What problems must be paid attention to in the treatment of helicobacter pylori?

As we all know, the harm of Helicobacter pylori (Hp) is related to most stomach diseases and digestive tract tumors, especially the culprits of peptic ulcer and gastric cancer.

Therefore, more and more people who have stomach trouble demand to get rid of it. However, the eradication rate of quadruple therapy recommended by the state is decreasing year by year. The success rate of previous data is 80%-96%, and the latest data is 50%-90%.

Professor Chen Hong from the Department of Gastroenterology, Peking University No.1 Hospital once wrote that one of her patients actually killed 19 times before success. The reason is nothing more than subjective and objective factors. Subjective factors are mainly patients' non-compliance with doctor's advice, while objective factors are bacteria, drugs and other problems.

Hp is a drug that is very prone to drug resistance. Once the first sterilization fails, it is likely to produce drug resistance, and even bacteria will produce mutant strains, making it more and more difficult to sterilize again.

Therefore, how to be healthy today is to talk about: as a patient, how to cooperate with doctors and try to ensure that this annoying "ghost" is eradicated once!

First, eat enough courses of treatment.

The quadruple therapy recommended by the state requires a course of treatment of 10- 14 days, not less than 10 days;

Less than 10 days may not completely eradicate bacteria, but more than 14 days is unnecessary, which will increase costs and side effects.

Many friends who failed to eradicate forgot to take medicine or only took it for 7 days.

Therefore, it is recommended that the longer the medication, the better.

Second, distinguish the time of medication.

These four drugs are taken twice a day, usually at breakfast and dinner respectively. It must also be divided into before and after meals:

Lasazole (such as lansoprazole) and bismuth (such as bismuth potassium citrate) 30 minutes before meals;

Two antibiotics (such as amoxicillin and clarithromycin) should be taken immediately after meals or 1 hour.

During taking medicine, there may be black stool, tongue coating, black teeth, dark yellow urine and other phenomena, which are normal phenomena, so don't be afraid.

It should be pointed out that:

1. In case of allergic reaction such as rash, stop taking medicine immediately and seek medical attention.

Be very careful when using antibiotics, and don't buy medicine for treatment yourself. Patients with chronic diseases such as liver and renal insufficiency, diabetes, heart disease, pregnant women, lactating women,/kloc-children under 0/2 years old, especially don't take drugs without authorization! ! !

Third, adequate dosage.

The dosage of several drugs in the eradication plan may be larger than usual, such as amoxicillin 1000mg and omeprazole twice a day.

Acid inhibitors: esomeprazole 20mg, rabeprazole 10~20mg, omeprazole 20mg, lansoprazole 30mg, pantoprazole 40mg, ipratropium 5mg.

Bismuth agent: potassium bismuth citrate 220mg, colloidal bismuth pectin 200mg.

The prescriptions shown below are not standardized:

Many friends will confuse the concept of dosage and several tablets, because in their impression, taking medicine is about "several tablets"; In fact, the specifications of different pharmaceutical factories are different. For example, clarithromycin has two different contents: 0. 125g and 0.5g, so the doctor's advice requires you to take 0.5g, 0.25g requires 2 capsules, and 0. 125 requires 4 capsules.

It's simple: you determine the number of g (or mg) per dose and then convert it into the number of tablets. For example, every time amoxicillin is 1000mg (or 1.0g), the content of the medicine you bought is 0.25g(250mg), so: 1000 mg ÷ 250 mg.

Fourth, quit smoking and alcohol.

Do not drink or smoke during treatment!

Smoking can reduce gastric mucosal blood flow and gastric mucus secretion, thus reducing the amount of antibacterial drugs reaching gastric mucosa;

Smoking can stimulate gastric acid secretion and reduce the efficacy of acid-sensitive antibiotics such as amoxicillin and clarithromycin. Smoking may reduce patients' compliance with treatment.

Drinking alcohol and taking antibiotics have many unknown and known risks. No matter what medicine you take, you are not allowed to drink. Some drugs, such as amoxicillin and metronidazole, may produce disulfiram-like reactions, which may be life-threatening.

5. Don't take other unnecessary drugs at the same time.

During the treatment, it is best to temporarily stop taking other irrelevant drugs, including so-called health care products and tonics. If it is really necessary to take it, you should make it clear to the doctor and take it under the guidance of the doctor.

The mixing of some drugs will produce unknown side effects or affect the curative effect of quadruple drugs.

Sixth, choose good quality drugs.

After a patient failed in sterilization, I asked why. He took a box of omeprazole 1.5 yuan.

Ordinary people use drugs, of course, the cheaper the better; But the quality of drugs in some small factories is really unreliable.

Not that they are fake drugs. At least the uniformity is poor. The content of this piece exceeds the standard, and that piece is not up to standard.

Therefore, I suggest you try to go to public hospitals and more standardized pharmacies to get better medicine.

Seven, oral problems

Oral cavity may be another residence of Hp, which is an important reason for the failure or recurrence of Hp eradication, and may also be an important way of its spread.

Microorganisms in dental plaque have a unique "biofilm" structure, and conventional Hp eradication therapy is ineffective for oral Hp. Repeated Hp eradication failure can improve the eradication rate of Hp through oral cleaning at the same time of treatment.

Therefore, paying attention to oral hygiene, brushing your teeth twice a day and gargling after meals can reduce the colonization of Hp in your mouth. Patients with oral diseases, it is best to see the stomatology department first, and then start sterilization.

In addition, because it is word of mouth, a family member is infected with Hp, and all members suggest to test Hp and carry out Hp eradication treatment to prevent family members from infecting each other.

Eight, the end of treatment and review

After the course of treatment, it should be rechecked more than 4 weeks after taking the medicine (carbon 13 or carbon 14 gas test is recommended), otherwise false negative may appear.

If the treatment fails, patients who need to be treated again should not be treated immediately, with an interval of 3 months (some experts think that the success rate of re-eradication after an interval of more than 6 months will increase) to restore the sensitivity of bacteria to antibacterial drugs.

The choice of drugs for retreatment is difficult and must be carried out under the guidance of gastroenterologists.