Peptic ulcer of the stomach and duodenum is perhaps the most common disease of the digestive system. This disease is characterized by the formation of ulcerative lesions on the mucosa of the small intestine and stomach.
Often a peptic ulcer leads to the development of serious enough complications: malignant ulcers followed by the development of stomach cancer, the penetration of ulcers into neighboring organs, perforation of the ulcer, internal bleeding, etc. At the moment there are quite a few methods of treating this disease, however, only some of them are really effective
For a long period of time peptic ulcer of the stomach and duodenum was considered as a simple imbalance between the restoration and destruction of the tissues of the mucous membranes of the stomach and duodenum. It was also believed that a significant role in ulcer formation was played by chronic stresses and increased secretion of hydrochloric acid.
However, after a more detailed and in-depth study of the pathogenesis of this disease, it was established that the Heliobacter pylori infection probably plays the main role in the formation of peptic ulcer, therefore antibacterial preparations have become one of the main components of the ulcer treatment.
Treatment of peptic ulcer of the stomach and duodenum has the following objectives:
- Completely eradicate Helicobacteriosis
- Prevent the development of complications
- Normalize the digestive process
- Protect the gastrointestinal tract from the adverse effects of modern foods
- To reduce the secretion of hydrochloric acid
- Protect the mucous membranes of the stomach and duodenum from the damaging effects of digestive enzymes and hydrochloric acid
- Speed up the healing of ulcers
- It is compulsory to treat concomitant diseases that can stimulate the further development of peptic ulcer disease
- Treat complications caused by peptic ulcer
Complete eradication of heliobacterial infection is carried out in two stages (most patients are cured after the first stage).
Types of drugs used in heliobacter therapy:
- Antibacterial drugs: a group of penicillins (Amoxycycline), a group of nitroimidazole (Metronidazole), tetracycline and a group of macrolides (Clarithromycin)
- Hydrochloric acid secretion inhibitors: proton pump inhibitors (omeprazole, rabeprazole and lansoprazole) and antihistamines (ranitidine)
- Gastroprotectors: preparations of bismuth (Bismuth subcitrate)
At the first stage of treatment, a proton pump inhibitor or antihistamine + metronidazole + clarithromycin is prescribed. It is possible to replace one drug with another (only a similar action). Dosage and the final composition of the entire course of treatment is approved only by the attending physician on the basis of the individual indicators of each individual patient. The usual course of treatment of peptic ulcer is carried out for seven days and the success of this course aimed at complete eradication of heliobacterial bacteria is about 95 percent, and the frequency of observed annual relapses is reduced to 3.5 percent.
In the process of treatment according to the scheme described above, the probability (about 63%) of the occurrence of various adverse reactions of the body is great. Most often there are side reactions of an allergic nature (various skin rashes), also cases of disruption of the normal functioning of the gastrointestinal tract (dysbacteriosis, diarrhea, nausea and vomiting) are rare, and violations of the hematopoiesis system (agranulocytosis) are less common. Significantly serious adverse reactions are observed with the use of such drugs as furazolidone and tetracycline (approximately 10 percent of patients in this case cancels this course of treatment).
In the absence of positive dynamics of treatment from the first stage, the second stage is appointed: bismuth subcitrate + tetracycline + proton pump inhibitor + metronidazole. The duration of this course of treatment is about fourteen days. However, it causes much more (in comparison with the first) adverse reactions and is fairly difficult to tolerate by patients.
To accelerate the healing of ulcers and stimulation of regenerative processes, it is prescribed: sea buckthorn oil, methyluracil, steroid anabolic, solcoseryl, aloe extract and vitamins.
To eliminate the pain syndrome and improve the healing process, preparations are prescribed: diamond, sucralfate and de-nol.
In case of complications (development of stomach cancer, stenosis, perforation of the ulcer and internal bleeding), surgical treatment is used, the main purpose of which is to eliminate the ulcer and the complications that have arisen. Removal of the ulcer is always combined with gastroplasty (restoration of the form of the stomach)
. Patients with acute forms of peptic ulcer are assigned the so-called diet number 1 .
From food are completely excluded:
- Raw vegetables and fruits (pears, peaches, cabbage)
- Fried dishes, pickles and smoked products
- Concentrated broths and spices
- Cocoa, coffee and carbonated drinks
: Recommended eating :
- Fish and meat (steamed)
- Kasha with manna and oatmeal
- Dairy products
- Black currant, apple, carrot and beet puree
Eating should be in the form of small portions five to six times a day. The food should be at room temperature.
For the entire treatment period, alcohol and tobacco use should be completely ruled out.