproducing. The bactericidal effect consists of inhibiting vital biochemical reactions in the microbial cell.

Homeopathy

Using homeopathy, it is possible to quickly eliminate pathogenic microorganisms. The essence of therapy is to change the environment in the stomach and duodenum, which is favorable for life and reproduction harmful microbes. Homeopathy involves a gentle effect on Helicobacter pylori that is safe for the body, which is why it is popular. An additional advantage is that homeopathic medicines affordable.

Features of treatment

If the patient is not prescribed on time effective scheme therapy, the presence of Helicobacter pylori will lead to the development of ailments such as stomach ulcers and gastritis. These diseases are the most common, so it is important to take care to get rid of them as soon as possible. Otherwise, the patient will have stomach cancer, and here the therapeutic measures are much more complicated.

Stomach ulcers

Treatment of ulcers is aimed at eliminating the bacterium Helicobacter pylori. The reason is that it is highly resistant to antibacterial drugs. When choosing antibiotics, it is necessary to test the medications the patient has previously taken. It may happen that the bacteria will be resistant to them, and the prescribed treatment peptic ulcer will not be able to kill the infection. To check the effectiveness of the completed course, the patient will have to undergo diagnostics, including a breath test and a Helicobacter test.

Erosive gastritis

When the formation of the disease is influenced by the Helicobacter bacterium, the treatment regimen for gastritis should include drugs that neutralize this microorganism (De-nol). It is also important to visit a sanatorium, where therapy involves the use of alkaline mineral waters. Be sure to adjust your diet: remove spicy, sour and smoked foods from your diet. To restore normal gastric motility, it is necessary to take medications such as Cerucal, Motilium.

Diet for the presence of Helicobacter pylori bacteria

Only an integrated approach to treatment will defeat bacteria and eliminate inflammation. Doctors must prescribe to patients special diet, which is compiled individually, taking into account the level of acidity, and can serve as therapy or prevention. Here are its main provisions:

1. The intervals between meals should not be long.
2. Portions are small.
3. Chew food thoroughly.
4. It is important to drink enough plain water during meals.

Video

Helicobacter pylori is a microbe that causes diseases of the gastrointestinal tract. Its cunning lies in the presence of its own immunity to many antibacterial drugs. This makes the treatment of diseases more difficult. digestive system caused by this microbe. For this reason, a special treatment regimen for Helicobacter pylori has been developed, which is divided into subtypes that differ in the use of different tablets.

When is it necessary to treat a microbe with antibiotics?

People who have encountered the causative agent of most gastrointestinal diseases are often interested in: when should you take antibiotics and in what situations can you do without them? Such questions are not surprising. After all, many medications have a negative effect on the microflora of the stomach, causing allergic reactions, colitis, and indigestion.

Deep therapy is prescribed if:

• atrophic gastritis;
• ulcers of the stomach and duodenum;
• gastroesophageal reflux;
• functional dyspepsia;
• damage lymphatic tissue mucous membrane of the digestive organ.

Besides, antibacterial drugs used after eliminating a malignant tumor in the stomach. They are recommended for patients whose relatives include people with cancer. digestive organs, that is, there is a predisposition to this disease.

What antibiotics are used?

Initially, scientists identified more than 20 drugs that successfully deal with the microbe. However, as studies have shown, many of them lose activity under the influence of hydrochloric acid. And only 7 medications were approved by the Ministry of Health.

The list includes the following:

• tetracycline;
• tinidazole;
• levofloxacin;
• amoxicillin (flemoxin);
• Metronidazole.

Treatment of helicobacteriosis is prescribed by the doctor after full examination patient. Therefore, you should not immediately buy all the medications from the above list. Perhaps the specific situation does not require the use of antibacterial agents. Many patients live with the microbe for many years without feeling any symptoms.

Experts are of the opinion that children under 8 years of age do not need antibiotic treatment for bacteria, since their immunity is not yet fully developed.

How to treat Helicobacter pylori with antibiotics using standard triple therapy (first line)?

The scheme provides simultaneous administration two antibiotics and any drug from the group of proton pump inhibitors (PPIs) or (PPI) pumps. Their actions are aimed at reducing the formation of gastric juice.

The scheme may vary depending on the habituation of the bacteria stamp to the medicines and the inability of the patient’s body to accept the medicine. The following options exist:

1. They take clarithromycin (500 mg 2 times a day) and amoxicillin (500 mg 4 times a day), PPI medication (20 mg twice a day).
2. Use of clarithromycin (500 mg twice a day), amoxicillin (500 mg 4 times a day), PPI (20 mg 2 times a day), De-nol (240 mg twice a day).
3. The PPI drug is not taken, De-Nol and antibiotics are left in the same doses.
4. This option is used for elderly patients if standard scheme impossible. Gentle treatment is used: amoxicillin at a dosage of 0.1 g twice a day, De-nol 120 mg 4 times a day, a PPI (lansoprazole, pantoprazole or another) 20-40 mg twice a day.

