Peptic ulcer of the stomach and duodenum: symptoms, treatment, causes. Treatment of stomach ulcers at home: the best recipes Three-component scheme for the treatment of peptic ulcer

During the treatment of stomach ulcers and duodenum necessary various groups drugs. With exacerbation of the pathology of the digestive system effective treatment must be treated with antibiotics. For a speedy recovery, the correct treatment regimen for the patient should be determined.

In order to cure a stomach or duodenal ulcer, the patient must be assigned the correct treatment regimen. medications. Modern medicine relies not only on therapy with various means of action, but also on other methods of treatment. However, such drugs are able to have a complex effect on the gastrointestinal tract and have a stronger effect.

For complex therapy diseases of the stomach and duodenum use a wide range of medications.

Antibiotics. The main antibiotics of this group of drugs are Metronidazole, Amoxycycline, Tetracycline, Clarithromycin. They are necessary for active antibacterial action. First of all, antibiotics are aimed at destroying the bacterium Helicobacter pylori, as it is the most common causative agent of stomach and duodenal ulcers.

Treatment with antibiotics allows you to have a complex effect on the digestive system, as well as stimulate its processes. During the treatment of diseases of the gastrointestinal intestinal tract along with the use of antibiotics, complementary drugs are necessarily prescribed.

Antiprotozoal agents. The most common is Trinidazole. The antiprotozoal group of drugs is necessary for the complete destruction of the Helicobacter pylori bacterium in gastric and duodenal ulcers. They help and enhance the effect of antibiotics if their substances are not enough to completely eradicate microorganisms.

Gastroprotectors. Among them, doctors distinguish Keal, Venter, Sucras and Sucralfat. They have a protective effect. Medicines are aimed at reducing the contact of hydrochloric acid and digestive enzymes with the walls of the stomach and intestines. The preparations have an enveloping property, due to which the mucous membrane receives additional protection from the increased acid-base balance in the digestive system.

Antisecretory agents. First of all, this group of drugs includes H2-histamine receptor blockers: Kvamatel, Roxatidine, Cimetidine, Ranitidine, Famotidine. Blockers are necessary for a direct effect on the acid-base balance in the hollow organ. If a elevated level acidity was caused by Helicobacter pylori, then such drugs will be very effective. They also contribute to the normalization of metabolism, reduce the amount of hydrochloric acid produced.

The second type of antisecretory drugs are proton pump inhibitors. These include Esomeprazole, Nolpaza, Omeprazole and Omez. Such pharmacological preparations can eliminate many exacerbated symptoms of stomach and duodenal ulcers (heartburn, belching, heaviness in the abdomen, hiccups). Proton pump inhibitors also act to reduce acidity in the digestive system and are antiseptic. They can enhance the effects of antibiotics, increasing the chance of killing Helicobacter pylori by up to 90%.

The third type of antisecretory agents is M1 anticholinergics. Gastrozepine, Telenzepine, Pirenzepine, and Gastrocepin are common. They are able to tone the transverse muscles of the stomach, reduce the secretion of pepsin and hydrochloric acid in the hollow organ.

Analgesics. These include Paracetamol, Ketorol, Baralgin. Analgesics are needed to relieve and alleviate the pain symptoms of a stomach or duodenal ulcer. Their effect contributes to the improvement of the general condition of the patient. With acute pain, they must be taken without fail with antibiotics.

Antacids. Phosphalugel, Maalox, Almagel. This group of drugs is necessary to relieve burning sensation and pain symptoms in case of a stomach or duodenal ulcer. They are not aimed at eliminating the cause of diseases of the digestive system, but help to alleviate the main symptoms in the patient.

Prokinetics. These include Motilium, Metoclopramide, Motilac and Ganaton. Such drugs are needed to stimulate the digestive system and improve the patient's metabolism. They help cure heartburn, nausea and vomiting. Prokinetics are contraindicated in case of narrowing of the outlet section of a hollow organ. For gastric or duodenal ulcers, such drugs should be used with other antiseptic agents.

Bismuth-containing drugs. The most common drugs in this group are De-nol, Vis-nol, Vikalin and Vikair. Bismuth preparations cover the mucous membrane of the digestive system with a special protective layer that neutralizes the effect of hydrochloric acid and enzymes on inflamed areas of the epithelium of a hollow organ. Also, such drugs help reduce the activity of the Helicobacter pylori bacterium and relieve some symptoms of stomach and duodenal ulcers.

Complex of vitamins. Among this group of drugs there are many different names. All of them are necessary to enrich the depleted body with vitamins and missing trace elements. They also contribute to the renewal of the body's immune system, activate the process of tissue repair of affected organs, and improve metabolism.
The vitamin complex is often prescribed during the rehabilitation period of the patient after active treatment of a stomach or duodenal ulcer.

