Gastroenterologist, Gastroenterology Journal

Question: Died doctor! I'm 40 years old. In the 12 had been diagnosed with gastritis, 30 was identified ulcer 12-duodenum. All my life I accompanies this stomach ailment, because the frequent exacerbation manifested erosive bulbitom, frequent treatment. . . I understand that with this disease need to throw smoke (smoke from 15 years), but throw prevent my stomach. I have the willpower to give up cigarettes sharply, which went through 4, 2 and half year ago. And throw easily, and for 3-5 days longer pulls, and I feel good, but every time after 30-35 days of my life without cigarettes begin to hurt the stomach. At first slightly, then stronger and stronger. I understand that starts peaking, and begin to take Omez (2t/den) or Kvamatel (2t/den) (in different cases were differently). And interestingly, the effect of antiulcer agents receive zero, because in spite of receiving these drugs, with each passing day the pain was not diminishing but increasing. After about 5-7 days, despite their drug I nachanayutsya even stomach pains at night – I wake up from them. And I'm beginning to suspect that the aggravation of peptic ulcer disease occurs in me because of the rejection of cigarettes, once even lekartva not help, and as a result, approximately 40-day, I light up. As soon as I light up, all symptoms of peptic ulcer go away within days. Taki way I tried three times to quit, and all three times experiencing this phenomenon with stomach pains for 30-35 days, which will not save even Omez and Kvamatel. Maybe it's something to do with regulation of the nervous system, but not much in it seems, because the field is how to quit smoking, I feel great, and absolutely do not observe the nervous excitability – easy to fall asleep, wake up easily, normal vital activity. How to be in a situation where the patient stomach – have quit smoking and quit smoking – begins exacerbation of chronic disease.

Answer: Two capsules per day omeza must remove the pain associated with ulceration / erosion of the mucous membranes, but gastroscopy with these periods, as understood, was not carried out, deterioration could be purely "clinical" (and therefore are in during the day). Dose omeza at the time of peak pain for a week for example, can be doubled (2×2), plus add Venter, and, of course, diet.

Question: doctor, I am 38 years old. Been treated at the chronic gastritis associated with H. pylori by the scheme (7 days): omez 20mg x 2p; amoxicillin 1000mg x 2p. , Clarithromycin 500 mg x 2p. After 3 weeks – urea breath test positive (an increase of 26 mm). The doctor said that even the tube is not enough! Suspected violation dosage or re-infection in the family. Assigned: esomeprazole 20 mg x 2p; de-nol or analogs 120mg x 4s; metronidazole 500mg x 3p; tetracycline 500 mg x 4 rows. (10-14 days). I told the doctor that had me several times prescribed metronidazole, and I have on the background every time thrush. The doctor changed the scheme: esomeprazole 20mg x 2 p; amoxicillin 1000mg x 2p, tetracycline 500 mg x 4 p (at 10-14 days), saying: "or even spit and do not treat!" If possible, explain, please: 1 . What may be due to the lack of effect from the first course (all assignments strictly adhered to, no smoking, no drinking, no antibiotics had not taken!) 2. Does it make sense to be treated again on a triple scheme with the same, and + (as I understand) the weaker antibiotic or better tolerated, and then treat the effects of metronidazole? 3. Still 10 days or 14? And is this too long course? Thank you.

Answer: 'goals: getting rid of carriage of the microbe or to improve well-being? Feeling not described (as well as, and endoscopy protocol), but it can not change for the better immediately after antimicrobial treatment. From microbe after such a chaotic treatment will be difficult to remove. The lack of effect of the first year due to the fact that microbes are usually resistant to metronidazole.

Question: I discovered an ulcer dvennadtsatiperstnoy intestine. Prescribe treatment Epicurus (2 capsules per day), Venter (2 tablets 3p. Per day for 40 minutes before eating), motilak (3 pp. Per day for 20 minutes before eating) and penzital (after eating). The question arose, whether the effective application of this scheme, 10 days Venter, and then replace it with de-nol and take it 4 weeks, along with the rest appointed by drugs. Go directly to the de-nol afraid, because in the new year, the doctor allowed alcohol or eat (only vodka), and de-nol with alcohol use is not recommended (other prescribed drugs, according to the attending physician, are not critical to the consumption of alcohol). P. S. The presence of bacteria heliobakter not been verified.

Answer: determining a reception Epicurus (lansoprazole), the duration depends on the endoscopic picture. The rest is not important.

