At present, more than half of the number of Helicobacter pylori infections in mainland China has reached many people, and many people have an uneasy appetite, and the existence of Helicobacter pylori will be found after the breath examination in the hospital, and anti-Helicobacter pylori is commonly used as a "quadruple" therapy.
But are you taking the right medicine for Helicobacter pylori?
Today, let's take a look at how to take anti-Helicobacter pylori drugs, and what should we pay attention to?
What diseases are associated with H. pylori infection?
Helicobacter pylori (H.p) is a spiral-shaped bacterium found in the stomach and duodenal bulb. Helicobacter pylori is closely related to chronic gastritis, peptic ulcer, and gastric cancer.
However, being positive for Helicobacter pylori does not mean that you will definitely get stomach cancer in the future, and being positive for Helicobacter pylori is only one of the main factors for the onset of stomach cancer.
Who needs to eradicate Hp?
1. Long-term NSAIDs:
Nonsteroidal anti-inflammatory drugs (NSAIDs), which increase the risk of peptic ulcer development in patients with Hp infection, are recommended for the eradication of Hp in patients who plan to use NSAIDs for a long time, including low-dose aspirin.
2. Long-term users of PPI (lazole):
In patients who take PPI for a long time, gastric acid secretion decreases, Hp colonization shifts from the antrum to the gastric body, and gastric corpus gastritis occurs. Eradication of Hp can reduce or eliminate the risk of gastritis in people who take PPIs for a long time.
3. Vitamin B12 deficiency:
Hp infection may be associated with vitamin B12 malabsorption, but vitamin B12 deficiency is often autoimmune, and eradication of Hp can play an adjunctive role.
4. Stomach disease and related diseases: see the following table for details↓
What are the benefits of eradicating H. pylori?
The eradication of Helicobacter pylori is the main means to prevent the occurrence and recurrence of gastritis, peptic ulcer and gastric cancer, especially for the prevention and treatment of the further development and exacerbation of atrophic gastritis.
Eradication of Helicobacter pylori before intestinization occurs has the potential to reverse the atrophy of the gastric mucosa and prevent almost 100% of the occurrence of intestinal gastric cancer.
Eradication should benefit most until the absence of symptoms, with the optimal age being 18-40 years;
How to check for Helicobacter pylori?
According to relevant statistics, more than half of the world's population has Helicobacter pylori, and even 80% of people in some areas carry this bacterium, and the infection rate of Helicobacter pylori in the mainland is 40%~60%, which is one of the countries with a high infection rate.
Helicobacter pylori is a group I carcinogen and is detected as follows:
1. Breath test: C13 or C14 breath test. At present, it is the most commonly used in clinical practice, accurate and convenient, but due to the influence of recent drug use, it is necessary to stop antibiotics for 4 weeks and lazoles for 2 weeks. Carbon-14 is not suitable for pregnant women and children.
2. Blood test: detect Helicobacter pylori antibodies and toxins in the blood. The disadvantage is that it may still be positive even after successful treatment, so it cannot be used as a post-treatment follow-up.
3. Rapid urease test: take part of the patient's antral mucosal tissue for testing. A biopsy is taken at the time of gastroscopy, which is an invasive test.
How Helicobacter pylori is treated:
At present, a quadruple therapy containing bismuth is recommended, namely: one PPI + bismuth agent (if gum bismuth) + two antibiotics, both taken twice a day, in the morning and evening, of which 2 are taken half an hour before meals (xx prazole and colloidal pectin bismuth), and the other 2 are taken after meals (antibiotics).
1. Selection of antibiotics: Please refer to the table below
Caution:
1. The combination of (5) and (6) in the table is suitable for penicillin-allergic patients;
2. (7) Due to the high drug resistance of levofloxacin, it is not recommended as a first-line drug and first-time sterilization.
3. To choose two kinds of antibiotics, you must choose at least one of the three drugs of amoxicillin, tetracycline and furazolidone.
Second, the choice of antacids
Choose one of the following, twice a day, half an hour before meals:
埃索美拉唑：20mg，奥美拉唑20mg，兰索拉唑30mg，泮托拉唑40mg，雷贝拉唑20mg。
3. Bismuth agent selection
colloidal pectin bismuth, 2 capsules at a time, twice a day, half an hour before meals;
Livzon Dela, 2 sachets (110mgx2), dosage as above.
Precautions for medication:
1. Confirm whether there is a history of allergies: those who are allergic to penicillin are forbidden to take amoxicillin! If there is an allergic rash, the drug must be stopped immediately and go to the hospital for treatment.
2. The course of treatment is 10-14 days, not less than 10 days, it is recommended to take as much as possible for 14 days, and the drug will be stopped at the end of the course. Do not arbitrarily discontinue the drug or prolong or shorten the time of taking the drug.
3. Some possible side effects: black tongue and stool, bitter mouth, ammonia or metallic taste, dizziness, nausea, fatigue, yellow urine, etc.
If you have intolerable side effects or allergies, palpitations, sweating, rashes, etc., stop the drug immediately and contact your doctor.
4. During the period of taking the drug (including within 7 days after stopping the drug), it is forbidden to drink alcohol and avoid spicy and stimulating diets.
5. Helicobacter pylori is an oral infectious bacteria, so do not share utensils with others in daily life, and it is recommended to disinfect tableware (boil with boiling water for 10 minutes or disinfect in a disinfection cabinet); After sterilization, replace old toothbrushes and other daily necessities that come into contact with the mouth.
6. Re-examination of Helicobacter pylori: 1 month after stopping the drug (gastric medicine and antibiotics), go to the endoscopy room on an empty stomach to open a breath test to re-check Helicobacter pylori, and re-examine the gastroscopy if necessary.
7. Secondly, antibacterial drugs (commonly known as "anti-inflammatory drugs"): most of them are also taken twice a day and immediately after meals. A penicillin skin test is done before taking amoxicillin. Avoid alcoholic beverages (including flavorings, fermented vinegar, syrup, tinctures, ginseng royal jelly and other tonic and strengthening agents) during and for a week after taking metronidazole and furazolidone.
Levofloxacin once daily and avoid direct sunlight (to reduce photosensitivity).
Clarithromycin extended-release tablets, taken during or after meals, do not crush or chew, do not eat grapefruit and grapefruit juice drinks.
Tetracycline should be taken two hours after meals, and should be taken with sufficient water (about 240ml) to avoid esophageal ulcers and reduce gastrointestinal irritation.
Milk cannot be drunk at the same time.
Finally, let's talk about review and prevention:
Stop taking antibacterial drugs (including berberine, etc.), bismuth and some traditional Chinese medicines with antibacterial effects (such as Banlan root, Pudilan anti-inflammatory tablets, Qingqi Coptis chinensis, etc.) in the previous month, and stop proton pump inhibitors for at least half a month.
A 1-month interval is recommended for re-examination.
To avoid reinfection, the following details should be noted: as shown in the figure
Since Helicobacter pylori is mainly transmitted through "mouth-to-mouth", it is recommended to avoid unclean eating, wash hands before and after meals, and advocate the use of chopsticks and separate meal systems in the family, and disinfection of eating utensils;
It is strictly forbidden for parents to chew food or lick it with their tongue and feed it to their babies;
If infected, it's a good idea for other members of the family to have a breath test at the same time.
In terms of diet, we would like to remind everyone:
Eat small meals frequently, chew slowly, regularly and quantitatively, rich in nutrition, and the food is soft and easy to digest;
Avoid oversatiety, alcohol, smoking, cold, sour and spicy, fried and stimulating, sweets, smoked and pickled food, and drink less coffee.