Treatment of the microbe Hilary Bacter pylori lasts 7-14 days. The duration of the therapeutic course depends on the stage of the lesion, symptoms and other factors.

Quadruple eradication therapy (second line)

When previous methods are ineffective, four-component options are used. The duration of the therapeutic course reaches two weeks.

The options are as follows:

1. Tripotassium bismuth dicitrate (4 doses of 120 mg daily), PPI, tetracycline (4 doses of 500 mg), metronidazole (500 mg, 3 doses).
2. De-nol (240 mg 2 times), amoxicillin (500 mg 4 times), PPI, nitrofuran medicine.
3. Amoxicillin (500 mg 4 times), PPI, bismuth subcitrate (120 mg 4 times), rifaximin (400 mg twice).

Third line

When previous methods do not help, antibiotics for Helictobacter are taken as a third line of therapy. The individual regimen is based on the use of colloidal bismuth subcitrate (De-nol). The bacteria's susceptibility to certain medications is first studied. De-nol is used for Helicobacter pylori precisely because the pathogen is not able to adapt to it. Although this medicine is not considered an antibiotic, it successfully helps treat diseases caused by Helicobacter pylori. Antibacterial drugs included in the third line are prescribed by a doctor on an individual basis.

De-nol forms a protective film on the surface of the digestive organs, preventing the effects of aggressive factors. In addition, it reduces acidity, increases the production of protective mucus, and promotes scarring of ulcers.

Amoxicillin against bacteria

Treatment of bacteria with amoxicillin is quite common. This medication is included in various eradication therapy regimens, not only in the first line, but also in the second line. This is a semi-synthetic penicillin with a bactericidal effect. Its activity manifests itself only on microorganisms that are at the reproduction stage. Thus, the drug is not used simultaneously with drugs that inhibit the division of microbes.

Amoxicillin contraindications:

• increased sensitivity of the body to penicillins;
• mononucleosis of infectious nature;
• predisposition to leukemoid reactions.

During pregnancy and kidney disease, the antibacterial agent is used with caution.

Clarithromycin against microbe

Clarithromycin is one of the most common medications used to treat gastritis and other diseases with Helicobacter pylori. It is usually prescribed as part of three-component eradication therapy. The advantage of the bactericidal agent is its low toxicity. Only 2% of patients had adverse reactions, such as:

• nausea;
• indigestion;
• vomit;
• stomatitis (very rare).

Clarithromycin is combined with antisecretory drugs from the PPI group. They are included together in eradication therapy to enhance the effect. It is not recommended to use clarithromycin if the body is intolerant of its components, under the age of 6 months, in the first trimester of pregnancy, with liver and kidney failure.

Azithromycin as a “backup” option

Azithromycin has a rare manifestation side effects, but it is less effective than other antibacterial drugs used to get rid of Helicobacter pylori. This tool often used as an alternative to clarithromycin if the latter cannot be taken for some reason.

Tinidazole for Helicobacter pylori

Tinidazole is used orally. The tablets are quickly absorbed from the gastrointestinal tract, active substances spread throughout the body. Since the components of the drug tend to penetrate the placental barrier and be absorbed into breast milk, it is not recommended to use it during pregnancy and lactation. The drug is excreted by the kidneys, a small part is excreted in feces.

Metronidazole for bacterial infection

Metronidazole belongs to the group of drugs called nitroimidazoles. Possessing bactericidal properties, it breaks down into toxic metabolites and destroys the genetic material of the microbe.

If metronidazole is used for a short period of time, side effects are quite rare. At long-term use The following reactions may occur:

• allergies in the form of an itchy rash on the skin;
• diarrhea;
• decreased appetite;
• vomit;
• metallic taste in the mouth.

It is forbidden to take metronidazole simultaneously with alcohol-containing drinks. Contraindications apply to the first trimester of pregnancy, intolerance by the patient's body to the components of the drug.

Tetracycline against Helicobacter pylori

Since tetracycline is relatively toxic, it is prescribed in cases where the first line has been ineffective. Antibacterial agent wide range action belongs to the group of tetracyclines of the same name. It's different high efficiency and can have a detrimental effect on everything, not just reproducing microorganisms.

