Helicobacter pylori (Hp) is a concave or spiral-shaped gram-negative bacterium that lives in the human gastrointestinal tract and, possibly, in some primates.
It has 4-6 flagella, with the help of which it moves like a corkscrew, penetrating under the mucous membrane of the stomach and duodenum, there is also evidence of the possibility of colonization of the epithelium of the oral cavity, pharynx, esophagus and rectum. The biochemical properties of this bacterium are the secretion of active enzymes - urease, protease,
alkaline phosphatase, oxidase, catalase, gamma-glutamyl transferase. It is these enzymes that determine its pathogenic effect on the mucous membrane of human organs and cause their inflammation in the hypersecretory type: gastritis, bulbitis, duodenitis, which in the future can lead to the development of peptic ulcer. In this regard, the direction of prevention and treatment of Helicobacter pylori infection has begun to develop in medicine - eradication therapy, which is a complex of drugs that actively fight the toxins of this microbe and help normalize the pH of the gastrointestinal tract, which ultimately leads to the complete evacuation of the bacterium .
Hp treatment regimens
Eradication therapy affects both the microorganism itself and the results of its pathogenic effect. 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 administration of probiotic drugs is also recommended to prevent the development of dysbiosis. At present, medical scientists have developed two main schemes for the destruction of Hp. Thus, three-component eradication therapy is a complex of two antibiotics (clarithromycin + amoxicillin / metronidazole) and a proton pump inhibitor (such drugs as Omeprazole, Rabeprazole, Pantoprazole and etc.) in standard doses twice a day. It can be ineffective only in two cases: if the patient does not comply with the rules for taking drugs, or if there is resistance to his Hp strain to one of the antibacterial agents.
Quadrotherapy
In the aforementioned case, a four-component regimen of eradication therapy is prescribed, which additionally includes bismuth dicitrate, an antiulcer drug that has high activity against Hp and is aimed at its destruction in the mucous membrane. This drug has limited controlled use due to its toxic effect on the central nervous system in the case of long-term administration in large doses, because bismuth has the property of accumulation in the nervous tissue and causes drug encephalopathy. However, eradication therapy of peptic ulcer disease is an integral component of its treatment, since it is primarily necessary to influence the etiology of the disease.