bismuth-tripotassium-dicitrate and Diarrhea

The aim of the study was to assess the expediency of prescription and efficiency of bismuth tri-potassium di-citrate in different therapeutic schemes for the management of irritable bowel syndrome (IBS) dominated by diarrhea. The open prospective study of de-nol efficacy and safety included 30 patients with this disorder allocated to 2 groups. Patients of the main group (n=20) were given 120 mg of de-nol thrice daily in combination with meteospasmyl (a spasmolytic and antifoaming agent). Control patients (n=10) received aluminium phosphate with meteospasmyl (1 capsule thrice daily). Duration of the treatment was 3 weeks. Therapeutic efficiency was assessed from the dynamics of abdominal pain syndrome, stool frequency, properties of faeces, results of their microscopic and microbiological studies, lactulose breath hydrogen test, rectoromanoscopy with rectal mucosal biopsy, and hepatic biochemical test. Before the study, all patients had abdominal pain, diarrhea, meteorism, altered composition of fecal bacteria, their excessive growth in the intestines, and morphological signs of chronic inflammation. Bacterial activity was recorded in 80 and 40% of the patients of the respective groups. By the end of therapy, abdominal pain was eliminated in 90 and 60%, meteorism was absent in 80 and 40%, diarrhea in 75 and 50%, excessive bacterial growth in small intestine in 75 and 30%, changes of fecal microflora persisted in 20 and 70%, histological signs of active mucosal inflammation remained in 40 and 85.7% of the patients of the main and control groups respectively. It is concluded that all patients with irritable bowel syndrome and diarrhea show altered composition of intestinal microflora, morphological signs of moderate chronic inflammation of intestinal mucosa. Most of them have apparent bacterial activity. Treatment with de-nol and spasmolytics for 3 weeks effectively eliminated clinical manifestations of the disease, restored normal composition of intestinal microflora, normalized faeces properties, and resolved active inflammation.

Topics: Adolescent; Adult; Anti-Infective Agents; Bismuth; Diarrhea; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Intestinal Mucosa; Irritable Bowel Syndrome; Male; Middle Aged; Organometallic Compounds; Propylamines; Prospective Studies; Treatment Outcome; Young Adult

To evaluate efficiency of colloid bismuth subcitrate (CBS) in gastropathies induced by nonsteroid anti-inflammatory drugs (NSAID).. 45 patients with rheumatic diseases (RD) taking NSAID with gastric and/or duodenal up to 1 cm in size or multiple (more than 10) gastric mucosa erosions detected at esophagogastroduodenoscopy were randomized into two groups. Patients of group 1 (n = 30) received CBS (240 mg twice a day + amoxicillin 2 g/day and furozolidon 400 mg/day--subgroup 1a, n = 10 or CBS monotherapy in the same dose--subgroup 1b, n = 20). Patients of group 2 (n = 15) received ranitidine 150 mg twice a day. Older women, RA patients, patients with gastric ulcer prevailed. H. pylori was detected in 73.3 and 90% patients, respectively. Dispepsia and heartburn occurred in 90 and 93.3%, respectively. The efficacy was assessed after 4 weeks of therapy.. Healing of ulcers and erosions were achieved in 22 of 26 patients of group 1 (84.6%) and in 7 of 14 (50%) of group 2 (p = 0.036, chi-square). After therapy dyspepsia persisted in 4 patients of group 1 and 9 patients of group 2. Side effects were in 3 patients on CBS. Untiulcer effect did not differ between the subgroups (88.8 and 82.4%, respectively) and was effective in 6 of 7 HP-negative patients (85.7%) and in 8 of 10 HP-positive patients (80%).. De-Nol is effective in NSAID-induced gastropathies. Its action is not related with influence on HP.

Topics: Aged; Anti-Infective Agents, Local; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Arthritis, Rheumatoid; Diarrhea; Drug Administration Schedule; Duodenal Ulcer; Duodenoscopy; Esophagoscopy; Female; Furazolidone; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Organometallic Compounds; Prevalence; Ranitidine; Severity of Illness Index; Sex Distribution; Stomach Ulcer

The best regimen for the treatment of Helicobacter pylori infection has yet to be defined. Four-day quadruple therapy with tetracycline, metronidazole, bismuth, and a proton pump inhibitor has been shown to obtain a very high cure rate. However, the fact that it must be taken four times daily may interfere with compliance. The objective of the study was to test the efficacy and tolerability of a new 4-day therapy with 4 drugs taken every 12 hours to cure H. pylori infection. Patients and Methods. Fifty-six consecutive patients with peptic ulcer disease and H. pylori infection were treated with an oral 4-day course with omeprazole (20 mg/12 hours), clarithromycin (500 mg/12 hours), amoxicillin (1 g/12 hours) and tinidazole (500 mg/12 hours). Efficacy of the treatment was determined at least 2 months after therapy either by biopsy (in the case of gastric ulcer) or by 13C-urea breath test. A second breath test was performed at least 6 months after therapy.. Two patients were lost to follow-up. Forty-nine of the remaining 54 patients were cured at the first control [intention-to-treat cure rate: 87.5% (CI 95% 75-94%); per protocol cure rate: 90.7% (CI 95% 81-98%)]. Forty-three of these 49 cured patients returned for a second 13C urea breath-test at 6-12 months. Two of them were not cured, giving a long-term cure rate of 85.5% per protocol and 73.2% by intention-to-treat. Compliance was good, although 25 patients had mild side effects.. This particular four-day therapy is well tolerated, easy to follow, and achieves an acceptably high cure rate.

