Gastritis with Helicobacter
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treatment
In 2005, the Nobel Prize in Medicine was awarded to two scientists whose names will forever remain in the history of gastroenterology. R. Warren and B. Marshall proved for the first time that gastritis, in the vast majority of cases (more than 90%), is caused by the bacterium Helicobacter pylori (Helicobacter pylori, H. pylori, HP). This conclusion radically changed the attitude to the etiology and pathogenesis of this disease, but even more changed the approaches to treatment that were already well-established at that time.
Helicobacter pylori, a spiral-shaped gram-negative bacterium, is a unique microorganism that can survive in the acidic environment of the stomach. Infecting not only the stomach, but also the duodenum, H. pylori can cause gastritis, duodenitis, gastroduodenitis, gastric and duodenal ulcers, and oncopathology of these localizations.
In order to survive in the acidic conditions of the stomach, Helicobacter pylori has several important properties.
First: spiral shape and the presence of flagella. After getting into the stomach, these devices allow Helicobacter to penetrate the protective layer of mucus and stop directly at the epithelial cells of the mucous membrane.
Secondly: Helicobacter is able to produce urease, which breaks down urea to ammonia and other compounds. Urea is always present in gastric contents in small concentrations, but for H. pylori this is enough to neutralize hydrochloric acid around itself with the help of the obtained ammonia.
In addition, Helicobacter pylori produces a number of its own enzymes that dissolve the protective layer of gastric mucus, thereby exposing the cells of the mucous membrane and exposing them to the aggressive action of their own gastric juice. Helicobacter also secrete endotoxins, which have a direct damaging effect on the cells of the stomach.
All these factors together lead to damage to the gastric wall and the occurrence of an inflammatory reaction in it - gastritis, which today is one of the most common diseases of the gastrointestinal tract, and this pathology is increasingly found in young people.
Indication for the search for Helicobacter pylori is the presence of symptoms of gastritis or other inflammatory diseases of the stomach and duodenum. The search for Helicobacter for prophylactic purposes does not have great diagnostic value, since about 90% of people among the entire population infected with this bacterium do not have any symptoms of the disease and are only carriers of H. pylori.
All diagnostic methods for Helicobacter pylori can be divided into invasive and non-invasive.
Among invasive methods - endoscopic examination of the stomach with a biopsy. The obtained section of the mucous membrane is subjected to biochemical examination for the presence of urease, immunological - to search for bacterial antigens and histological - to directly visualize Helicobacter and obtain its quantitative characteristics. Non-invasive Helicobacter determination methods include immunological studies and reduced respiratory tests. Using immunological studies, the titer of antibodies to H. pylori is determined in the blood, and the antigens of this bacterium in feces.
Truncated breath tests are of two types. In one case, urea with radioactive carbon is used; in the other, urea is used. The latter method, due to its safety and speed, is gaining wide popularity and can be used in children. Performing a breath test for Helicobacter pylori allows you to determine the level of ammonia in the exhaled air and based on this draw a conclusion about the infection of the stomach with H. pylori.
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Helicobacter eradication methods
To remove Helicobacter pylori from the body, clinic gastroenterologists K + 31 is prescribed a three-component therapy, including an antisecretory drug and two antibiotics (clarithromycin and amoxicillin).
We keep the health of our patients in focus, therefore, to monitor the effectiveness of treatment, we recommend conducting a urease breath test for Helicobacter, or other methods for detecting this infection.
If such treatment is ineffective, they switch to a four-component therapy (antisecretory drug, bismuth drug, metronidazole and tetracycline).
If in this case the eradication of Helicobacter pylori remains unsuccessful, then to continue therapy, the sensitivity of the bacterium to already specific antibiotics is determined with their subsequent appointment.
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