De-nol with gastritis: a correct treatment regimen

Gastritis is almost the most common disease of the digestive tract. It is caused by the development of the inflammatory process, which, in turn, occurs when a specific Helicobacter pylori gets on the mucosa. To cure gastritis, the use of only anti-inflammatory drugs is small: it is necessary to protect the internal tissues of the stomach, to stabilize acidity and enzyme activity and to neutralize the pathogenic bacterium. Medication De-nol with gastritis is prescribed for these purposes: based on bismuth, this medicine successfully regulates the supply of hydrochloric acid, has a harmful effect on Helicobacteria, covers the gastric mucosa with an emollient film to protect against damaging factors. In addition, De-nol stimulates the recovery of stomach cells, heals small tissue defects, speeding up recovery.

[1], [2], [3], [4], [5], [6], [7], [8], [9]

Indications De-naught

De-nol is included in the therapy regimen not only with gastritis, but also with other pathologies of the digestive system:

• peptic ulcer (stomach and duodenum);
• chronic gastroduodenitis in acute period;
• irritable bowel syndrome with frequent loose stool;
• functional dyspepsia, which does not have a connection with the organopathology of the digestive system.

Gastritis is the main indication for the appointment of a de-nol medicine.

• De-nol with erosive gastritis is used in combination with medications that suppress acid production: it can be proton pump inhibitors (omeprazole) or H ₂ -blockers. Complex treatment allows for a short period of time to eliminate dyspepsia, stop signs of nausea and vomiting. With acute stress gastritis, De-nol promotes the healing of bleeding erosions.
• De-nol with atrophic gastritis is also part of the main treatment: it is prescribed together with Metronidazole, proton pump inhibitors. Therapy is performed during the active phase of the inflammatory atrophic process. In the period of calm of the disease, the treatment is redirected to compensate for the shortage of digestive enzymes.
• De-nol with gastritis with high acidity helps to improve the protection of the gastric mucosa, normalize enzyme activity, neutralize the activity of Helicobacter pylori. In addition, prescribe drugs-antagonists of dopamine, prokinetic drugs. Most often, the treatment regimen for this type of gastritis includes taking Motilium (Reglan), De-nol, Festal, Maalox, and a special diet to normalize the acidity in the stomach.
• De-nol with gastritis with low acidity is prescribed as an antibacterial and enveloping agent. The main role is played by substitution therapy: pepsidil, gastric juice, acetidine-pepsin. To activate the function of the stomach, it is appropriate to appoint Limontar, Ethizimol, Proserin, Calcium Gluconate.
• De-nol with chronic gastritis is prescribed in the acute stage of the disease: this drug forms a protective layer on the mucous tissues, which provides a multi-hour organ protection. In addition, De-nol possesses high bactericidal abilities in Helicobacter pylori, so the treatment is carried out in several directions: the bacterial cause of gastritis is eliminated, the stomach tissues are protected and restored. De-nil with exacerbation of gastritis is taken for 1-2 months, and bismuth preparations at this stage play a particularly important role. Chronic gastritis can be cured if you have the patience and exactly follow all the doctor's prescriptions.
• De-nol with reflux gastritis is not used as the main drug, but only as a supplement to the main treatment. The basic means are proton pump inhibitors (Pantoprazole, Omeprazole). It will also be necessary to set up the hepatobiliary system (Ursohol, Urosan, etc.) for this purpose.
• De-nol with superficial gastritis (or catarrhal) is mainly used to kill Helicobacter pylori. In addition, funds are prescribed to normalize the acidity in the stomach, fortifying and, if necessary, enzyme preparations.
• De-nil with hyperplastic gastritis can be useful if during the diagnosis were found pathogens - Helicobacter pylori. The treatment scheme is determined in accordance with the presence of these bacteria. With extensive growths, surgical treatment can be prescribed, in preparation for which De-nol is also prescribed.