Video “Treatment of ulcers with folk remedies”

Treatment regimens

After diagnosing the patient, the doctor must prescribe a specific treatment method if a conservative approach is not able to provide the desired result.

Usually the patient is treated with various antibiotics and complementary drugs. The main objective of the course of treatment is aimed at the complete eradication of the bacterium Helicobacter pylori in the human body.

The doctor must select medications and their dosage, taking into account the weight, age, and individual characteristics of the patient's body.

Scheme 1. First line therapy. This method treatment involves taking type 1 antibiotics at the same time as an additional drug to help relieve the symptoms of gastrointestinal disease.
In first-line therapy, Clarithromycin, Amoxicillin, Ranitidine, Metronidazole can be used. They are the most common, but also interchangeable.

When using Clarithromycin, the average dose per person is 500 mg, 2 doses per day during meals.

Amoxicillin - 1 gram, 2 doses per day. Take 30 minutes before a meal or 2 hours after a meal.

Metronidazole - 250 mg, 4 doses per day or double the dosage, designed for 2 doses. Drink after meals.

Together with the antibiotic, it is necessary to take an additional drug that will be aimed at a specific action. The most commonly used first-line therapy is proton pump inhibitors. If these funds do not have the proper effect on the patient, then they are replaced with H2-histamine receptor blockers to enhance the antiseptic properties of the antibiotic.

If necessary, an anesthetic drug may also be prescribed.
First-line therapy usually lasts up to 14 days.

Scheme 2. Therapy of the second line. During the treatment of diseases of the gastrointestinal tract, this scheme is necessary if the first approach does not help the patient. Second-line therapy involves the use of 1 type of antibiotics and 2 complementary drugs at the same time to speed up the patient's recovery.

The second line therapy is designed for 10 days.

The use of 3 drugs at once (tritherapy) enhances the process of eradication of Helicobacter pylori bacteria.

During treatment according to this scheme, the dosage of antibiotics that were used in first-line therapy is increased.

Tetracycline is also used - 500 mg, 4 doses per day after meals.
Tinidazole - 500 mg, 2 doses per day after meals.

Also, 2 additional drugs of different groups with different properties are prescribed.

They are aimed not only at strengthening the main antibiotic, but also expanding the effect. So combination medications relieves symptoms of diseases of the digestive system, eliminates harmful microorganisms and normalizes the level of acid-base balance in the stomach.

Scheme 3. Combination therapy. This method of treatment is prescribed when the first two approaches did not have the expected effect. Usually, combination therapy is necessary for exacerbated pathologies of the gastrointestinal tract.
This approach is based on the simultaneous use of 2 different antibiotics and 2 complementary drugs. Antibiotic use of previous regimens may vary. Amoxicillin, Clarithromycin, Tetracycline and Metronidazole are combined at the same time.

Josamycin may also be prescribed - 1 gram, 2 doses per day.
Nifuratel - 400 mg, 2 doses per day.

Usually, proton pump inhibitors are used in combination therapy. Among them may be Omeprazole, Esomeprazole or Rabeprazole - 20 mg, taken 2 times a day. If inhibitors cannot help the patient because of his individual immunity to active substances medications, then he can be prescribed H2-histamine receptor blockers.

At the end of the twentieth century. a significant step was taken towards changes in the principles of treatment of peptic ulcer (PU). The success of modern approaches to therapy is associated primarily with the use of new antisecretory drugs and eradication schemes. Helicobacter pylori(NR). Currently, the pharmacotherapy of PU includes more than 500 various drugs and about 1000 combinations of them. The modern concept of PU treatment provides for active therapeutic tactics, including multicomponent drug regimens and long-term use of medications according to indications.

An important component of modern peptic ulcer pharmacotherapy is the absence of fundamental differences in approaches to the treatment of gastric and duodenal ulcers. The main principles of therapy for peptic ulcer disease are:

influence on factors of aggression and/or protection;
etiological therapy;
correction of drug treatment taking into account concomitant diseases;
individual characteristics of the patient (age, body weight, tolerability of the medications used, activity, i.e., the ability to serve oneself);
financial capacity of the patient.
The main directions in the treatment of peptic ulcer during an exacerbation include:
etiological treatment;
treatment mode;
medical nutrition;
drug treatment;
herbal medicine;
use of mineral waters;
physiotherapy treatment;
local treatment long non-healing ulcers.

Currently, in the pathogenesis of PU, especially duodenal ulcers, great importance is attached to the infectious agent - H. pylori. Epidemiological data obtained in various countries indicate that 100% of duodenal ulcers and more than 80% of ulcers with localization in the stomach are associated with the persistence of HP.

