The scheme of treatment of gastritis with high acidity
Gastroenterologists selected treatment regimen for gastritis with high acidity, in the first place, should take into account the etiology of the disease. The list of causes of hyperacid gastritis is quite extensive, and it appears: infection of the gastric mucosa with a Gram-negative bacterium Helicobacter pylori (H. Pylori); parasitic infections (cytomegalovirus); some drugs (iatrogenic gastritis caused by long-term use of non-steroidal anti-inflammatory drugs, etc.); chronic reflux of bile from the duodenum to the stomach (reflux gastritis); alcohol; allergic reactions (eosinophilic gastritis); reaction to stress; radiation exposure; injuries; autoimmune pathologies (Type I diabetes mellitus, Zollinger-Ellison syndrome, Hashimoto's thyroiditis).
The common cause # 1 for the development of gastritis with high acidity is the H. Pylori bacterium, which colonizes the gastrointestinal tract more than half of the world's population, but does not manifest itself far from everyone. However, infected people are much more likely to develop peptic ulcer disease of the stomach and duodenum, as well as an increased risk of stomach cancer - MALT-lymphoma of the stomach, adenocarcinoma of the body and antrum of the stomach. The discovery of helikobacteria radically changed the approaches to the treatment of gastritis, stomach ulcers and all hypersecretory diseases of the gastrointestinal tract.
The current scientifically valid scheme for the treatment of gastritis with high acidity associated with H. Pylori, developed by coordinated efforts of key specialists in gastroenterology, united two decades ago in the European Group of H. Pylori (EHSG). Approved by numerous clinical studies, the diagnostic system and the scheme of drug therapy for helicobacterial hyperacid gastritis allows to completely destroy H.Pylori.
Gastroenterologists conduct such a course of eradication, that is eradicating therapy for 14 days, using two types of antibiotics and drugs that suppress the effect of acid on the mucinous layer of the gastric mucosa - inhibitors of the proton pump. This is a variant of the three-part treatment regimen, and with the quadrocomponent scheme, even bismuth preparations are prescribed.
After the treatment is completed, H. Pylori should be checked with blood for antibodies, analysis of feces for antigens and urease respiratory test with labeled urea.
Treatment of gastritis with high acidity: antibiotics
Antibacterial treatment of gastritis with high acidity, caused by H. Pylori, is a two-week intake of two antibiotics, such as Amoxicillin, Clarithromycin, Metronidazole and Tetracycline.
Clarithromycin is administered 500 mg 2 times a day and Amoxicillin 1 g 2 times a day. Instead of Amoxicillin, Metronidazole 500 mg 2 times a day can be prescribed. In the case of a four-drug regimen, doctors prescribe metronidazole-500 mg three times daily and tetracycline-500 mg four times a day-for 10 days.
The most effective against H. Pylori bacteria is the acid-resistant semi-synthetic penicillin Amoxicillin (Amoxiclav, Amofast, Augmentin and other trade names) and macrolide Clarithromycin (Clarcat, Clerimed, Aziklar, Claricid, etc.). True, the bioavailability of the latter is almost half lower, and its maximum effect is manifested in an alkaline medium.
Antibiotics through the systemic bloodstream quickly enter the mucous membrane of the antral part of the stomach and accumulate there, having a bactericidal and bacteriostatic effect on H. Pylori cells. Side effects of antibiotics are manifested by nausea and vomiting, diarrhea and epigastric pain, dizziness and headache, sleep disturbance, noise in the ears, stomatitis, itching of the skin and rashes.
Treatment of gastritis with high acidity: antisecretory drugs
To antimicrobial treatment of gastritis with hyperacidity caused by helicobacteriosis (eradication therapy), it was more effective, as well as to reduce pain by reducing the synthesis of hydrochloric acid in the stomach, antisecretory drugs of the benzimidazole group are prescribed, inhibiting the production of hydrochloric acid - inhibitors of the proton pump (PPI).
