What are the four drugs in the quadruple therapy for gastric disease?

Patients with stomach problems choose a quadruple drug treatment method that uses omeprazole, clarithromycin, amoxicillin, and potassium citrate bismuth. Stomach problems may be caused by genetics, the environment, diet, medication, bacteria, or excessive drinking. Therefore, you must pay attention to hygiene in your diet and try to reduce the frequency of drinking, which can reduce the chance of developing stomach problems.

Causes

Gastric disease is a multi-causal disease, which can be caused by factors such as genetics, environment, diet, drugs, bacteria, smoking, and excessive drinking. The above factors can lead to excessive secretion of gastric acid and destroy the protective layer of the stomach and duodenum, thereby causing ulcers. Modern theory believes that Helicobacter pylori is the main cause of stomach diseases.

Clinical manifestations

The most common symptoms are upper abdominal discomfort or pain, nausea, vomiting, diarrhea, and loss of appetite. Symptoms of gastritis and duodenal ulcers include burning pain in the upper abdomen, especially between meals, before breakfast, or after drinking orange juice or coffee. In severe cases, there may be tarry, black or bloody stools.

1. Acute simple gastritis

It is mainly caused by chemical substances, such as strong tea, coffee, liquor, condiments and other irritants, or taking salicylates, sulfonamides, anticancer drugs, antibiotics, reserpine, corticosteroids and other drugs that damage the gastric mucosa; physical factors like eating too cold, too hot or rough food that damages the gastric mucosa; and microbial infection or bacterial toxins. Acute corrosive gastritis is often caused by suicide or accidental ingestion of corrosive agents such as strong acids and alkalis.

2. Acute erosive (hemorrhagic) gastritis

It often occurs in stressful conditions caused by surgery, burns, shock, trauma, multiple organ failure, etc., as well as drinking or taking non-steroidal drugs, and accounts for about 20% of upper gastrointestinal bleeding.

3. Acute suppurative gastritis

It is mainly a suppurative disease caused by bacteria such as streptococci, staphylococci and Escherichia coli infecting the stomach wall, also known as cellulitis gastritis. Acute gastritis is a reversible disease and can return to normal through treatment. Through proper treatment, many patients with acute gastritis can recover effectively and completely, and the disease is characterized by coming and going quickly. However, if the treatment is not timely or thorough and the diet is improper, the condition will turn into chronic gastritis if it persists for a long time.

4. Chronic gastritis

Chronic gastritis refers to chronic inflammatory changes in the gastric mucosa due to various reasons. It is one of the most common and frequently occurring diseases. The characteristics are that the incidence rate in men is higher than that in women, and the incidence rate tends to increase with age. The essence of chronic gastritis is that after the gastric mucosal epithelium is repeatedly damaged, the mucosa is remodeled due to its specific regenerative ability, and eventually leads to irreversible atrophy or even disappearance of the intrinsic gastric glands.

(1) Causes of chronic gastritis It is now generally believed that it is a chronic persistent infection of pathogenic bacteria, especially Hp (Helicobacter pylori); or it can be transformed from acute gastritis. Like acute gastritis, physical factors such as overheating, overcooling, and overly rough food are also one of its causes. In addition, chemical factors, such as strong tea, coffee, strong liquor, condiments, etc.; long-term and large-scale use of non-steroidal drugs (such as aspirin, indomethacin, etc.) can inhibit the synthesis of prostaglandins in the gastric mucosa and damage the mucosal barrier. When smoking, nicotine in tobacco not only affects the blood circulation of the gastric mucosa, but also can cause pyloric sphincter dysfunction, resulting in bile reflux, and various bile reflux can damage the mucosal barrier and lead to the occurrence of chronic gastritis; in addition, immune factors are also the cause of chronic gastritis.

(2) Classification of chronic gastritis There are mainly chronic superficial gastritis and chronic atrophic gastritis, and the two sometimes exist at the same time. Chronic superficial gastritis includes three types: simple type, erosive type and hemorrhagic type. According to the common site of disease occurrence, it can be divided into two categories: Type A, which is rare, with lesions occurring in the gastric body and fundus, mostly caused by autoimmune reactions; Type B, which is more common, with lesions mainly in the gastric antrum, and about 90% of patients are caused by Hp infection. Type B is the more common type in my country.

5. Non-ulcer dyspepsia

Non-ulcer dyspepsia is a functional gastric disease, and a small number of cases are mild organic lesions. In the past, many doctors diagnosed the disease as chronic gastritis, gastric neurosis, gastrointestinal autonomic nervous system dysfunction, functional gastric dyspepsia, gastric spasm, etc. According to the latest authoritative epidemiological survey, the incidence of this disease in the population is as high as 10%, and it is also a common and frequently occurring disease of the stomach. Patients may experience intermittent or persistent upper abdominal pain or occasional severe pain and discomfort, nausea, vomiting, acid reflux, heartburn and other upper gastrointestinal symptoms. However, clinical examinations such as gastroscopy, upper gastrointestinal barium angiography and hepatobiliary and pancreatic ultrasound cannot reveal organic lesions or mild lesions in the stomach and other organs that cause these symptoms. That is to say, there are many subjective symptoms of the stomach, but few or no positive findings in objective examinations. The cause of the disease should be related to gastric motility dysfunction, mild gastroduodenal inflammation, and mental factors.

treat

1. Notes

First, regularize your diet. Secondly, pay attention to food hygiene. Again, take less medications that are irritating to the stomach. Fourth, stay in a good mood.

2. Medication

(1) Eliminate the cause of the disease, rest in bed, and stop all foods and medications that may irritate the stomach. If appropriate, short-term fasting should be implemented, and then an easily digestible, light, low-residue liquid diet should be given to help the stomach rest and the injury heal.

(2) Encourage drinking water. Since patients lose too much water due to vomiting and diarrhea, they should drink as much water as possible to replenish the lost water. It is better to use sugar and salt water (made by adding a small amount of sugar and salt to boiled water). Do not drink beverages high in sugar to avoid excessive acid production and aggravate abdominal pain. Patients who vomit frequently can drink a small amount of water (about 50 ml) after each vomiting, and drink it multiple times to avoid vomiting.

(3) Pain relief. Belladonna tablets, atropine, 654-2 (scopolamine) and other drugs can be used. You can also apply local hot compress to the abdomen to relieve pain (not necessary for those with gastric bleeding).

(4) For patients with diarrhea and fever, antibacterial drugs such as berberine and norfloxacin can be used appropriately. It is generally not used by patients with mild conditions to avoid further irritation to the stomach.

(5) Severe vomiting, diarrhea, and obvious dehydration should be sent to the hospital for intravenous infusion treatment in time. Generally, the disease will be cured within 1 to 2 days.