Release form

The basic ingredient of De-nol, which is used for gastritis, is bismuth tricalium dicitrate. One tablet contains 304.6 mg of this ingredient: its properties are also the basis for the therapeutic effect of the drug. By the way, here is a list of these properties:

• enveloping;
• anti-inflammatory;
• astringent;
• restorative;
• antibacterial in relation to Helicobacter pylori.

De-nol looks like ordinary white convex on both sides of the tablet with a barely noticeable beige hue. On one side of each tablet there is a gbr 152. The opposite side shows a square with rounded corners.

The tablets are sealed in blister plates, eight in each blister. A cardboard package may contain seven or fourteen plates.

Other Possible Denominations

As we have already said, De-nol is an active ingredient in bismuth tricalium dicitrate (bismuth subcitrate). This drug with a similar composition is not the only one of its kind: there are a lot of similar products having the same composition, but produced by other pharmaceutical companies. For example, De-nol with gastritis can be replaced with such drugs as Vis-Nol, Gastro-Norm, Ulkavis, Ventrisol, Escape, Novobismol, etc.

Vis-Nol	One Visin-Nil gelatin capsule contains 499.8 mg of colloidal bismuth subcitrate (recalculation on Bi 2 O 2  120 mg).
Gastro-Norm	One tablet contains 320 mg of bismuth subcitrate, as well as a number of supplementing substances.
Ulkavis	The tablet contains 120 mg of bismuth oxide in the form of tricalium dicitrate.
Ventrisol	In one tablet, 0.12 g of bismuth titrate dicitrate is present.
Eskeyp	One tablet contains 300 mg of bismuth tricalium dicitrate (recalculation on bismuth oxide - 120 mg).
Novobismol	The tablet contains 304.6 mg of bismuth tricalium dicitrate (recalculation on bismuth oxide - 120 mg).

The medicines listed in the table are complete analogues of De-nol, which can easily replace this drug with gastritis. Preparations with a similar action, but with another active ingredient in the formulation are presented in the following table:

Parries	Pariet is an active ingredient of rabeprazole sodium.
Ampilop	Ampilop contains an extract of Ampilopsis cantonics, refers to antiulcer drugs. It is allowed to use from the age of 12. The standard dosage for gastritis is 2 capsules three times a day after meals.
Venter	The drug is based on sucralfate, used in treatment regimens for gastritis, peptic ulcer, gastroesophagitis. Venter take one tablet 4 times a day between meals.
Let's go	A complete analog of omeprazole, is used to treat erosive and atrophic gastritis, peptic ulcer and reflux esophagitis. Can be used in children from 1 year of age. For adults, the standard dosage is used - 20 mg daily, at one time. The average period of treatment is two weeks.
Omeprazole	Domestic preparation, proton pump inhibitor. A complete analogue of the preparation Omez.
Nolpaz	Tablets based on pantoprazole (20 mg in one tablet). Refers to the inhibitors of the proton pump. It is taken by analogy with omeprazole.

That is more preferable at a gastritis - Omez or De-nol, - the doctor solves. In fact, these two drugs belong to different drug groups and can not replace each other. Sometimes they enter into one treatment regimen, supplementing the main antibacterial and anti-inflammatory action. Such an integrated approach allows accelerating the restoration of mucous tissues, and at the same time the functional capacity of the stomach.

Omeprazole or De-nol with gastritis is always prescribed in combination with other medicines, because they have the same properties, but different mechanisms of action. And if Omega and Omeprazole are practically the same drugs, De-nol is absolutely another means. Therefore, you should not try to replace them yourself with a doctor's appointment.

Pharmacodynamics

De-nol is a representative of a group of antiulcer drugs with bactericidal properties (meaning a bactericidal action directed at Helicobacter pylori). In addition, De-nol with gastritis helps to remove the inflammatory reaction and creates enveloping protection of the mucous tissues of the stomach.

Acidic acid causes sedimentation of insoluble oxychloride and bismuth citrate, with the formation of chelating compounds with a proteinaceous source material, which form a protective film on the damaged surface of mucous tissues.