Tetracycline has the following side effects:

• leukopenia;
• anemia;
• circulatory disorders;
• thrombocytopenia;
• disturbance of spermatogenesis;
• erosions and ulcers in the digestive organs;
• bone growth disorder;
• neurological disorders;
• disruptions in liver function.

Considering a large number of side effects, tetracycline is not used to treat children under 8 years of age during pregnancy. Medicines are not prescribed for liver failure, ulcers in the gastrointestinal tract.

Levofloxacin in the fight against Helicobacter pylori

Levofloxacin belongs to new group– fluoroquinolones. It is characterized by relatively high toxicity, so it is used only in extreme cases and with caution. Levofloxacin is not prescribed to patients under 18 years of age, as it interferes with the development and growth of bone and cartilage tissue. It is not recommended to use it during pregnancy and breastfeeding, with lesions of the central nervous system.

What determines the ineffectiveness of eradication?

Sometimes, during deep therapy of helibacteriosis, it is not possible to destroy pathogenic microorganisms. This is a consequence of the following errors:

• the use of medications that are not included in the developed treatment regimens or the prescription of incorrect doses;
• short therapeutic course;
• lack of laboratory control.

If you do not follow the prescribed dosages and do not adhere to bacteria eradication regimens, the risk of side effects increases. If you refuse to take medications, they are not excluded. severe complications. Therefore, it is necessary to strictly follow all the instructions of the attending physician in order to get rid of unpleasant symptoms and avoid serious consequences.

Medicines for Helicobacter pylori have been in the arsenal of medicine for about half a century, but only relatively recently it was proven that the Pilari bacterium is responsible for ulcerative lesions of the gastrointestinal tract. Previously, it was simply not considered necessary to treat, believing that it was a normal representative of the gastrointestinal flora in some people.

The mainstay of treatment for this infection is antibiotics against Helicobacter pylori. The traditional course of therapy lasts several weeks and is usually well tolerated by the patient, which is confirmed by patient reviews, although some individuals may develop complications of therapy.

There is no need to talk about the effectiveness of antimicrobial therapy for Helicobacter pylori, since antimicrobial drugs are the basis for treating this infection.

Antibiotic tablets are most often used, but if necessary, the attending physician may prescribe the drug by injection.

The bacterium Helicobacter pylori may develop resistance to certain types medications, but even in this case it is possible to achieve a complete cure; all that is required is individual approach to the patient and his management by several specialists.

Overall, no need repeat course treatment can achieve a cure in 80-85% of patients, which indicates the extremely high effectiveness of Helicobacter pylori therapy with antibiotics. Now at the research stage there are even more modern and effective drugs than those currently available to doctors, which could theoretically increase efficiency primary therapy up to 95-98%.

Who prescribes treatment?

Symptoms and treatment of the presence of this pathogen in the gastrointestinal tract can be read in any medical encyclopedia or on any website on the Internet. However, without differential diagnosis, even if there are obvious symptoms of the presence of bacteria, there is no way to talk about it with certainty.

If you suspect an infection with Helicobacter pylori, you need to visit a doctor, and the sooner the better, since it is possible to develop not just a banal ulcer, but even a perforated one with massive bleeding.

Only a doctor knows how to treat Helicobacter pylori, what treatment regimens to use and what antibiotics to use. All this is often calculated collectively, by doctors of several specializations.

The initial consultation with suspected infection should be carried out either with a general practitioner or a gastroenterologist. At the same time, it is important to know that the general practitioner does not have the right to independently prescribe treatment regimens for Helicobacter pylori, he can only diagnose primary diagnosis and refer the patient to a hospital specialist-gastroenterologist.

Indications and contraindications for treatment

Not in all cases, the presence of Helicobacter pylori bacteria in the gastrointestinal tract requires complex treatment.

Mandatory therapy is prescribed only for the following indications:

1. Availability ulcerative lesion stomach or duodenum in the stage of exacerbation or remission, as well as in the presence of a complicated form of ulcer or treatment of its complications in the past.
2. The presence of MALToma (a rare B-cell lymphoma originating from lymphoid tissue, associated with the mucous membranes of the gastrointestinal tract).
3. The presence of atrophic gastritis.
4. Previous gastric resection for cancer.
5. Presence of close relatives suffering from malignant tumor stomach or having this disease in the past.
6. The patient's own wishes.

There are practically no contraindications to Helicobacter pylori treatment. One of the main contraindications is an allergy to the medication selected for the course of therapy. Treatment may also be delayed if the patient has an exacerbation of severe chronic diseases(Crohn's disease, UC, diabetes and so on).

What antibiotics are used?

The list of antibiotics available for use in the treatment of Helicobacter Pylori is huge and includes dozens of drugs. At the same time, in different countries They apply their own treatment regimens.

