- Aggressive microbe
- Prepare the soil
- Neutralize enemy
Peptic ulcer disease - a big problem forhealth because the disease is widespread (found in approximately 10% of the population), it is chronic, often recurs, and is fraught with the development of complications, leading to high costs for the treatment and maintenance of remission.
The essence of the disease is ulceration wallstomach or duodenum 12, due to the imbalance between "aggressive" and "protective" factors. The leading role in strengthening the aggression factors belong the bacteria Helicobacter pylori.
It is found that this bacterium infectedan average 85-90% of persons suffering from a stomach ulcer. In 1994, experts from the World Health Organization (WHO), Helicobacter pylori was entered in the class of so-called reliable carcinogens. After all, the risk of cancer (adenocarcinoma), stomach infected patients increases by 3 times.
Helicobacter pylori (Helicobacter pylori) -spiral gram-negative bacteria that have been found at more than half a century ago, the mucous membrane of the stomach, but they did not cause much interest to the early 1980's. When organisms cultivation method from the mucous membrane of the material has been developed.
In 1983 Australian physician Barry Marshall discovered that Helicobacter pylori is almost always present in the stomach of patients with chronic gastritis or ulcer. Bacteria themselves, gastric or duodenal ulcers do not cause, however, provoke inflammation and impaired gastric mucosa natural protection from exposure to the acidic environment of the stomach; wherein gelikobakter stimulates hypersecretion of hydrochloric acid by acting on the mechanisms of its regulation. If pursued therapy reduces the acidity of the stomach, the ulcer may be delayed, but after cessation of treatment there is a possibility of its recurrence. Long-term observations have shown that in patients not receiving antimicrobial therapy, the ulcer recurs in 100% after 2 years, and in patients treated repeatedly occur (usually as a result of re-infection) only 5-10%.
Source of infection Helicobacter pylori -infected person, cats, pigs, cattle and monkeys (rhesus monkeys). Most infection occurs through contaminated feces of water and food (such as vegetables, when watering that contaminated water was used). The object of transmission of infection can be the start of soiled hands, saliva droplets of saliva or sputum by coughing. There is evidence of transmission of infection through gastroscopes and gastric probes.
Research conducted by doctors from the United Stateshave shown that Helicobacter pylori infection can be considered a family, and if the family has identified the carrier of these bacteria, the chances of other family members become infected is 95%.
For accurate diagnosis of peptic ulcer disease andHelicobacter infection is necessary to conduct endoscopic examination of the stomach and duodenum 12, during which performed a biopsy of the mucous membrane of the stomach wall and is confirmed or rejected by the presence of bacteria. There are also non-invasive detection of Helicobacter infection - blood or exhaled breath analysis - however, they are not always available in practice.
There antisecretory drugs,providing not only the healing of ulcers, but also create optimal conditions for the destruction of bacteria. Among them we should highlight the preparation of the new generation - esomeprazole.
For the eradication of Helicobacter pylori esomeprazole20 mg administered two times a day at 8 and 20 hours for 7 days in combination with antibacterial agents, selected gastroenterologist. For the treatment of acute peptic ulcer disease 12 duodenal ulcer quite a seven-day course of therapy without subsequent maintenance therapy, which is economically viable.
Today, all over the world in the treatment of peptic schemediseases introduced antimicrobials. They are used together with proven anti-acid agents. The destruction (eradication) of Helicobacter using the appropriate combination of drugs provides disease-free for not only peptic ulcer disease, but also regression of chronic gastroduodenitis, relieves the patient of the possible complications of the disease, and is probably a measure of prevention of gastric cancer.
The list of drugs with antigelikobakterna activity WHO experts included antibiotics clarithromycin and amoxicillin and metronidazole (Trichopolum).
Despite the emergence of new highdrugs, the success of treatment of peptic ulcer disease depends to a large extent on strict compliance with requirements of the patient and physician recommendations (including diet and diet, smoking cessation, etc.).