Along with increasing the production of prostaglandin E, De-nol stimulates mucus formation and bicarbonate secretion, activates cytoprotective reactions, strengthens the mucous membrane, making it less vulnerable to the effects of pepsin, enzyme and salt components of bile acids, hydrochloric acid.

De-nol enhances accumulation in the damaged area of the reducing agent, which is the epidermal growth factor. During the treatment with the drug, the action of pepsin and pepsinogen becomes less active.

[10], [11]

Pharmacokinetics

The active composition of De-nol, represented bismuth subcitrate, can be absorbed in the digestive system only in negligible amounts. Such amounts are not considered clinically significant, so the kinetic properties of the preparation have not been studied in detail. It is known that less than 1% of the active ingredient is absorbed in the cavity of the stomach and small intestine, and the rest is absorbed through the intestine. Such properties of the drug make it possible to take it for a long time, while the concentration content of bismuth in the plasma is maintained at 37.67 ± 25.06 μg / liter and is fully excreted on the 30th day after therapy.

The excretion of the active ingredient is carried out predominantly with caloric masses. That negligible proportion of the drug that enters the systemic circulation is removed from the bloodstream through the renal filtration system.

[12], [13]

Dosing and administration

The appointment of De-nol with gastritis involves such treatment regimens:

• Adults and children over fourteen drink one tablet a day. De-nol four times a day (including before bedtime), or two tablets twice a day, between meals.
• Children older than eight years and under the age of fourteen drink one tablet twice a day, in between meals.
• Children from the age of four and up to eight years take the drug at the rate of 8 mg per kilogram of weight per day. The resulting amount of De-nol is divided into two doses. The daily dose for this age group should not exceed 2 tablets.

The course of De-nol with gastritis may last 1-2 months. At the end of treatment it is forbidden to take any bismuth-containing drugs for the next 2 months. Specific information on how to take De-nol with gastritis can be obtained from your doctor. To cancel the drug, a diagnostic confirmation of the positive dynamics of recovery of the mucous membrane and the functionality of the stomach is necessary.

With what do they prescribe De-nol for gastritis? The so-called quadrotherapy is the combination of De-nol treatment and tetracycline (0.5 g 4 times a day), matronidazole (0.5 g three times daily) and omeprazole or another IPN (in a usual dose twice a day). This course is standard up to two weeks.

Before taking De-nol with gastritis, you need to make sure that female patients do not have a pregnancy. It is also important to drink sufficient amounts of liquid throughout the period of therapy.

[18], [19], [20]

Application for children

De-nol with gastritis in pediatrics can be used according to special schemes, with exact calculation of dosage. Experts point out that the appointment of the drug in certain dosages and a short course is absolutely safe for the child's body. True, there is a restriction: a child must be older than 4 years.

In many European countries, given the increased resistance Helicobacter pilori to such drugs as Metronidazole and Clarithromycin, treatment with bismuth drugs is becoming more common. Some experts not only report on the effectiveness of the use of De-nol in gastritis, but also advise its use as a "first-line" drug. Treatment is supplemented with means for normalizing the intestinal biocenosis - for example, prebiotics or probiotics.

Use De-naught during pregnancy

If gastritis made itself felt during pregnancy, it is necessary, at the first signs, to consult a doctor who will perform the diagnosis and try to solve the problem with the help of the safest drugs.

It is unacceptable to engage in self-medication: bismuth preparations, which are used for heartburn and gastritis, are contraindicated for use by pregnant women, since they can negatively affect the nervous system of the baby's future.

To avoid adverse effects, before taking De-nol with gastritis, you should first discuss treatment options with the doctor. If De-nol can be replaced by any other, safer means, then it is better to make this replacement and not to jeopardize the further development of the fetus.

Contraindication to the treatment of gastritis De-nol, except for pregnancy, is also the entire period of breastfeeding.

Contraindications

The doctor will not prescribe De-nol for gastritis, if the patient has certain contraindications:

• hypersensitivity of the body to bismuth-containing drugs;
• severe kidney and / or liver damage;
• the entire period of gestation and lactation of the baby.

