Treatment of gastritis with hyperacidity

Systemic treatment of gastritis with high acidity is aimed at eradicating the cause of the disease, reducing the production of hydrochloric acid by the stomach and thereby reducing the acidity level of gastric juice.

This, in turn, helps relieve inflammation of the gastric mucosa and create favorable conditions for the regeneration of its cells.

Treatment regimen for gastritis with high acidity

The treatment regimen for gastritis with high acidity selected by gastroenterologists should first of all take into account the etiology of the disease. The list of causes of hyperacid gastritis is quite extensive and includes: infection of the gastric mucosa with the gram-negative bacterium Helicobacter Pylori (H. Pylori); parasitic infections (cytomegaloviruses); certain medications (iatrogenic gastritis caused by long-term use of non-steroidal anti-inflammatory drugs, etc.); chronic reflux of bile from the duodenum into the stomach (reflux gastritis); alcohol; allergic reactions (eosinophilic gastritis); reaction to stress; radiation exposure; injuries; autoimmune pathologies (diabetes mellitus type 1, Zollinger-Ellison syndrome, Hashimoto's thyroiditis).

The generally accepted cause #1 of gastritis with high acidity is the bacterium H. Pylori, which colonizes the gastrointestinal tract of more than half of the world's population, but does not manifest itself in everyone. However, infected people are much more likely to develop gastric ulcer and duodenal ulcer, and there is an increased risk of gastric cancer - MALT lymphoma of the stomach, adenocarcinoma of the body and antrum of the stomach. The discovery of Helicobacter has radically changed approaches to the treatment of gastritis, gastric ulcer and all hypersecretory diseases of the gastrointestinal tract.

The current scientifically proven treatment regimen for gastritis with increased acidity associated with H. Pylori was developed through the coordinated efforts of key gastroenterologists who united two decades ago in the European H. Pylori Study Group (EHSG). The diagnostic system and drug therapy regimen for Helicobacter pylori hyperacid gastritis, tested in numerous clinical studies, make it possible to completely destroy H. Pylori.

Gastroenterologists conduct such a course of eradication, that is, eradication therapy for 14 days, using two types of antibiotics and drugs that suppress the effect of acid on the mucin layer of the gastric mucosa - proton pump inhibitors. This is a variant of a three-component treatment regimen, and with a quadruple-component regimen, bismuth preparations are also prescribed.

At the end of treatment, the presence of H. Pylori is checked using a blood test for antibodies, a stool test for antigens, and a urea breath test with labeled urea.

Treatment of gastritis with high acidity: antibiotics

Antibacterial treatment for gastritis with high acidity caused by H. Pylori consists of taking two antibiotics for two weeks, such as Amoxicillin, Clarithromycin, Metronidazole and Tetracycline.

Clarithromycin is prescribed at 500 mg 2 times a day and Amoxicillin at 1 g 2 times a day. Instead of Amoxicillin, Metronidazole can be prescribed at 500 mg 2 times a day. In case of using a scheme with four drugs, doctors prescribe Metronidazole - 500 mg three times a day and Tetracycline - 500 mg 4 times a day - for 10 days.

The most effective against the H. Pylori bacteria are the acid-resistant semi-synthetic penicillin Amoxicillin (Amoxiclav, Amofast, Augmentin, etc. trade names) and the macrolide Clarithromycin (Klarbact, Klerimed, Aziklar, Klaritsid, etc.). However, the bioavailability of the latter is almost half as low, and its maximum effect is demonstrated in an alkaline environment.

Antibiotics quickly enter the mucous membrane of the antrum of the stomach through the systemic bloodstream and accumulate there, exerting a bactericidal and bacteriostatic effect on H. Pylori cells. Side effects of antibiotics include nausea and vomiting, diarrhea and pain in the epigastrium, dizziness and headache, sleep disturbance, tinnitus, stomatitis, itching of the skin and rashes.

Treatment of gastritis with high acidity: antisecretory drugs

To make antibacterial treatment of gastritis with high acidity caused by Helicobacter pylori infection (eradication therapy) more effective, and also to reduce pain by reducing the synthesis of hydrochloric acid in the stomach, antisecretory drugs of the benzimidazole group are prescribed, which inhibit the production of hydrochloric acid - proton pump inhibitors (PPIs).

These drugs bind hydrogen-potassium ATP (adenosine triphosphatase) - a hydrolase protein enzyme (called a proton pump), which is located on the membranes of the cells of the fundic glands of the stomach and ensures 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 high acidity uses the following PPIs: Omeprazole (Omek, Losek, Omiton, Omizak, Cerol, etc.) - 20 mg twice a day; Rabeprazole (Zulbex) or Esomeprazole (Emanera) - 20 mg twice a day; Lansoprazole (Lanzal) - 30 mg twice a day; Pantoprazole (Protonix) - 40 mg twice a day. The course of therapy lasts a week.

Side effects of these drugs include headaches and dizziness, dry mouth, bowel movement disorders, nausea, abdominal pain, skin rashes. Long-term use of these drugs, especially in high doses, can lead to an increased risk of bone fractures.

PPIs are used in the symptomatic treatment of hyperacid reflux gastritis, gastroesophageal reflux disease, alcoholic and eosinophilic gastritis, as well as gastritis after long-term use of nonsteroidal anti-inflammatory drugs.

