This is an automatically translated article.
The article was professionally consulted by a doctor from the Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.Up to 90% of patients with peptic ulcers are caused by Helicobacter pylori bacteria, the presence of HP increases the risk of stomach cancer. Therefore, when detecting the presence of HP, it is necessary to treat with antibiotics according to the regimen and adhere to the treatment time.
1. Issues related to HP eradication treatment
Helicobacter pylori abbreviated as HP is a bacteria that resides in the stomach, the leading cause of peptic ulcer disease and increases the risk of stomach cancer.
Patients should go for a gastrointestinal examination to detect HP infection when: There are signs of peptic ulcer disease or when there is a family member with stomach cancer, peptic ulcer disease...
HP bacteria are very resistant to antibiotics, so treatment often requires a combination of 2 or more antibiotics and monitoring of the eradication of HP by subclinical testing methods.
The use of antibiotics to treat HP must comply with the instructions of the doctor and not arbitrarily use antibiotics without a positive diagnosis for HP to avoid antibiotic resistance of HP bacteria.
During treatment, the patient should completely abstain from alcohol and tobacco.
2. Diagnosis of gastritis caused by HP
Methods in medicine applied to detect HP bacteria include:
Invasive method: The patient is carried out gastroduodenal endoscopy, general assessment of the condition of gastric ulcer - duodenal ulcer . At the same time, after the endoscopy, the doctor takes a biopsy tissue sample and conducts a rapid urease test, histological biopsy or bacterial culture. Non-invasive method: This method patients can know if they are infected with HP bacteria or not without the need for gastroscopy, with the following 3 ways: Breath test : Can be used before treatment Treatment to detect HP bacteria and after treatment to evaluate successful HP eradication Test for HP bacteria in stool: Also a method to find HP that can be used before and after HP treatment Antibody test anti-HP in the blood (rarely applied)
3. Treatment methods for HP-positive gastritis
Các trường hợp có loét dạ dày tá tràng có HP dương tính
According to the Vietnam Gastroenterology Association, treatment to kill HP bacteria is indicated in the following cases:
All cases of peptic ulcer have positive HP. HP-positive gastritis Family history of gastric cancer, peptic ulcers Chronic atrophic gastritis After gastric cancer surgery Long-term treatment with non-steroidal anti-inflammatory drugs (NSAIDs) Anemia iron of unknown cause, idiopathic thrombocytopenic purpura.. Regimen for gastritis with positive HP : Below are the treatment regimens to eradicate HP being applied, the goal of treatment is to kill at least from 80-95% of bacteria HP
PPI is a proton pump inhibitor, has the effect of reducing gastric acid secretion.
Initial standard 3-drug regimen: PPI and 2 antibiotics. Use time from 10-14 days. PPI: Proton pump inhibitor to reduce gastric acid, usually omeprazole 1 tablet twice a day. Amoxicillin 1g/time 2 times a day Clarithromycin 500mg/times 2 times a day Or
PPI: 2 times a day. Amoxicillin 1g/time 2 times a day Metronidazole 500mg/times 2 times a day 4-drug regimen is applied when the standard 3-drug regimen fails or has previously used macrolide antibiotics (clarithromycin). The duration of use of the drug is from 10-14 days. PPI 2 times a day Tinidazole or Metronidazole 500mg / time 2 times a day Bismuth 120mg / 4 tablets / day divided into 2 times Or
PPI: 2 times a day. Amoxicillin 1g/time 2 times a day Clarithromycin 500mg/times 2 times a day Metronidazole 500mg/times 2 times a day Serial HP regimen for the first 5 days: PPI+Amoxicillin for the next 5 days: PPI+Clarithromycin+Tinidazole Rescue regimen: When treatment fails with regimens above PPI-levofloxacin-amoxicillin PPI-rifabutin-levofloxacin PPI-rifabutin-amoxicillin PPI-bismuth-tetracycline-amoxicillin PPI-furazolidone-amoxicillin PPI-bismuth-doxycycline-amoxicillin PPI-amoxicillin (dose) high 1gx 3 times/day) PPI-bismuth-tetracycline-furazolidone The treatment of HP is not simple, so the patient must absolutely follow the doctor's instructions during the treatment. After the end of a course of treatment, the patient is assessed whether HP eradication is successful or not.
Gastritis with positive HP should be treated according to the schedule in time, avoiding the risk of the disease becoming a stomach ulcer. Patients should not self-diagnose and arbitrarily use antibiotics, but should be checked for HP before proceeding to kill HP.
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