Do not use De-nol for the treatment of gastritis in children less than four years old.

In all the remaining cases, the drug can be taken after consultation with the treating doctor.

[14], [15]

Side effects De-naught

It should be remembered that, despite the predominantly positive properties of De-nol in gastritis, this drug still applies to salts of heavy metals. Therefore, De-nol is dangerous by the appearance of many side-effects. So, against the background of treatment of gastritis, dyspeptic reactions can develop in the form of nausea, vomiting, loss of appetite, taste of "metal" in the mouth, bloating, constipation. No less often there are pains in the zone of the projection of the stomach or in the abdomen. In addition, other painful conditions can arise: gingivitis, joint pain, pseudomembranous colitis.

On the part of immunity, the development of allergic reactions is often noted.

[16], [17]

Overdose

With an increase in the concentration of bismuth in plasma, symptoms of bismuth encephalopathy may appear:

• headache;
• dizziness;
• hyperexcitability, or vice versa, apathy;
• sleep disorders;
• photophobia;
• depressive states.

Similar complications arise when the bismuth content in the bloodstream increases to more than 1500 μg / liter.

To avoid an overdose, it is not recommended to take De-nol with gastritis for more than 6-8 weeks in a row (under the condition of taking an adequate dose of the drug).

If signs of an overdose are found, the affected person is washed with a stomach, activated charcoal and osmotic laxatives. With persistent impairment of kidney function, hemodialysis is indicated.

Interactions with other drugs

Like any other medication used for gastritis, De-nol has a number of drug interactions that should be taken into account throughout the treatment period. Thirty minutes before taking De-nol, and also within half an hour after taking it, you should not use any other medicines, no food or drinks.

De-nol can reduce the absorption of tetracyclines and other antibiotics.

Combined reception of De-nol with other bismuth-containing drugs (we are talking about Vikalin, Vikira, etc.) can provoke an overdose against an increased concentration of bismuth in the bloodstream.

Any antacids, which are often prescribed for gastritis, are also taken no later than half an hour before taking De-nol, or half an hour after its use. For example, this principle applies to a combination of drugs, such as De-nol and phosphalogel: the interval between the two preparations should be at least thirty minutes.

Omez and De-nol simultaneously with gastritis are prescribed if there is an erosive form of the disease. However, the word "simultaneously" does not mean that the drugs should be taken at one time. De-nol take two or four times a day, and Omega - once a day. The interval between taking two medications should be no less than thirty minutes.

[21], [22], [23], [24]

Storage conditions

The instruction proposes to keep the De-nol in dry places located away from direct sunlight. Preferably, the storage location is darkened and the ambient temperature does not exceed + 25 °.

It is necessary to protect the place of storage of the drug from the access of children and mentally unhealthy people.

Keep the medication in the refrigerator is unacceptable, as this can adversely affect the healing properties of De-nol.

[25], [26]

Shelf life

De-nol can be used for the treatment of gastritis for 4 years (the period is calculated from the production date, which is indicated on the package).

Reviews after applying De-nol with gastritis

De-nol is often prescribed specifically for the treatment of gastritis, which is due to the pronounced anti-inflammatory, antibacterial, enveloping property of the medication. The drug is in the form of tablets: it is convenient, since De-nol has to be taken several times a day. Tablets can be taken with you and taken when necessary.

About 80% of patients note that De-nol with gastritis is really effective. But only under condition of carrying out of a full course of therapy. For example, if the doctor prescribed medication for 4 weeks, and the patient felt relief in a week, then this is not a reason to stop treatment: the course must be completed and the drug must not be discontinued independently. To enhance the effect of De-nol taken separately from other medicines and food. During the whole treatment course it is recommended to exclude from the diet alcohol, strong coffee and tea, carbonated drinks.

Many patients warn that against the background of taking De-nol with gastritis, there may be a darkening of the surface of the tongue, and fecal masses may acquire a dark color. Such symptoms are transitory and are explained by the presence of bismuth in the preparation. At the end of treatment, the condition is normalized.