In addition to proton pump inhibitors, treatment of gastritis with high acidity is carried out using antisecretory drugs that block histamine cell receptors (histamine H2 receptor antagonists). According to the American Gastroenterological Association, their use in the treatment of gastritis with high 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 a response from the body - activation of the inflammation mediator interleukin-1β. As a result, the parietal glandulocytes of the gastric mucosa begin to synthesize more hydrochloric acid. The drug Ranitidine (Acidex, Histac, Zantac, Ranigast, Ranitab, etc.), used by most gastroenterologists, selectively blocks the histamine H2 receptors of the cells of the gastric mucosa and inhibits the process of HCl production. The standard dose is 400 mg twice a day. Side effects of drugs in this group include diarrhea, dizziness and headaches, skin rashes, 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 high doses can lead to hormonal disorders (gynecomastia, amenorrhea, impotence).

Apparently, European doctors, unlike American ones, do not include histamine receptor blockers in the treatment of hyperacid Helicobacter gastritis due to side effects. In addition, H2 blockers reduce the synthesis of hydrochloric acid less effectively than proton pump inhibitors.

Currently, among antisecretory drugs that block acetylcholine receptors (anticholinergics), only Gastrocepin (Gastropin, Gastril, Pirenzepine, Piren, etc.) is used in the treatment of gastritis with high acidity. It does not penetrate the BBB and does not have such side effects as benzodiazepine derivatives with a similar structure. By acting on the parietal cells of the stomach, this drug reduces the synthesis of hydrochloric acid and pepsin proenzymes. The recommended average dose is 50 mg twice a day (half an hour before meals). Gastrocepin has side effects such as headache, dry mouth, dilated pupils, constipation, dysuria, and increased heart rate.

Treatment of gastritis with high acidity: bismuth preparations and other antacids

If the treatment regimen for gastritis with high acidity based on three drugs does not give the expected result for some reason, then patients are prescribed a fourth drug containing salts of the heavy metal bismuth - Bismuth subcitrate (Bismuth tripotassium dicitrate, Bisnol, Ventrisol, Vis-Nol, Gastro-Norm, De-Nol, Tribimol and other trade names). This is an enveloping and antacid (anti-acid) agent, which also has bactericidal properties. Due to the formation of a film on the mucous membrane (as a result of the interaction of bismuth salt with gastric acid), Bismuth subcitrate creates a barrier to acid diffusion. And by binding the sulfhydryl groups of proteins of Helicobacter Pylori bacteria cells, bismuth salts inactivate their enzymatic system, causing a stop in reproduction and the death of pathogenic microorganisms.

Bismuth subcitrate is recommended to be taken 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 is 56 days. Side effects of this drug include nausea, vomiting, increased frequency of bowel movements and dark-colored stool. Contraindications to its use include kidney dysfunction, pregnancy and lactation, as well as childhood.

Antacids and alginates are considered symptomatic drugs for the traditional treatment of gastritis with high acidity, the purpose of which is to provide short-term relief to patients by reducing pain. Taking antacids - Phosphalugel (Alfogel, Gasterin), Almagel (Alumag, Gastrogel, Gastal, Maalox) - helps to neutralize acid in the stomach for some time. And the therapeutic effect of alginates (Gaviscon) is based on the fact that they form a gel-like protective coating on the gastric mucosa, but the acidity of 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 undesirable side effects (there are diarrhea, flatulence and vomiting).

Gaviscon tablets should be chewed after meals (2 tablets); children aged 6-12 years are recommended to take the suspension - 5-10 ml. The maximum duration of protective action is on average about four hours.

Anyone who has gastritis with high acidity, during its exacerbation, must adhere to therapeutic diet No. 1b, which provides for fractional meals (five times a day) and the exclusion from the diet of fried and spicy dishes, fresh bread, fatty meat and broths, legumes, mushrooms, raw vegetables, coffee, alcohol, carbonated drinks. At the same time, it is necessary to drink at least 1.5 liters of water per day

Treatment of gastritis with high acidity using folk methods

Among the recommendations for treating gastritis with high acidity using folk methods, the most common are recipes for decoctions and infusions of medicinal plants that help combat the effects of hydrochloric acid on the stomach walls. The causes of the disease cannot be eliminated by any folk medicine.

Let's consider what kind of treatment for gastritis with high acidity can be done with herbs. The most commonly used plants in phytotherapy for stomach inflammations are: chamomile (flowers), peppermint, calendula (flowers), marsh cudweed, fireweed, St. John's wort, burdock (root), licorice (root and rhizome).

To prepare a medicinal decoction according to the first recipe, take a tablespoon of chamomile, mint and fireweed per 600 ml of boiling water, simmer the mixture over low heat for 10 minutes, leave to cool and drink half a glass after each meal (after 45-60 minutes).

The following collection also alleviates the condition in hyperacid gastritis of various etiologies:

1 tablespoon of mint, 2 tablespoons of calendula flowers and 4 tablespoons of immortelle and St. John's wort. Mix all the herbs and take a tablespoon of this mixture per glass of boiling water, brew, cover and let stand for about an hour. It is recommended to take the infusion before meals, 60-70 ml three times a day.

Another effective folk remedy for gastritis with high acidity is considered to be an infusion of burdock and licorice roots (in equal proportions). It is best prepared in a thermos: grind the plant material, place it 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 means of drug therapy for hyperacid gastritis, as you have seen for yourself, is quite powerful. The main thing is to undergo an examination, identify the true cause of the disease and begin treatment for gastritis with high acidity so that the stomach and the entire digestive system work normally.