Many studies confirm that anti-Helicobacter therapy leads to a decrease in the frequency of recurrence of gastric ulcer (GU) and duodenal ulcer (DU). The strategy for the treatment of PU using the eradication of HP infection has undeniable advantages over therapy with all groups of antiulcer drugs, as it provides a long-term remission of the disease and, possibly, a complete cure. Anti-Helicobacter Therapy Is Well Established According To Standards evidence-based medicine. Modern approaches to the diagnosis and treatment of infection H. pylori that meet the requirements of evidence-based medicine are reflected in the final document of the second Maastricht Consensus, adopted in September 2000. The main differences between the current document and the five-year-old agreement are several important points.

First treatment for infection H. pylori, and consequently, the diseases associated with it, are the responsibility of the doctor general practice and not a specialist gastroenterologist, as was previously accepted. The competence of the gastroenterologist includes only those cases where the treatment of the disease, including the use of second-line therapy, was unsuccessful, as well as cases that clearly require the intervention of a specialist.
For the first time, a two-stage treatment has been introduced: when choosing a first-line regimen, the doctor must immediately plan a backup therapy at the same time.
It is recommended to use anti-Helicobacter therapy in patients with functional dyspepsia, as well as in cases where long-term therapy with non-steroidal anti-inflammatory drugs is planned.
Patients with uncomplicated duodenal ulcer are encouraged to prescribe only the recommended courses of anti-Helicobacter therapy, without the subsequent use of antisecretory drugs.

The main criterion for choosing anti-Helicobacter therapy is its expected effectiveness, providing a high percentage of eradication (more than 80%).

If the used treatment regimen did not allow to achieve eradication, it should not be repeated according to this regimen.
If the regimen used did not lead to eradication, this means that the bacterium has acquired resistance to one of the components of the treatment regimen.
If the use of one and then another treatment regimen does not lead to eradication, then the sensitivity of the HP strain to the entire spectrum of antibiotics used should be determined.

Adopted by the Russian Gastroenterological Association in 1998 national recommendations on the diagnosis and treatment of Helicobacter pylori infection and mass familiarization of doctors with them have not yet led to a decrease in the number of strategic and tactical errors in determining indications for eradication and choosing adequate anti-Helicobacter pylori regimens (see Table 1) .

Table 1. Errors in the treatment of HP infection.

What does a doctor need to know when starting anti-Helicobacter therapy? Every general practitioner, especially those with more than five years of experience, will most likely have to overcome some psychological barrier before prescribing antibiotics to a patient with peptic ulcer. To date, gastroenterologists and therapists still have different attitudes towards anti-Helicobacter therapy in PU. Strict, strict adherence to the anti-Helicobacter treatment regimen is necessary. Their effectiveness has been proven, they correspond to the characteristics of HP and the pharmacokinetics of drugs, and side effects of such therapy are also known.

It is better not to carry out anti-Helicobacter therapy at all than to carry it out incorrectly, since in this case HP resistance to a number of components quickly develops. In this regard, the patient must be told in detail about the upcoming treatment and obtain his consent to cooperate with the doctor. It is also important to assess the material possibilities of the patient. He should know that due to expensive, single treatment, it will be possible to achieve stable remission in patients with duodenal ulcer in 70-80% of cases, and in DU - in 50-60%, which is ultimately cost-effective.

What eradication scheme to choose? If there is a stomach ulcer or duodenal ulcer against the background of increased acid production, then preference should be given to the classic three-component schemes based on a proton pump blocker (PPI) (omeprazole, etc.). Then it is possible to switch to a single dose of PPI without antibacterial drugs. You should not use schemes containing nitroimidazoles (metronidazole, tinidazole), if in the anamnesis the drugs of this group were prescribed for other indications.

Currently in Russia there is a sharp increase in the number of HP strains resistant to nitroimidazoles. With this in mind, the search for more effective HP eradication regimens seems to be an urgent task today. Therefore, in last years There is a growing interest in the use of macrolides in the treatment of HP-associated diseases. Numerous works have shown the effectiveness of the use of macrolide antibiotics for the treatment of HP. These drugs have a high ability to penetrate into cells, are intensively released onto the mucous membranes (SO), which increases their effectiveness against HP. In addition, macrolide antibiotics have fewer contraindications, as well as side effects, they have a higher percentage of eradication than tetracyclines, which can also accumulate in cells. A feature of HP infection is that it is accompanied by hyperacidity.

In this regard, most macrolide antibiotics undergo enhanced hydrolysis and cannot be used. An exception is clarithromycin, which is resistant to hydrochloric acid.