These drugs bind hydrogen-potassium ATP (adenosine triphosphatase) - a hydrolase protein enzyme (called proton pump), which is located on the membranes of the cells of the fundal glands of the stomach and provides the transfer of hydrogen ions. Thus, the hydrophilic secretion of HCl is suspended, which reduces the level of acid in the gastric juice and prevents further damage to the gastric mucosa.
The treatment regimen for gastritis with increased acidity uses such IPPs as: Omeprazole (Omek, Losek, Omiton, Omizak, Tserol, etc.) - twice a day for 20 mg; Rabeprazole (Zulbek) or Esomeprazole (Emanera) - twice a day for 20 mg; Lansoprazole (Lansal) - twice a day for 30 mg; Pantoprazole (Protonix) - twice a day for 40 mg. The course of therapy lasts a week.
Side effects of these drugs are expressed in the form of headaches and dizziness, dry mouth, violations of defecation, nausea, abdominal pain, skin rashes. Long-term use of these drugs, especially in high doses, can lead to an increased risk of fracture of the bones.
PPI are used in the symptomatic therapy of hyperacid reflux gastritis, gastroesophageal reflux disease, alcoholic and eosinophilic gastritis, and gastritis after long-term use of nonsteroidal anti-inflammatory drugs.
In addition to proton pump inhibitors, treatment of gastritis with increased acidity is performed using antisecretory drugs that block histamine receptors of cells (antagonists of histamine H2-receptors). According to the American Gastroenterological Association, their use in the treatment of gastritis with increased acidity increases the effectiveness of therapy in 92-95% of clinical cases.
The fact is that the cytotoxins and mucolytic enzymes produced by H. Pylori cause the body's response - activating the mediator of inflammation of interleukin-1β. As a result, parietal glandulocytes of the gastric mucosa begin to synthesize more hydrochloric acid. The drug Ranitidine (Acidex, Gistak, Zantak, Ranigast, Ranitab, etc.) used by most gastroenterologists selectively blocks histamine H2 receptors of gastric mucosa cells and inhibits the production of HCl. The standard dose is 400 mg twice a day. Side effects of drugs in this group include diarrhea, dizziness and headaches, skin rashes, a feeling of fatigue, a decrease in the number of platelets in the blood (thrombocytopenia), a slight increase in creatinine in the blood. However, prolonged use of this drug in large doses can lead to hormonal disorders (gynecomastia, amenorrhea, impotence).
Obviously, European doctors, unlike the US, do not include histamine receptor blockers in the treatment of hyperacid helicobacterial gastritis because of side effects. In addition, H2 blockers reduce the synthesis of hydrochloric acid less efficiently than proton pump inhibitors.
Currently, among antisecretory drugs blocking the acetylcholine receptors (anticholinergics), only gastrocepin (Gastropin, Gastril, Pyrenzepine, Piren, etc.) is used in the treatment of gastritis with high acidity, which does not penetrate the BBB and does not have such side effects as similar in structure to benzodiazepine derivatives. Acting on the parental cells of the stomach, this drug reduces the synthesis of hydrochloric acid and proenzymes of pepsin. The recommended average dose is 50 mg twice a day (half an hour before meals). Gastrotsepin has such side effects as headache, a feeling of dry mouth, dilated pupils, constipation, dysuria, increased heart rate.
Treatment of gastritis with high acidity: bismuth preparations and other antacids
If the scheme of treatment of gastritis with high acidity on the basis of three preparations does not give the expected result for any reason, patients are assigned to receive the fourth drug containing bismuth heavy metal salts - Bismuth sub-citrate (Bismuth tricalium dicitrate, Bisnol, Ventrisol, Vis-Nol, Gastro -Norm, De-Nol, Tribimbol and other trade names). It is an enveloping and antacid (antacid) agent, which also has bactericidal properties. Due to the formation of a film on the mucous membrane (as a result of the interaction of the bismuth salt with the acid of the gastric juice), the bismuth subcitrate creates a barrier for the diffusion of the acid. And by binding the sulfhydryl groups of proteins in cells of Helicobacter pylori bacteria, bismuth salts inactivate their enzyme system, causing the reproduction and death of pathogenic microorganisms to stop.