In the CIS countries, treatment of Helicobacter pylori is carried out the following types antimicrobial medications:

1. Amoxicillin. Cost 167 rubles.
2. Clarithromycin. Cost 300 rubles.
3. Metronidazole. Cost 100 rubles.
4. Tetracycline. Cost 30-35 rubles.
5. Rifaximin. Cost 1200-1500 rubles.

In this case, antibiotic treatment is carried out in combination. Simply put, not one specific drug is used, but a combination of 2-3 drugs. With the help of such a simple combination, it is possible to treat even strains of the bacterium Helicobacter pylori that are resistant to some antimicrobial agents.

Treatment regimen for Helicobacter pylori with antibiotics

On this moment Even the most powerful antimicrobial agents do not guarantee complete cure patient in the first course of therapy. That is why treatment can be carried out in several stages, using several options and lines of therapy.

When a patient first approaches, they try to cure Helicobacter Pylori using first-line therapy, which has four treatment options.

The first treatment option is carried out using the following antimicrobial and supportive agents:

• Amoxicillin;
• Clarithromycin (sometimes replaced by Josamycin or Nifuratel).

Second option:

• Amoxicillin;
• Clarithromycin;
• one of the inhibitors proton pump;
• bismuth tripotassium dicitrate.

Third option:

• Amoxicillin;
• Clarithromycin;
• bismuth tripotassium dicitrate.

Fourth option:

• one of the proton pump inhibitors;
• Amoxicillin;
• bismuth tripotassium dicitrate.

If the first line of therapy is ineffective, a second line is used, which includes three treatment options:

First option:

• one of the proton pump inhibitors;
• bismuth tripotassium dicitrate;
• Metronidazole;
• Tetracycline.

Second option:

• one of the proton pump inhibitors;
• bismuth tripotassium dicitrate;
• Amoxicillin;
• Nifuratel or Furazolidone.

Third option:

• one of the proton pump inhibitors;
• bismuth tripotassium dicitrate;
• Rifaximin;
• Amoxicillin.

Diagnosis and treatment of Helicobacter pylori (video)

List of other medications for the treatment of Helicobacter pylori

In addition to antibiotics, patients are prescribed other medicines, predominantly of a supporting type (to protect the mucous membrane, regenerate damaged tissues, and so on).

The most commonly prescribed secondary medications are:

1. Bismuth tripotassium dicitrate (antiulcer and gastroprotective agent, which also has a slight antimicrobial effect).
2. Proton pump inhibitors (Omez, Pariet, Pantoprazole, Emanera, etc.), used to reduce the secretion of hydrochloric acid.
3. Antacids (Gastal, Rennie, Phosphalugel, Almagel), used to neutralize gastric juice.
4. In some cases, medications may be prescribed to maintain or restore intestinal flora(for example, Linux). They are not always prescribed, since there is still a debate in the scientific community about their effectiveness.

On the effectiveness of folk remedies

Treatment of Helicobacter pylori folk remedies It looks like a rather dubious activity and can only be used against the background of drug therapy. The traditional method of treatment involves the use natural ingredients(herbs, vegetables, fruits), which may simply be contraindicated for many patients during therapy.

Is it possible to completely replace drug therapy? traditional treatment? The answer is clear: no. Moreover, this is not only not recommended, but extremely dangerous, since folk remedies can blur the symptoms of the disease, and the patient will not suspect that the spread of the infection is progressing.

Even if the patient decides to carry out treatment with folk remedies against the background of drug therapy, this cannot be done without the permission of the attending physician, since it is fraught not only with serious health consequences, but even fatal.

List of traditional methods of treating Helicobacter pylori

Traditional healers offer to cure Helicobacter Pylori in many ways, of which only a few seem to be the most adequate.

Let us note the most effective and safe ones:

Method number 1. You should chop the calamus rhizomes and pour boiling water over them. The proportion of the tincture should be one liter of boiling water per 4 tablespoons of dry raw materials. This infusion should be consumed 30-40 minutes before a meal, half a glass.

Method number 2. One hour before a meal, you should take a 10% alcohol tincture of propolis. The dosage should not exceed 10 drops per glass of water. The course of therapy with this remedy is 14-30 days (depending on the severity of the infection).

Method No. 3. To destroy bacteria and reduce acidity, you should drink a tablespoon of juice from plantain leaves (obviously, previously washed and crushed). In case of severe illness, two teaspoons of the product should be consumed 30-40 minutes before meals.

Helicobacter Pylori is a bacterium that inhabits inner surface stomach and duodenum. It causes peptic ulcers in these parts of the digestive tract. Without getting rid of it (the so-called eradication), the patient should not expect a successful recovery from an ulcer, gastritis or gastroduodenitis.

