NEW ASPECTS OF ERADICATIVE ANTI-HELICOBACTER PYLORI IN TYPE 2 DIABETIC PATIENTS WITH CHRONIC GASTRODUODENAL DISORDERS

Abstract

The aim of the study was to analyze the effectiveness of different regimens of anti-Helicobacter pylori 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. Gastroduodenal pathology was confirmed by gastroduodenoscopy, the H.pylori contamination by use of the unease method or finding bacterial antigen in excrements. The SIBOS was recognized by a respiratory hydrogen method with lactulose. Depending on the type of anti-H.pylori regimen all the patients were divided into 3 groups. Optimization 14-days triple therapy by use of Rabeprazol instead of Omeprazol was found to be effective with 80.6% of H.pylori eradication. Addition of both vismuth and probiotic resulted in increased eradication up to 94.1%, while the optimized triple regimen with Metronidazol and probiotic (intensified combined therapy) proved to be the most effective (97.2%) in H.pylori eradication. All 3 regimens of anti-H.pylori therapy resulted in the 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%, respectively. The positive influence of anti-H.pylori therapy on SIBOS seen in the study allows the authors to propose one more indication for anti-H.pylori therapy.