Therefore, the aim of our study was to develop new schemes for the eradication therapy of duodenal ulcer associated with H. pylori, using omeprazole (O), as well as a combination of amoxicillin (A) and clarithromycin (K). We used the following eradication regimen - ultop (omeprazole) 20 mg twice a day + fromilid (clarithromycin) 500 mg twice a day + chiconcil (amoxicillin) 1000 mg twice a day - a course of seven days. Eradication was 90%. The study showed that the use of fromilid (clarithromycin) is effective and appropriate in anti-Helicobacter therapy regimens with the use of PPIs.

The data of numerous studies and the results of their meta-analysis led to the conclusion that the inclusion of antisecretory drugs in the HP eradication regimens not only improves HP eradication when combined with antibiotics, but also accelerates ulcer scarring, and allows you to quickly eliminate the symptoms of ulcerative dyspepsia. As for the specific mechanisms for increasing the effectiveness of eradication due to the use of antisecretory drugs, then, first of all, with an increase in the pH of the gastric contents, the indicator of the minimum inhibitory concentration of antibiotics (MIC) decreases and, accordingly, their effectiveness increases. The viscosity of gastric juice and the concentration of the antibiotic in the gastric contents also increase, which increases the exposure time of antibacterial drugs with bacteria. H. pylori. We have studied the effectiveness of Ultop (omeprazole) - pH> 4 of gastric contents with a single dose of 20 mg was for 12-14 hours (see Figure 1).

However, first-generation PPIs do not fully meet the practical needs of clinicians. They are slowly converted to active form and create the maximum antisecretory effect for eradication only by the fifth or eighth day of therapy. Other drugs in this class include lansoprazole, pantoprazole, rabeprazole, and esomeprazole. They bind to the enzymes of the cell wall of parietal cells - H + , K + -ATPase, and are the most powerful agents that control gastric acid production.

Using pH-metry in HP-negative volunteers, the effect of a new dosage form Moose Maps. After a course of treatment with this drug, the antisecretory effect

in the daytime was even more pronounced than with the use of pantoprazole. However, pharmaceutical companies, continuing to search for new, more effective antisecretory agents, created new drug- Nexium. The antisecretory effect of Nexium is superior in severity, speed of onset and duration of exposure to the same effect of omeprazole in standard doses of 20 and 40 mg, pantoprazole 40 mg and lansoprazole 30 mg.

In connection with the foregoing, a new PPI, pariet (rabeprazole), is of great interest. Pariet 40 mg once a day or 20 mg every 12 hours is recommended in the treatment of GU and duodenum. The most effective, fast-acting antisecretory and antibacterial drug in eradication regimens is pariet 20 mg twice a day. It does not need to be prescribed seven days before the start of antibiotic treatment, as in the case of other PPIs, since a reliable antisecretory effect is achieved already on the first day of treatment (from the recommendations of the Russian Gastroenterological Association).

Unfortunately, the presence of antibiotic resistance in some patients is forcing researchers to develop alternative treatment options for patients suffering from peptic ulcer associated with H. pylori.

Thus, we have studied the effectiveness of eradication schemes with the use of reserve antibacterial drugs. The best eradication result (90%) was achieved using the scheme: de-nol 240 mg twice a day, 14 days + tetracycline 1 g/day and furazolidone 200 mg twice a day, seven days.

Quite often the question arises of the need for eradication therapy in elderly and senile patients. To date, this can be attributed to the fact that with prolonged persistence of HP, intestinal metaplasia and atrophy of the gastric mucosa develop, and the risk of developing gastric carcinoma increases. Age features enzymatic activity and atrophic processes in the mucosa of the gastrointestinal tract also change the rate of biotransformation medicines interfere with their absorption. It was noted that the concentration of ranitidine increased in patients over 60 years of age with concomitant pathology of the hepatopancreatobiliary region.

"Achilles heel" conservative treatment peptic ulcer disease is known to have a high complication rate. It has been proven that HP eradication completely prevents the complications of peptic ulcer disease. So, in the course of four large studies, the course of peptic ulcer disease was studied in patients in whom it manifested by bleeding (see Figure 2). As can be seen from the presented data, any other type of treatment does not exclude the risk of re-bleeding - within a year after the previous bleeding, it recurs in about every third patient. In the case of HP eradication, bleeding does not recur at all (see Figure 2).

Evaluation of the effectiveness of eradication is carried out after completion of treatment and is aimed at identifying vegetative and coccal forms. H. pylori. The "Recommendations" clearly define the scheme for carrying out this stage of diagnostics:

timing - not earlier than four to six weeks after the end of the course of anti-helicobacter therapy, or after the treatment of concomitant diseases with any antibiotics or antisecretory agents;
diagnosis of eradication is carried out using at least two of these diagnostic methods, and using methods that make it possible to directly detect bacteria in biopsy material (bacteriological, histological, urease). It is necessary to study two biopsies from the body of the stomach and one biopsy from the antrum.

