Rh-factor Once 4. Feces for occult blood Once 5. Urinalysis Once 6. Iron in blood serum Once 7. Reticulocyte count Once 8. Blood sugar Once 9. Histological and cytological Once evaluation of biopsy sample if endoscopy was conducted May be also used to diagnose successful eradication of Helicobacter pylori. Antibiotics and bismuth medications should be discontinued at least four weeks before the test.
Ranitidin and other histamine receptors blockers should be discontinued at least seven days prior to the procedure. The test should be conducted no earlier than six hours after the last meal. This test is not recommended in case of the prior partial gastrectomy related to gastric cancer, prolonged use of proton pump inhibitors Omeprasol, etc. Instrumental Evaluation 1. Ultrasonography of liver, biliary tract and duodenum: 2. Esophagogastroduodenoscopy with targeted biopsy and brush cytology: twice if indicated prior and after treatment.
Additional Evaluation and Consultation ofGastroenterologist An additional evaluation should be performed if malignant ulcer is suspected, in case of complications of comorbidities or in case of treatment failure.
If in two weeks following the completion of therapy there are no results, one should exclude other causes of peptic ulcers. Treatment Goal: HP eradication, healing of ulcers, prevention of recurrences and complications of ulcer.
HP eradication regimen includes use of antibiotics and antacids level A recommendations. Prolonged antacid use for treatment of ulcers caused by HP is not recommended level B recommendations.
[Helicobacter pylori update].
Seven day regimen:May be taken days, however, there is no data available to show the benefits of a to day regimen as compared to a seven-day regimen. The last two — after the meal before going to bed. With this medication the tongue and the feces may develop dark color; half an hour before and after taking the medication it is not recommended to drink milk; it should be used with caution in patients hypersensitive to aspirin; in case of tinnitis the medication should be discontinued.
In case of complicated ulcer, endoscopy is indicated to confirm the success of the therapy. Refractory ulcer. The most common causes of refractory and recurrent ulcer include: 1 ineffective eradication therapy; 2 unidentified use of NSAID and poor compliance with medications regimens, incomplete healing of large ulcers, Zollinger-Ellison syndrome and malignant neoplasms.
Should the first stage of therapy fail, a second stage of eradication therapy with other antibiotics is recommended; term ofthe therapy: 14 days.
Effectiveness of Citrus Fruits on Helicobacter pylori.
Treatment success in the case of gastric and gastrojejunal ulcers is monitored endoscopically in eight weeks; in the case of complicated duodenal ulcer; in 4 weeks.
Use of serology testing to confirm eradication of HP is not justified, since antibody titer remains elevated even in the absence of HP. To prevent gastric and duodenal ulcer recurrence and their complications: 1. If the symptoms of the exacerbation disappear, the therapy is discontinued. Continuous supportive therapy for a month or even years with half the dose of antacid.
For example, one should take every evening: mg of Ranitidin or 20 mg Famotidine gastrosidin, kvamatel, ulfamide. Ranitidin Zantak and other analogues mg a day, single dose at 7—8 P. Famotidin Gastrosidin, Kvamatel, Ulfamid 40 mg a day at 7—8 P. Sukralfat Venter, Sukrat gel 4 g a day; more often 1 g 30 min. For the treatment of refractory duodenal ulcers not associated with HP, maximal dose of proton pump inhibitors is recommended Omeprasol, etc.
Concurrent use of proton pump inhibitors PPI and 2nd type histamine receptors blockers HRB is not recommended due to the potential.
Recommendation levels: A. Randomized clinical trials or meta-analysis with statistically valid results. Randomized clinical trials or meta-analysis in which clinical outcome is possible but not valid.
Non-randomized clinical trials, the physician makes his own decision. Recommendations of panel, results of separate clinical observations. En savoir plus à propos de l'abonnement Scribd Bestsellers.
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Duodenal ulcer disease in children
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Regimen of peptic ulcer
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Regimento interno tre mg video
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