New aspects of eradicative anti-Helicobacter pylori in type 2 diabetic patients with chronic gastroduodenal disorders
Abstract
Goal of the study was to analyze the effectiveness of different regimens of anti- Helicobacter pylori (HP) therapy and their influence on the small intestinal overgrowth syndrome (SIBOS) in type 2 diabetic patients with chronic gastroduodenal disorders. For this purpose an open comparative randomized study was performed in 138 type 2 diabetic patients with chronic gastroduodenal disorders, aged 54,4±5,2 on average. Methods: Gastro-duodenal pathology was confirmed by gastroduodenoscopy, the HР contamination - by use of the urease method or finding bacterial antigen in excrements. The SIBOS was recognized by a respiratory hydrogen method with lactulose. Depending on the type of anti- HP regimen all the patients were divided into 4 groups. Results. The classic 10-days triple therapy showed the lowest HP eradicative effectiveness - 68,7% of eradication cases. Optimization of this therapy by use of Rabeprazol instead of Omeprazol was found to be more effective with 80.6% of HP eradicatition. Addition of both Bismuth and probiotic resulted in increased eradication up to 94,1%, while the optimized triple regimen with Metronidazol + probiotic (intensified combined therapy) proved to be the most effective in HP eradication. The all 4 regimens of anti-HP therapy resulted in decreased number of SIBOS cases, but the best results in comparison with the initial data were obtained in the groups on the triple optimized and intensive combined therapy - up to 60 and 78,3% correspondingly. The positive influence of anti-HP therapy on SIBOS seen in the study allows the authors to propose one more indication for anti-HP therapy.
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