The role of antacids in the treatment of PU and duodenal ulcer should not be underestimated. These drugs, known since ancient times, lower the acidity of gastric juice due to chemical interaction with acid in the stomach cavity. Preference is given to non-absorbable antacids - almagel, maalox, phosphalugel, talcid, rutacid. With exacerbation of GU and duodenum in complex treatment we used rutacid 500mg three times a day + one tablet at bedtime. Against the background of taking this remedy, the symptoms of gastric dyspepsia disappeared.

by the end of the first or second day of treatment. Despite the introduction of modern inhibitors of gastric secretion into medical practice, antacids remain important as effective remedy treatment of patients with PU and duodenal ulcer.

As a result of treatment, complete clinical and endoscopic remission should be achieved, with negative results of HP testing.

It should be noted that we very rarely encounter cases where the patient has an isolated ulcer. Treatment of comorbidity is associated with a number of problems.

Sometimes conservative therapy turns out to be ineffective. This may be due to two factors: the often recurrent course of peptic ulcer disease and the formation of refractory gastroduodenal ulcers. The analysis revealed the causes of frequent recurrences during PU, these are HP infection, the use of non-steroidal anti-inflammatory drugs, the presence of complications of PU in history, as well as low compliance. The factors listed above, as well as the latent Zollinger-Ellison syndrome, can act as factors contributing to the formation of refractory gastroduodenal ulcers.

In conclusion, it should be emphasized once again the extreme importance of developing domestic standards for the treatment of PU and duodenal ulcer and their prompt introduction into the practice of a general practitioner and gastroenterologist. Important arguments in favor of anti-Helicobacter treatment were obtained by evaluating the cost/effectiveness ratio. PU is widespread and characterized by a chronic relapsing course. eradication H. pylori reduces both direct and indirect costs in PU, while eliminating the need for expensive maintenance treatment with antisecretory drugs, reducing the risk of recurrent exacerbations, complications and, in some cases, surgical treatment.

Thus, modern drug therapy PUD and PUD can provide a relapse-free course of these diseases and save patients from complications. However, in most cases, outpatient treatment is sufficient. The success of therapy depends not only on the appointment of the optimal drug combination, but also, to a large extent, on its implementation with the participation of the patient.

Literature.

Vertkin A. L., Masharova A. A. Treatment of peptic ulcer in a modern clinic // Attending physician, October 2000, No. 8. - S. 14-19.
Grigoriev P. Ya., Yakovenko E. P., Agafonova A. et al. Pyloric helicobacteriosis: diagnosis, treatment // Attending physician, June 2002, No. 6. - S. 3-8.
Erashchenko P. P., Snegova E. A., Churilin Yu. Yu. Pharmacoeconomic rationale for the use of rabeprazole (Pariet) in peptic ulcer // Clinical pharmacology i Therapy, 2001, 10(1). - S. 42-46.
Ivashkin V. T. Prevention and treatment chronic diseases upper divisions gastrointestinal tract. - M.: "MEDpress - inform", 2002. - S. 127.
Isakov V.A., Shcherbakov P.L. Comments on the Maastricht Agreement. - 2, 2000//V International Symposium "Diagnostics and Treatment of Diseases Associated with H. pylori", Pediatrics, No. 2, 2002. - P. 5 -7.
Kokueva O. V., Stepanova L. L., Usova O. A. et al. Pharmacotherapy of peptic ulcer with regard to concomitant pathology of the gastrointestinal tract // Experimental and practical gastroenterology, 1/2002. - S. 49-52.
Koltsov P. A., Zadionchenko V. S. Pharmacotherapy of chronic diseases of the digestive system // Practical guide. - M., 2001. - S. 200.
Lapina T. L., Ivashkin V. T. Modern approaches to the treatment of peptic ulcer of the stomach and duodenum // Russian Medical Journal. - V. 3, No. 1, 2001. -
10-15.
Lapina T. L. Modern approaches to the treatment of acid-dependent and H. pylori-associated diseases // Clinical perspectives of gastroenterology, hepatology. 1, 2001. -
21-27.
Pimanov S. I. Esophagitis, gastritis, and peptic ulcer - N. Novgorod, 2000. - 376 p.
Strachunsky L. S., Kozlov S. N. Macrolides in modern clinical practice. - Smolensk, 1998. - 303 p.

I. V. Maev, Doctor of Medical Sciences, Professor of Moscow State Medical University, Moscow

In traditional medical practice, a treatment regimen is a balanced set of drugs selected to combat a specific ailment. In everyday speech, such an expression often denotes all measures, from medication to folk.

Our site is designed not so much for professionals as for ordinary patients, so we will try to give the most extensive information. Here is a description of the standard measures to combat peptic ulcer.

