Modern approaches in treatment of helicobacteriosis in patients with peptic ulcer
Peptic ulcer is a chronic recurrent disease, accompanied by alternating periods of exacerbation and remission, its main feature is the formation of an ulcer in the wall of the stomach and (or) duodenum, penetrating - in this difference from superficial damage to the mucous membrane (erosions) - into the submucosal layer. The etiology is the appearance of Helicobacter pylori (H. pylori) falling into favorable conditions with weakened microflora and the presence of aggressive factors from the environment. In the pathogenesis of peptic ulcer disease, thinning of the gastrointestinal mucosa and violation of compensation mechanisms at the local level are of paramount importance. An important role in the diagnosis is given to a carefully collected anamnesis and complaints of the patient supplemented by physical examinations, laboratory and instrumental examination methods. The treatment of patients is based on modern methods of treatment, where the latest drugs with proven efficacy and well-proven in clinical practice are used, consistent with the international recommendations of the Maastricht V / Florence Consensus, where anti-helicobacter therapy is mandatory for patients with peptic ulcer and chronic gastritis. Currently, treatment is still based on a combination of antimicrobial agents (amoxicillin, clarithromycin, metronidazole), and antisecretory agents (proton pump inhibitors). Standard triple therapy, which includes PPIs and two antibiotics (clarithromycin and amoxicillin/metronidazole) are widely used as a main-line regimen for the treatment of infection. In addition, the concomitant use of alternative medicine is important for the emergence of adaptive or synergistic effects against H. pylori infection.