Principles of H. pylori eradication with antibiotics

1. Treatment should be preceded by an examination. All patients with abdominal pain should be tested for Helicobacter pylori. When this infection is initially detected, complex antibacterial therapy is carried out, taking into account the individual characteristics of the patient, concomitant pathology or allergic reaction for drugs. If the pathogen is re-identified after therapy, the patient is sent for EGD (esophagogastroduodenoscopy) with the obligatory taking of a biopsy (a piece of the mucous membrane of the affected organ). The material is sent to the laboratory to determine the sensitivity of the pathogen to antibiotics.
2. It is necessary to treat not only the patient, but also his relatives. All relatives who permanently live with the patient need to be examined. At positive result Antibacterial therapy is also carried out for them, regardless of the presence or absence of symptoms.
3. Control of eradication. It is carried out 1.5 months after treatment. If the test result for Helicobacter is repeated positive, a repeat 3-4 day course of antibiotics is prescribed in the maximum permissible doses.
4. Combination of drugs. To date, the effectiveness of three-component or four-component therapy has been proven.

Is it possible to get rid of Helicobacter pylori without antibiotics?

There are opinions that helicobacteriosis can be cured using traditional medicine. Treatment with herbs or other natural substances can be used as aid to basic antibiotic therapy. Herbal medicine is also quite effective as a means of preventing diseases of the gastrointestinal tract.

Helicobacteriosis treatment regimen

To date, a list of drugs that are highly effective in eradicating this infection has been established:

1. Colloidal bismuth subcitrate (De-nol). There are treatment regimens with or without De-nol. But it has been proven that the effectiveness of the therapy is much higher when De-nol is included in the treatment regimen. This is because this drug significantly reduces the absorption of antibiotics. They are concentrated in more high dose exactly at digestive tract, in the habitat of Helicobacter pylori.
2. Antibiotics. Drugs of the amoxicillin group (Augmentin, Flemoxin solutab, Amoxil), clarithromycin (Klacid), azithromycin (Sumamed, Ziomycin, Ormax).
3. A group of antisecretory drugs (Omez, Ranitidine, Gastromax, Gastrocepin).
4. Antimicrobial drugs (Macmiror, Metronidazole).

The duration of the standard course of treatment is 7–10 days. In more severe cases the course can be extended up to 14 days.

There is first-line therapy, the so-called triple regimen, and second-line therapy, the so-called quadruple therapy. The first line can be with or without the use of De-nol. How to treat the patient and what therapy to start with is decided by the doctor after a full examination.

Triple therapy includes:

• De-nol (1 t in the morning);
• antibiotic (amoxicillin or clarithromycin or azithromycin group) + antimicrobial agent(McMirror, Metronidazole).

• 2 antibiotics (from the amoxicillin group + from the clarithromycin or azithromycin group).

Triple therapy includes:

• antisecretory drug (Omez, Gastromax, Gastrocepin);
• antibiotic (from the group of amoxicillin, clarithromycin or azithromycin) + antimicrobial agent.

• antisecretory drug;
• 2 antibacterial agents a (from the amoxicillin group + from the clarithromycin or azithromycin group).

Quad therapy (quadruple therapy) includes:

• an antibacterial agent (your choice of amoxicillin, clarithromycin or azithromycin);
• antisecretory drug (Omez);
• antimicrobial drug (Macrimor or Metronidazole).

Azithromycin preparations (Sumamed, Ziomycin, Ormax) are added to therapy on the 3rd – 4th day of treatment and prescribed for 3 – 5 days.

A big problem in the treatment of helicobacteriosis is the resistance of bacteria to antibiotics. This is due to the frequent and uncontrolled use of antibacterial agents to treat various diseases.

To resolve the question of what antibiotics should be used to treat a patient with unsuccessful eradication in the first and second lines of therapy, a study is conducted to determine the sensitivity of Helicobacter pylori to antibiotics during fibrogastroscopy. After this, a third-line treatment regimen is selected using an antibiotic to which the particular patient’s bacteria is highly sensitive.

If, in addition to the underlying disease, the patient also has reflux disease (reflux of gastric contents from the stomach into the esophagus), then domperidone drugs (Motilium, Motilak) are added to therapy.

Additional administration of probiotics (Lactobacterin, Bifidobacterin) is also used. It has been proven that the combined use of probiotics with antibacterial therapy improves the barrier functions of the stomach and slows down the growth of H. pylori, since the bacteria contained in them compete with Helicobacter. As a result, the percentage of eradication increases.