Principles of therapy for ulcers

Usually, the disease can be detected during the period of exacerbation: until the thunder breaks out, the patient will not go to the doctor. Accordingly, the doctor prescribes first enhanced therapy, and then - preventive treatment to prevent relapse.

Reinforced Program

Preparations are selected in order to destroy pathogenic bacteria (if any and the general condition of the patient is not too severe) and to suppress irritating factors. The following groups of drugs are usually prescribed:

antibacterial drugs, antibiotics (clarithromycin, amoxicillin, metronidazole, tetracycline, furazolidone);
bismuth preparations that counteract excessive activity of hydrochloric acid, pepsin (vicalin, bismuth subnitrate);
proton pump inhibitors that correct the secretion of gastric juice (omeprazole, lansoprazole, etc.).

The stronger the antibacterial agent, the faster the result can be achieved. However, the abuse of antibiotics is fraught with side effects and complications. The task of the doctor is to adequately assess the general condition of the patient, not to harm the latter with too intensive treatment.

Usually, the most simple circuit, and then, with good tolerance of medications, the patient is recommended more serious pills. The combination of omeprazole with two antibiotics (for example, clarithromycin and amoxicillin) gives a quick result almost always.

At the end of the intensive course, control tests are usually carried out.

Prevention of new exacerbations

Then the patient switches to a moderate diet - avoids those foods that are contraindicated for him. He is often advised to be treated by reliable folk remedies, decoctions of herbs, and also make it a habit to perform special gymnastic exercises.

Helps reduce the effects of irritants mineral water(not any, but selected taking into account the nature of the disease!).

Medicines are offered already sparing. Read more about medications used in the treatment of ulcers in a separate article on our website.

The effectiveness of the treatment of peptic ulcer

Surgery is now much less common than in past decades. If before every second ulcer was operated on, today only two patients per thousand are subjected to this procedure.

Treatment has become more effective due to successful scientific research aimed at studying the bacterium Helicobacter pylori.

In 35% of cases, professionally selected medication allows you to almost completely eliminate the symptoms of a painful illness, in 60% of situations it greatly lengthens the periods of remission.

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The principle of treatment of peptic ulcer of the stomach and 12 duodenal ulcer

The human body is a vulnerable structure that requires constant care. Unfortunately, often people do not attach due importance to changes in health. In the majority, gradually developing into a chronic form.

Ulcers in the stomach and duodenum are very common. The development of the disease leads to the inevitable formation of a gastrointestinal defect, which turns into a constant hindrance to normal functioning. internal organs.

People who want to avoid the disease will benefit from knowledge of methods that prevent development. For patients suffering from this disease, one should list the methods, indicate the course of treatment that is beneficial in the prevention of ulcer attacks.

Are there paraclinical methods and treatment regimens for the disease?

Diagnosis of duodenal ulcer is considered a problematic task. Modern doctors are constantly looking for drugs and techniques that can help an ever-growing list of patients.

Unfortunately, the defeat of these two organs entails a severe course of the disease. People complain of a number of symptoms: unbearable pain caused by perforation of internal organs, burning abdominal cavity gastric juice, affected intestines, constant bleeding. It is believed that doctors offer a limited list of methods of assistance in such a situation.

Laboratory research

Some patients are not satisfied with the scope of the treatment. They become sources of gossip that the list of methods is small. Any medically educated person will be able to prove otherwise.

For example, popularity is laboratory research. Manipulations are considered mandatory, the patient undergoes a series of studies. You will need to submit:

blood test (general);
stool analysis;
coprocytogram (results of a cytological examination of feces);
urine;
histological diagnosis;
analysis for HP.

The listed procedures are carried out under the supervision of people who collect the necessary biomaterials and present the results to the patient in an understandable form. In some cases, doctors may independently prescribe additional tests. For example, research on occult blood in feces, the procedure for determining the level of hormones in the blood.

Instrumental Research

Among instrumental studies, a general study of internal secretion is distinguished. stomach and twelve duodenum subjected to a number of analyses. For example, we are talking about intragastric pH-metry. The doctor needs a procedure to observe the pathological nature of the "behavior" of the body.

These organs represent a complex system, any violation in the communication between parts of the body will lead to the formation of malfunctions. Defense mechanisms and aggression factors enter into a "conflict" in which the doctor will need immediate intervention. The doctor should be guided by endoscopic criteria for the stages of duodenal ulcer.

Typical diagnostic criteria

In the study, the physician identifies the phase of exacerbation. The first stage of the gap is the manifestation of an acute duodenal ulcer, in the process of pathology development, there are sharp changes in the functioning of the stomach and duodenum. For example, the round shape is broken, the walls reveal an unequal structure, the surrounding organs resemble edema due to severe inflammation of the tissues. The second stage is considered the beginning of epithelialization. During the application of individual regimens for the treatment of PU, the inflammatory area is smoothed and gradual remission, which is considered an important step in healing.

