Management of helicobacter pylori in upper gastrointestinal dyspepsia

ABSTRACT

The present study included 60 patients who were CLO-test positive at the time of endoscopic examination and with compensated liver. They were divided into 4 groups, each of them comprised 15 patients. The first group received colloidal bismuth subcitrate 120 mg tablet twice daily before breakfast and dinner for 30 days, the second group received metronidazole 250 mg tablets t.d.s. after meals for 30 days, the third group received the previous two drugs also for 30 days, while the fourth group received symptomatic treatment for dyspepsia and they were considered as control group, according to the regimen of drug taken. All cases were subjected to full history taken, thorough clinical examination, laboratory investigations including urine and stool examination for detection of schistosoma ova, liver function tests including total serum bilirubin, SGPT and SGOT, in addition to sigmoidoscopy with fresh rectal biopsy for detection of bilharzial ova. Also, abdominal ultrasonography was performed for all subjects. Upper endoscopy was performed for all cases and the biopsies taken from the antrum were subjected to CLO test, then all cases re- endoscoped and investigated by CLO test 30 days after treatment. It was concluded that combined therapy by DE-Nol and metronidazole is highly effective to eradicate H. pylori colonies and improve the gastropathy and upper gartointestinal dyspeptic symptoms