Helicobacter pylori (H.p.) is a gram-negative bacterium of a concave or spiral shape that lives in the human gastrointestinal tract and possibly some primates.
It has 4-6 flagella, with whichmoves like a corkscrew, penetrating the mucous membrane of the stomach and duodenum, there are also data on the possibility of colonization of the epithelium of the mouth, pharynx, esophagus and rectum. Biochemical properties of this bacterium consist in the release of active enzymes - urease, protease, alkaline phosphatase, oxidase, catalase, gamma-glutamyltransferase. It is these enzymes that determine its pathogenic effect on the mucous membrane of human organs and cause their inflammation in a hypersecretory type: gastritis, bulbitis, duodenitis, which in the future can lead to the development of peptic ulcer. In this connection, medicine began to develop the direction of prevention and treatment of Helicobacter infection - eradication therapy, which is a complex of drugs actively fighting the toxins of this microbe and contributing to the normalization of the pH of the gastrointestinal tract, which ultimately leads to a complete evacuation of the bacterium .
Treatment regimens H.p.
Eradication therapy affects both directlyon the microorganism, and on the results of its pathogenic action. This is due to its components: antibiotics kill bacteria, and proton pump inhibitors reduce the acidity of the stomach and duodenum, preventing the development of ulcers and, thereby, creating conditions that are not viable for the microbe. And since eradication therapy in its scheme contains several antibacterial agents, parallel reception of probiotic drugs is also recommended to prevent the development of dysbacteriosis. At present, medical scientists have developed two main schemes for the destruction of H.p. So, three-component eradication therapy is a complex of two antibiotics (clarithromycin + amoxicillin / metronidazole) and a proton pump inhibitor (such drugs as "omeprazole", "rabeprazole", "pantoprazole", etc.) in standard doses twice a day. It can be ineffective only in two cases: if the patient does not follow the rules for taking drugs, or if there is resistance of his H.p. strain. to one of the antibacterial agents.
Quadrotherapy
In the above case,four-component scheme of eradication therapy, which additionally includes bismuth dicitrate - an antiulcer drug that has a high activity against H.p. and aimed at its destruction in the mucosa. This drug has limited controlled use due to its toxic effects on the central nervous system in the case of long-term administration in large doses, because bismuth has the property of accumulation in the neural tissue and causes drug encephalopathy. However, eradication therapy of peptic ulcer is an integral component of her treatment, because first of all it is necessary to influence the etiology of the disease.