Remission

After the patient undergoes a biopsy, a diagnosis is carried out similar to that carried out at the beginning of treatment. Greater preference is given to X-ray studies, which are auxiliary in nature at the stage of application of these treatment regimens. Such procedures will help the specialist to carry out a complete and effective diagnostics confirming the absence of pathologies.

Peptic ulcer treatment: will ultrasound help?

The methods described above are sufficient to draw up the correct course of treatment for a particular patient. Often doctors insist on ultrasound intervention - a procedure that brings the patient's recovery closer, helping in making the correct diagnosis and the degree of development of the ulcer.

An additional diagnostic method is inpatient treatment of gastric ulcer, which contributes to the full monitoring of the patient. Without the treatment regimens established by the doctor, the peptic ulcer will not recede. The methods described above are rather auxiliary methods of treatment that enhance the effect of drugs taken by a person.

What drugs are prescribed first

Patients are interested in the list of priority drugs for purchase at the pharmacy. Modern medicine offers three main treatment regimens that are effective for the patient.

Any use of the drug is consistent with the attending physician. The following information serves as a guide before visiting a specialized medical facility.

Bismuth circuit

The composition of the first scheme includes a multicomponent intake of drugs:

denol;
flemoxin;
clarithromycin;
erythromycin.

The course takes several days. The doctor establishes a certain order of taking medicines, which the patient must follow for the next seven days. For example, on the first day, the body is treated with denol and flemoxin. The frequency and dosage are clearly prescribed by the attending physician.

Scheme based on inhibitors

For such a scheme, drug treatment of peptic ulcer is determined by drugs:

ompeprazole;
flemoxin;
clarithromycin.

The assignment situation is the same as in the description of the first scheme. The doctor determines the dosage, method of handling medications and the time of administration. Often the treatment regimen for gastric and duodenal ulcers looks like this: ompeprazole + flemoxin + clarithromycin. Sometimes such an alternation undergoes changes, depending on the opinion of the employee of the medical institution.

Histamine blocker regimen

Other drugs are used in the context of the new treatment regimen. For example, a doctor prescribes the use of famotidine, ranitidine, flemoxin.

Often the structure of the treatment regimen looks like this: Fa + (Ra) + Phl. Changes are at the discretion of the attending physician.

quadruple therapy

For many representatives of the older generation, this term is unfamiliar. This therapy is already firmly established among the possible treatment regimens offered to the patient.

For conventional therapy, a four-component treatment regimen consisting of 4 antibiotics is considered characteristic. During quadruple therapy, two antibacterial drug: tetracycline and metronidazole. The fears that are caused by a decrease in the effective treatment drugs will turn out to be groundless. For effective treatment of these drugs is enough.

The treatment regimen for peptic ulcer disease can be limited in duration to seven days, the result depends on how the doctor considers the therapy productive and suitable for a particular patient.

Is physical therapy necessary?

The described techniques will help many get rid of the disease or prevent further development. In addition to these schemes, a popular procedure is known, which is very controversial. It's about physical therapy.

The difficulty lies in the fact that some doctors consider this technique to be secondary. The role of physiotherapy is completely undefined, sometimes doctors do not see the need for procedures. Such therapy will not become superfluous, perhaps it will help to consolidate the result.

Physiotherapy is prescribed as an auxiliary procedure, for example, at the stage of remission. Suitable for prevention:

magnetotherapy;
electrosleep;
hydrotherapy;
thermotherapy.

Although the role of the technique is not defined, selected patients eventually recognize that in the course of these manipulations, the necessary tone was returned to the body. In any case, treatment regimens do not negate physiotherapy, such measures will help to enhance the positive effectiveness of the treatment of PU.

What antibiotics should be taken for gastric and duodenal ulcers?

Without a well-designed drug treatment regimen, it will be difficult to cure a person from a stomach or duodenal ulcer.

In modern medical practice, the treatment regimen is formed using antibiotics, which are prescribed to suppress the growth and development of Helicobacter pylori.

After all, it is this microorganism that lives on the walls of the digestive organs that most often causes peptic ulcers.

In addition to choosing antibiotics, the doctor pays attention to the technical rules of treatment and selects drugs that can increase the effectiveness of therapy.

To be more precise, the specialist selects his own set of medicines for each clinical case.

Unfortunately, almost all ulcer patients fall into the hands of physicians only when they begin to feel acute attacks of pain in the stomach or duodenum.

Since the pathology of the gastric mucosa or duodenal mucosa has already become aggravated, the treatment regimen also provides for the use of dynamic principles of assistance.

After successful manipulations, the patient is prescribed preventive therapy, which may include not only pharmacological preparations, but also folk remedies.

