Title: A Prospective study on Symptomatic Improvement of Helicobacter pylori Positive patients taking Standard Triple Therapy: A Pilot study

Authors: Limi Joseph Gomez, Arathi S Nair, Bushra Abdul Rahim, Aleena Francis, Soumya R V, Prasobh G Nair, I John Wesely

 DOI: https://dx.doi.org/10.18535/jmscr/v7i4.99

Abstract

Background: The symptomatic improvement of Helicobacter pylori (H.pylori) infection can be achieved using standard triple therapy. Recently eradication rate of the regimen has declined and this study to find evidence how beneficially the symptoms can be reduced by the 14 day therapy.

Aim: To assess the symptomatic betterment from standard triple therapy.

Methods: Fifteen patients diagnosed with H.pylori infection were recruited for the study. They were administered with standard triple therapy for 14 day course. The regimen consists of Proton pump inhibitor (40 mg b.i.d), Amoxicillin (1000mg), Clarithromycin 500mg b.i.d).The symptoms were assessed using Gastrointestinal Symptom Rating Scale(GSRS) questionnaire. Patients completed GSRS questionnaire during the first week of treatment and after the completion of treatment.

Results: A total of 15 patients with RUT (Rapid Urease Test) positive for H.pylori were treated with standard triple therapy for 14 days. No patients were excluded due to an incomplete questionnaire. The overall symptom reduction after successful completion of therapy is 71.75%. In terms of five major symptom patterns like abdominal pain score, reflux score, indigestion score, diarrhoea and constipation score were also found to be reduced significantly.

Conclusion: Significant reduction in symptoms with H.pylori infection were seen in patients those complete the standard 14 day triple therpy. Patients were found to be symptomatically improved.

Keywords: Symptomatic improvement, Helicobacter pylori infection, Standard triple therapy, 14 day course, GSRS .

References

  1. Hajimahmoodi M, Shams-Ardakani M, Saniee P, Siavoshi F, Mehrabani M, Hosseinzadeh H, Foroumadi P, Safavi M, Khanavi M, Akbarzadeh T, et al. In vitro antibacterial activity of some Iranian medicinal plant extracts against Helicobacter pylori. Nat Prod Res. 2011;25:1059–1066.
  2. Buzás GM. Metabolic consequences of Helicobacter pylori infection and eradication. World J Gastroenterol. 2014;20:5226–5234.
  3. Hurlimann, S, Dür, S, and Schwab, P (1998). Effects of Helicobacter pylori on gastritis, pentagastrin-stimulated gastric acid secretion, and meal-stimulated plasma gastrin release in the absence of peptic ulcer disease. Am J Gastroenterol. 93, 1277-1285
  4. Am J Gastroenterol2017; 112: 212–238; doi:10.1038/ajg.2016.563
  5. Xu S, Wan X, Zheng X, et al. Symptom improvement after helicobacter pylori eradication in patients with functional dyspepsia-A multicenter, randomized, prospective cohort study. Int J ClinExp Med. 2013;6(9):747–756. Published 2013 Sep 25.
  6. McColl KE, el-Nujumi A, Murray LS, et al. Assessment of symptomatic response as predictor of Helicobacter pylori status following eradication therapy in patients with ulcer. Gut. 1998;42(5):618–622.
  7. McColl K, Murray L, El-Omar E, et al. Symptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia. N Engl J Med 1998;339:1869-74
  8. Wang J, Zhang G, Hu X, Liu Y, Bao Z, Huang Y. Two-week triple therapy has a higher Helicobacter pylori eradication rate than 1-week therapy: A single-center randomized study. Saudi J Gastroenterol. 2015;21(6):355–359. doi:10.4103/1319-3767.170951
  9. Romano M, Cuomo A. Eradication of Helicobacter pylori: a clinical update. Med GenMed. 2004;6(1):19. Published 2004 Feb 18.
  10. Svedlund J, Sjodin I, Dotevall G. GSRS – a clinical ratingscale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig. Dis. Sci.1988; 33: 129–34.
  11. Suzuki H, Masaoka T, Sakai G, Ishii H, Hibi T. Improvement of gastrointestinal quality of life scores in cases of Helicobacter pylori-positive functional dyspepsia after successful eradication therapy. J Gastroenterol Hepatol. 2005;20:1652–1660.
  12. Veldhuyzen Van  Zanten  SJ,  Chiba  N,Armstrong  D,et  Validation  of  a  7-point  Global  Overall  Symptom  scale  tomeasure the severity of dyspepsia symptoms in clinical trials. Aliment PharmacolTher2006;23521–9.
  13. SanpingXu, Xuemung Wan et al- Symptom improvement after helicobacter pylori eradication in pateints with functional dyspepsia – A multicentre , randomized, prospective coort study.
  14. ACG clinical gudideline treatment of helicobacter pylori infection
  15. Jamie NatanEisig et al_-Standard triple therapy versus sequential therapy in helicobacter pylori eradication: A double blind randomized control study

Corresponding Author

Soumya R V

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