Check out how to do Helicobacter pylori positive? Although Helicobacter pylori does not necessarily cause gastric cancer, eradication of Helicobacter pylori can significantly reduce the risk of gastric cancer. Therefore, once we find that we are infected with Helicobacter pylori, we should seek medical treatment in time and carry out standardized treatment.
First, how to treat it?
At present, the commonly used drug therapy is quadruple therapy, which, as its name implies, contains four drugs: a stomach acid inhibitor, a bismuth agent and two antibacterial drugs, with a course of 10-14 days.
1. Drugs
for inhibiting gastric acid Drugs that
inhibit gastric acid often choose proton pump inhibitors, which can inhibit the secretion of gastric acid, create a suitable environment for antibacterial drugs to kill Helicobacter pylori, and significantly increase the antibacterial activity of antibacterial drugs. Acid suppressants can also improve the stability of some antibacterial drugs. Commonly used drugs include esomeprazole, omeprazole, pantoprazole and so on.
2. Bismuth
Bismuth also has a certain bacteriostatic effect and plays an auxiliary bactericidal effect. Commonly used drugs include bismuth pectin, hydrotalcite, bismuth potassium citrate and so on.
3. Two kinds of
antibiotics Antibiotics commonly used in
eradication therapy include amoxicillin, clarithromycin, levofloxacin and metronidazole, which can kill Helicobacter pylori. Doctors will choose different antibiotics for patients according to their past medication history and local antimicrobial resistance background, not everyone’s medication is the same.
2. How to take drugs?
1. Drugs for inhibiting gastric acid: take orally twice a day, 30 minutes before meals.
Acid suppressants create a suitable environment for antimicrobial sterilization by inhibiting gastric acid secretion. Commonly used standard doses of PPIs include omeprazole 20 mg, esomeprazole 20 mg, rabeprazole 10 mg, lansoprazole 30 mg, pantoprazole 40 mg, and ilaprazole 5 mg.
2. Bismuth: Take orally twice a day, 30 minutes before meals.
Bismuth protects gastric mucosa and has auxiliary bactericidal effect. Commonly used drugs include bismuth potassium citrate 220mg, pectin bismuth and so on. 3. Antibacterial drugs: take orally about 30 minutes after meals.
Scheme 1: Amoxicillin 1.0 G, twice daily and clarithromycin 0.5 G, twice daily.
Scheme 2: amoxicillin 1.0 G twice daily + levofloxacin 0.5 G once daily or levofloxacin 0.2 G twice daily.
Scheme 3: amoxicillin 1.0 G, twice daily + metronidazole 0.4 G, 3-4 times daily.
For patients who are allergic to penicillin, the following options are available:
Combination 1: tetracycline 0.5g, 3-4 times daily + metronidazole 0.4g, 3-4 times daily.
Combination 2: cefuroxime 0.5g twice daily + levofloxacin 0.5g once daily.
Combination 3: clarithromycin 0.5g, twice daily + metronidazole 0.4g, 4 times daily.
3. What should we pay attention to during medication?
1. Do not smoke or drink alcohol during medication, because it may hinder treatment.
2. Amoxicillin is contraindicated for those allergic to penicillin.
3. Clarithromycin should be used with caution in patients with severe arrhythmia.
4. Pay attention to the medication time of different kinds of drugs, and do not confuse before and after meals, otherwise it will affect the efficacy.
5. In the course of treatment, because of taking bismuth, the stool will turn black, which is a normal phenomenon caused by the color of the drug, and will return to normal after stopping the drug, so there is no need to panic.
6. Drug-related adverse reactions such as bitter taste in the mouth, metal odor in the mouth and yellow urine may occur during medication. If the symptoms are mild, it is not recommended to stop taking the drug.
7. During medication, if skin itching, allergic rash, fever, liver function damage or even expiratory dyspnoea occur, it is necessary to stop medication immediately and seek medical treatment in time.
8. Take the medicine according to the medical supervision. The course of treatment is 10-14 days. Do not stop taking the medicine at will, or shorten or extend the course of treatment at will. Interruption of medication or irregular medication can easily lead to treatment failure and drug resistance of flora, which not only causes certain economic losses, but also brings greater difficulties to eradication treatment in the future.
4. What do you need to do after medication?
Helicobacter pylori infection should be reexamined in time after
treatment, and breath test should be reexamined 1-2 months after radical treatment.
5. What to do if eradication fails?
If the first or multiple eradication fails, the second eradication program should not be started immediately. It is recommended to select antibiotics according to the drug sensitivity results of the infected strains and start the second eradication treatment at least 3 months later.
Helicobacter pylori Helicobacter pylori infection