As a rule, with an exacerbation of a stomach or duodenal ulcer, enhanced treatment is used, which is usually distributed over ten days.

During this period, the patient must comply with bed rest and strict dietary nutrition.

As for the list of medicinal compositions, the list includes funds, focusing on the causes that provoked the occurrence of peptic ulcer.

They also prescribe means that will eliminate the irritating effect on the body of external and internal factors.

For the treatment of ulcerative formations, drugs of the following type are prescribed:

antibiotics - allow you to completely suppress the growth and development of infectious microorganisms;
antiulcer agents containing bismuth;
antisecretory drugs to normalize the acidic environment.

Intensive antibiotic therapy can result in severe complications for the body weakened by the disease.

Therefore, the primary task of the attending physician is to assess the state of the patient's body and draw up an adequate treatment plan.

Should gastritis be treated with antibiotics?

With gastritis, as with a stomach or duodenal ulcer, a complex treatment scheme is used.

Previously, with gastritis, drugs such as Metronidazole (Metronidazole) and Bismuth subsalicylate (Bismuth subsalicylate) were prescribed.

The effectiveness of these drugs has been time-tested, but more and more often completely new antibiotics have been used in the treatment of gastritis:

antibiotics made on the basis of the active substance clarithromycin: Klacid, Clarexide and Bionclar;
antibiotics made on the basis of omeprazole: "Omez", "Omefez" and "Ultop";
antibiotics containing amoxicillin: Ecobol, Amoxicar and Amoxicillin.

It is possible to treat gastritis with the means listed in the list according to different schemes, it all depends on the degree of complexity of the disease and the body's reaction to the constituent components.

Since bacteria tend to get used to active substance antibiotic, then with gastritis, drugs from different groups can be prescribed.

For example, "Metronidazole" can be combined with the funds from the third paragraph.

With gastritis, as with a stomach or duodenal ulcer, the attending physician develops a medication regimen. Moreover, all therapy takes place directly under his control.

For gastritis, strong antibacterial drugs are prescribed for 7 days, and weak drugs for a longer period.

In addition to antibiotics, given the symptoms of pathology, other drugs are also prescribed for gastritis.

With gastritis with low acidity, the patient is credited with the use of artificial or natural gastric juice during meals.

The tool is necessary, since during this period it is not produced enough by the cells of the stomach, it contains substances that promote the digestion of food.

With gastritis with high acidity, the patient is prescribed acid blockers. As a rule, the following drugs are used: Vikalin, Maalox, Rennie and Atropine.

Since the disease of the gastrointestinal tract is rarely accompanied by pain, nausea and vomiting, then, accordingly, painkillers are prescribed.

In this case, these are analgesics and antispasmodics: Baralgin and Analgin, No-shpa and Papaverine, as well as the antiemetic drug Motilium and psychopharmacological agents: Valerian Extract and Sanason.

Propolis - a natural antibiotic against ulcers and gastritis

Sometimes standard antibiotics for gastric and duodenal ulcers are replaced or supplemented with natural antibacterial agents.

In this case we are talking about natural propolis, which is also called bee glue.

Unlike drugs of chemical origin, propolis in the treatment of gastritis and peptic ulcers alleviates the symptoms of inflammation without suppressing immune system person, but, on the contrary, strengthening it.

You can treat stomach and duodenal ulcers with propolis using the following advice: it is recommended to start the treatment course with propolis oil, which covers the mucous membrane of the digestive organ with a protective film and removes the symptoms of inflammation.

Butter recipe: butter (95 g) is combined with 5 g of propolis, put on a steam bath and stirred for 15 minutes, not allowing to boil. The cooled medicine is taken 3 times a day for 1 tsp.

To remove the symptoms of peptic ulcer, you can use propolis tincture, which is made with alcohol.

The tool has antimicrobial properties, allows you to normalize acidity, improves the functioning of the liver and gallbladder, and also relieves painful spasms and promotes healing of ulcers. Tincture is purchased at a pharmacy.

If treatment with tincture of gastric and duodenal ulcers does not cause discomfort, but gives positive result, then in a week you can switch to 20 - 30% propolis tincture.

The course of treatment is accompanied by a diet, which is made by a doctor, and lasts 1-2 months.

This medicine is also taken 3 times a day, 30 minutes before meals. If, using the above two drugs, it was not possible to completely cure gastritis or gastric and duodenal ulcers, then the course of treatment must be repeated.

Since bee glue is not only a strong natural antibiotic, but also the strongest allergen, it cannot be used to treat peptic ulcers without a doctor's recommendation.

In order for propolis treatment to be most effective, it is recommended to accompany it with a properly formed nutrition system and maintaining a healthy and stress-free lifestyle.

Any use of the drug is consistent with the attending physician. The following information serves as a guide before visiting a specialized medical facility.