Topics: Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Ulcer Agents; Clarithromycin; Diarrhea; Drug Administration Schedule; Drug Therapy, Combination; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Nausea; Omeprazole; Organometallic Compounds; Patient Compliance; Pilot Projects; Tetracycline; Time Factors; Tinidazole; Treatment Outcome

Peptic ulcer patients need to be treated with antimicrobials to cure Helicobacter pylori infection. Seven-day quadruple therapy is the regimen with the highest cure rates. An ultra-short quadruple therapy was evaluated prospectively.. Forty-six consecutive H. pylori positive patients (33 had proven ulcer disease) were prescribed lansoprazole 30 mg b.d. on days 1-4, and on day 4 they received in addition tripotassium dicitrato bismuthate 120 mg, tetracycline 250 mg and metronidazole 250 mg at 09.00, 11.00, 13.00, 15.00, 17.00, 19.00, 21.00, 23.00 hours. Repeat endoscopy with biopsies for CLOtest, Giemsa stain and culture was carried out 6 weeks later.. Follow-up was complete. Overall cure rate (all three biopsy-based tests negative) was 26/46 (57%; 95% CI: 41-71%). Antibiotic sensitivity was available in 42. Thirty-nine carried a metronidazole sensitive strain and 23/39 (59%) were cured, three carried a resistant strain and therapy failed in all. Three out of four in whom susceptibility was unknown were cured. Metronidazole resistance was induced in 8 out of 16 with a sensitive strain. Only one patient (3%) reported severe side effects.. This convenient quadruple regimen showed that a short contact time is sufficient to kill H. pylori in vivo. Since 57% of patients are cured with a 14-h treatment, a slightly longer treatment duration may increase the cure rate to above 90%.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Anti-Ulcer Agents; Bismuth; Diarrhea; Drug Therapy, Combination; Dyspepsia; Endoscopy, Gastrointestinal; Enzyme Inhibitors; Female; Helicobacter Infections; Helicobacter pylori; Humans; Lansoprazole; Male; Metronidazole; Middle Aged; Omeprazole; Organometallic Compounds; Peptic Ulcer; Prospective Studies; Proton Pump Inhibitors; Tetracycline

We investigated whether addition of bismuth subcitrate (BSC, 4 x 120 mg) to a two week therapy scheme of omeprazole (OME, 2 x 40 mg)/amoxicillin (AMO, 4 x 500 mg) increases Helicobacter pylori eradication.. Patients with dyspepsia underwent upper endoscopy. H. pylori positive patients were randomized to treatment A (OME/AMO, 83 patients) or treatment B (OME/AMO/BSC, 84 patients).. In 65 patients of group A (78%) H. pylori was eradicated as determined from the histological assessment (Sydney classification) of antrum and corpus biopsies. In comparison, in 68 patients of group B (81%) H. pylori was eradicated (p = NS between groups). H. pylori eradication in both groups was associated similarly with a decrease of inflammation and activity whereas atrophy and intestinal metaplasia were not affected. A positive association was revealed between the decrease of H. pylori score and the decrease of both inflammation and activity scores for antrum as well as corpus biopsies.. Addition of BSC to OME/AMO does not increase H. pylori eradication in patients with dyspepsia. Eradication of H. pylori is associated with disappearance of epithelial damage (inflammation and activity) in antral and corpus mucosa.

Topics: Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Ulcer Agents; Atrophy; Biopsy; Data Interpretation, Statistical; Diarrhea; Digestive System; Drug Therapy, Combination; Female; Gastroenteritis; Helicobacter Infections; Helicobacter pylori; Humans; Inflammation; Male; Middle Aged; Omeprazole; Organometallic Compounds; Penicillins; Pyloric Antrum; Time Factors; Treatment Outcome

To evaluate two triple-therapy (TT) regimens of colloidal bismuth subcitrate (CBS), metronidazole, and tetracycline HCl in eradicating Helicobacter pylori, with particular attention to the frequency of resulting adverse effects of the two therapies.. A prospective, randomized controlled trial was conducted in patients with symptoms of dyspepsia who were positive for H. pylori. Subjects received a 14-day course of either 4 x/day therapy of CBS (108 mg), tetracycline HCl (500 mg), and metronidazole (250 mg), or 5 x/day therapy of CBS (108 mg), tetracycline HCl (250 mg), and metronidazole (200 mg). H. pylori status was determined endoscopically by urease test, histology, and culture. Standard questionnaires were administered to determine compliance to treatment and side effects of therapy.. H. pylori was eradicated in 196/213 (92%) patients in the 4 x/day group and 202/210 (96%) in the 5 x/day group (p = 0.07). Side effects were significantly less frequent and less severe in the 5 x/day group (p < 0.01).. We conclude that a lower dose, 5 x/day triple therapy treatment of H. pylori is equally efficacious to the standard 4 x/day therapy, but is accompanied by fewer and milder adverse effects.

Topics: Abdominal Pain; Anti-Bacterial Agents; Constipation; Diarrhea; Drug Administration Schedule; Drug Therapy, Combination; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Middle Aged; Nausea; Organometallic Compounds; Patient Compliance; Prospective Studies; Tetracycline; Vomiting

Topics: COVID-19; Diarrhea; Helicobacter Infections; Humans; SARS-CoV-2