Bismuth subcitrate is recommended to take 0.4 g twice a day or 0.12 g 4 times a day (half an hour before meals); the minimum course of treatment is 28 days, the maximum - 56 days. Among the side effects of this drug: nausea, vomiting, more bowel movements and darker stool color. And contraindications to its use are kidney dysfunction, pregnancy and lactation, and also children's age.
Antacids and alginates are considered to be simtomatic drugs for the traditional treatment of gastritis with high acidity, whose task is to provide a short-term relief of the patients, reducing pain syndrome. The intake of antacids - Fosfalugel (Alfogel, Gasterin), Almagel (Alumag, Gastrogel, Gastal, Maalox) - helps for a time to neutralize the acid in the stomach. And the therapeutic effect of alginates (Gaviscon) is based on the fact that they form a gel-like protective coating on the mucous membrane of the stomach, but the acidity of the gastric juice does not decrease.
Antacids in the form of chewable tablets, powders and suspensions should be taken after meals, and before bedtime: chew 1-2 tablets or drink 1-2 teaspoons - three times a day. These drugs have a short-term effect, but almost do not cause unwanted concomitant effects (there are diarrhea, flatulence and vomiting).
Gaviscon tablets should be chewed after eating (2 pcs.); Children 6-12 years are recommended to take a suspension - 5-10 ml. The maximum duration of the protective action is about four hours on average.
To everyone who has gastritis with high acidity, during the period of its aggravation it is necessary to adhere to the therapeutic diet No. 1b, which provides for fractional meals (five times a day) and the exclusion of fried and spicy dishes, fresh bread, fatty meats and broths, beans, mushrooms , raw vegetables, coffee, alcohol, carbonated drinks. It is necessary to drink at least 1.5 liters of water per day
Treatment of gastritis with high acidity by alternative methods
Among the recommendations for the treatment of gastritis with increased acidity by alternative methods, most often recipe recipes and infusions of medicinal plants that help to fight the impact of hydrochloric acid on the walls of the stomach. The causes of the disease are not eliminated by any means of alternative medicine.
Let's consider, what treatment of a gastritis with the raised acidity by grasses can be. The most used plants in the phytotherapy of inflammation of the stomach: chamomile (flowers), peppermint, calendula officinalis (flowers), wheatgrass swamp, swampy narrow-leaved, St. John's wort, burdock big (root), licorice naked (root and rhizome).
To prepare a medicinal broth for the first recipe, take 600 ml of boiling water over a tablespoon of chamomile, mint and kipreja, boil the mixture on low heat for 10 minutes, insist on cooling and drink half a glass after each meal (45-60 minutes) .
Also facilitates the condition with hyperacid gastritis of different etiology such collection:
1 tablespoon of mint, 2 tablespoons of calendula flowers and 4 tablespoons of cucumber and St. John's wort. All herbs to dislodge and a glass of boiling water take a tablespoon of this mixture, brew, cover and let stand for about an hour. Infusion is advised to take before meals 60-70 ml three times during the day.
And an effective alternative means for gastritis with high acidity is the infusion of burdock and licorice roots (in equal proportions). Its best to cook in a thermos: grind vegetable raw materials, place in a thermos at the rate of a tablespoon for every 200 ml of water, pour boiling water and close. After 6 hours, the infusion is ready for use: 100-120 ml at least four times a day.
The arsenal of medicines for the treatment of hyperacid gastritis, as you saw, is quite powerful. The main thing is to pass the examination, to reveal the true cause of the disease and to start treatment of gastritis with high acidity, so that the stomach and all digestive systems work normally.