Treatment and prophylaxis of stomach ulcers should be aimed at eliminating the causes( bacterial, physiological) and symptoms( nausea, vomiting, belching, heartburn) of the disease. Since such a disease has a cyclic chronic character with a probability of manifestation of mandatory seasonal exacerbations, it is necessary to determine effective therapy of gastric ulcer.
The peculiarity of this pathology is that it often occurs asymptomatically, and its relapses and exacerbations can be eliminated even without the use of medicines, using only dietary recommendations and the right way of life. But hope for spontaneous scarring of the ulcer is not worth it, as this can lead to the manifestation of dangerous complications( bleeding, stenosis, perforation).
To prevent the occurrence of undesirable consequences, after the diagnosis, throughout the course of treatment, endoscopic control is performed. It is conducted no more often than 2 times / 14 days. This allows us to assess the quality and effectiveness of the medical measures used.
Gastric ulcer therapy includes a comprehensive approach, combining drugs of different actions and destinations, according to anamnesis.
Combined therapy of peptic ulcer depends on a number of individual characteristics of the human body( age, lifestyle, state of immunity), from the secretion of the digestive organ and the presence of bacterial soil. This scheme of therapy of peptic ulcer is as follows:
- Bismuth preparations ( Vikalin, Visnol, De-Nol, Vikair, Bismuth subnitrate) and antacids( Maalox, Fosfalugel, Almagel).They carry out the enveloping action, prevent the influence of pepsin and hydrochloric acid on the walls of the stomach.
- Proton pump blockers - BPP( Omeprazole, Lansoprazole, Omez, Nolpaza) and H2 receptors( Ranitidine, Kvamatel, Zantak, Famotidine).Create a balance of gastric juice, thereby eliminating pain.
- Antibacterial agents ( antibiotics).Suppress the development of infections and contribute to their complete destruction( Metranidazole, Clarithromycin, Amoxicillin, Tetracycline).
This complex of treatment has been called the triple therapy of peptic ulcer. In the early stages of the disease for quick elimination of symptoms, the doctor prescribes the simplest scheme - antibiotics Amoxicillin and Clarithromycin in combination with BPP.If it does not help, the patient is prescribed stronger drug combination regimens. The course of treatment is 5-7 days
Many patients and doctors note the effectiveness of complex therapy of peptic ulcer, which necessarily includes antibacterial agents. In the 90 years of the last century, the so-called Protocol for the treatment of peptic ulcer was developed and introduced into medical practice, which implies basic secretory therapy( cicatrization of ulcerative formations in a short time).It determines when and in what doses an antisecretory drug should be administered.
Eradication therapy for gastric ulcer
One of the causes of ulcerative stomach disease is the bacterium Helikobakter Pilori. This microorganism differs among other bacteria with resistance to hydrochloric acid. This immunity allows it to rapidly multiply and create whole colonies in the cavity of the digestive organ. To eliminate these manifestations, there are special measures - eradication therapy for gastric ulcer, which means the destruction of Helicobacter bacteria. It is not recommended to take one antibacterial agent. Eradication treatment also requires an integrated approach, and it goes in two stages:
- І stage .The doctor prescribes proton pump inhibitors( Omeprazole) in combination with the antibiotics Metronidazole and Clarithromycin. The course of treatment is 7 days. Dosage and combination of these drugs should appoint a gastroenterologist.
- Stage II of the .If the first treatment option is ineffective, a different complex of antibiotics( Metronidazole and Tetracycline), PPI( Omeprazole) and bismuth preparation( De-nol) are used. The course of treatment lasts about 14 days and is accompanied by a large number of side effects.
To facilitate the influence of antibiotics on the mucous membrane and the walls of the stomach, auxiliary substances are prescribed: Almagel, vitamins, sea buckthorn oil, aloe extract.
Quadratherapy of gastric ulcer
By definition, quadrotherapy means the treatment of the second line. This was regulated by the recommendations of the Maastricht Agreements of 2-2000 g. As experience shows, it is not advisable to use a more effective second-line scheme, instead of the first one, for inhibiting the Helicobacter bacteria, since the microorganism has high resistance( stability).Therefore, the first scheme must first be applied, and then the second one.
Quadratherapy of peptic ulcer involves the use of bismuth sub-citrate( De-nol), proton pump blocker or H2-blockers, two antibiotics( Amoxicillin, Clarithromycin or Furazolidone) in combination with the antibacterial Nifuratel. Quadrotherapy is used after the ineffectiveness of triple therapy, in the case of Helicobacter resistance to antibacterial drugs.
Quadrotherapy is almost 98% successful in destroying a harmful bacterium, regardless of its sensitivity to antibiotics.