Hospital therapy. Treatment of stomach ulcers (most important)

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Hospital therapy. Treatment of stomach ulcers (most important)

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43. Treatment of gastric ulcer

Treatment. Rational therapy for peptic ulcer should include a regimen, appropriate nutrition, drug treatment, psychotherapy, physical and spa treatments. During the period of exacerbation of peptic ulcer, it is necessary to strictly observe the fragmentation in nutrition (from 4 to 6 times a day with a small amount of each serving of food taken at certain hours). Food products should have good buffering properties and contain a sufficient amount of protein (120-140 g).

Psychotherapy is essential for stopping or reducing psychoneurotic reactions arising from persistent pain syndrome and its expectation.

Medicines used to treat peptic ulcers are divided into 5 groups:

1) drugs that affect the acid-peptic factor (antacids and histamine H2 blockers, other antisecretory agents);

2) drugs that improve the gastric mucosal barrier;

3) drugs that increase the synthesis of endogenous prostaglandins;

4) antibacterial and antiseptic agents;

5) drugs that normalize motor-evacuation disorders of the stomach and duodenum.

Antacids:

1) soluble (absorbable) - bicarbonate of soda, calcium carbonate (chalk) and magnesium oxide (burnt magnesia);

2) insoluble (non-absorbable): magnesium trisilicate and aluminum hydroxide.

Several schemes of combination therapy (two-, three-, four-component).

Two-component therapy: amoxicillin 1000 mg 2 times a day for 2 weeks; omeprazole 40 mg twice a day. The three-component scheme includes the preparation of colloidal bismuth 2 mg 120 times a day; tetracycline 4 mg 250 times a day; metronidazole 4 mg 250 times a day. The therapy cycle is 4 days.

The four-component regimen involves omeprazole 20 mg 2 times a day from days 1 to 10; denol 120 mg 4 times a day from the 4th to the 10th day; tetracycline 500 mg 4 times a day from the 4th to the 10th day; metronidazole 500 mg 3 times a day from the 4th to the 10th day. The most effective is a four-component treatment regimen for gastric and duodenal ulcers. 6 weeks after its implementation, healing of the peptic defect is observed in 93-96% of patients.

After scarring of a peptic ulcer of the stomach and duodenum, two types of treatment are traditionally used.

1. Continuous maintenance therapy is carried out with antisecretory drugs at half the daily dose for a period of up to one year.

2. Therapy "on demand", involves the use of one of the antisecretory agents in half the daily dose for two weeks when symptoms of peptic ulcer appear.

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