Question: Good day! Stomach always bothered me, but the survey never took place. Now I am 27 years old. 10 years ago in the summer I have had angioedema and urticaria, but after the injection all over. Allergists placed on the pollen. . . But in the winter swelling appeared again and again for an hour all over. That was over 6 years. 2-3 times per year. And one day I was sent to fibrogastroduodenoscopy, where he found an ulcer 12-duodenum and helicobacter. After treatment all over, 4 years no allergies! I became pregnant and gave birth to a healthy baby. And then again on December 24 edema. . . . I was horrified. Was tested: no ulcer, gastritis, but again just helicobacter. QUESTION: Can occur due to swelling helicobacter ???????????????

Answer: Cases of angioedema connection with Helicobacter pylori are not known to me.

Question: Please consult regarding treatment. I first asked the gastroenterologist about the problems, made FEGDS results are as follows: stomach, gastric mucosa is hyperemic (diffuse), the antral mucosa is hyperemic (diffuse). Folds enlarged, biopsies of H. p. , Invasion sharply positive, duodenal-ulcerogenic strain. Division passes freely, localization: onion KDP, peristalsis in the normal mucosa hyperemic follicles, mucosa zalukovichnogo Department hyperemic, enlarged fold lesions: ulcer, location: KDP bulb, medial wall, the form is incorrect, Size: maximum 0. 8 cm, the minimum 0. 5cm, the base (bottom) under the fibrin, the edge nodulated (non-uniformly convex), the surrounding mucosa infiltration, Vater papilla is not visualized. Unfortunately, I absolutely do not possess the above terms and can not objectively evaluate their diagnosis, therefore, be so kind as to tell me how to be treated and how all this is treated in general. Thanks

Answer: banal ulcer 12-duodenum with ulcer in the beginning stages of healing, "associated with Helicobacter pylori. It is treated and cured. Every doctor knows what to do.

Question: Dear doctor! 3 months ago after severe stress, there were abdominal pain, rumbling, bloating, severe nausea, weakness, occasionally abundant 1.2 times liquid stools, pain in the shoulder blade. Self (New Year's holidays were) taken 12 days kvamatel, Almagel, Rennie, but, Univ. Some improvement with minor aggravations. At the Uzi was diagnosed Mts. pancreatitis (small) and the bending of the gall bladder without stones + spikes (9 years ago was peritonitis due to missed ectopic with fetal attachment in the intestines). They appointed pancreatin-improvement, the food was perivarivatsya disappeared madhouse, but remained nausea. Analysis of blood Hp-73, reduced hematocrit, mikrotsitoz, anisocytosis, poikilocytosis, erythrocyte 3. 2, platelets 380, erythrocyte sedimentation rate 24, the rest is normal, elevated ALT-55 (N-34). They began to poke Ferrum-Lek. At FGS found 2 ulcers and pyloric pyloric division, diaphragmatic hernia and signs of mild pancreatitis. They appointed ultop (omeprazole) 20.2 times a day, month, mezim and valerian. Pancreatin was told to cancel, to the pancreas to work. After 2 days FGS black chair. At ultope was better, vanished nausea, pancreatin take one day at dinner, or inflate the stomach. Went on vacation at sea, everything is gone and without a strong diet, Hp is 116, everything else is normal, but only came to work-stress + weak and nauseated. Ultop reduced dose of 2 times and like 5 days worse. Must go for a second FGS, but familiar to doctors all say differently, it is felt that an ulcer rasstrevozhat nanervnechuyu again and I imagined it to study (my day always breaks before any investigation, even the ultrasound. And another question: how long can drink ultop and drink for me pancreatin (it helps me) Fresh amylase-90 (up to 100 standard), but for 2 days, I drank 1 tab. pancreatin. Thank you

Answer: There is a plague or not – still need a couple of weeks to resume reception ultopa in the previous dose. Ultop can drink indefinitely, also pancreatin. Social cause of the disease and here we can not help dramatically.

Question: doctor! My son (17 years) after antibiotic treatment of sinusitis, there was a raid on the tongue of a dark gray color. A couple of days has passed, but the tongue is 2-3 days was wrapped with white bloom. The same pattern was observed 4 months ago, after taking antibiotics. Gastroenterologist appointed to respiratory helik test. Result positive (basal level-1, load-5, growth rate-4). After the test, read online that two weeks before the test can not take antibiotics and other drugs, which he took 9 days ago. Could this affect the outcome and there is a need in the treatment of bacteria? Thank you in advance.

Answer: This is not the point: the tongue inhabit very different microbes.

Question: Doctor, is it possible to parallel with the standard triple scheme (amoks., Clara., IPP) to take Creon enzyme and probiotics Lineks. I should also be very grateful if you can give advice on diet during treatment with HP-Assoc. pangastrita (antral and fundic cron. surface. Active 2ST. HP + + +) or link (but it's better advice:). Also interested in the question, Does HP-gastritis effect on the pancreas (ultrasound revealed diffuse changes)? And can we find the relationship between HP with the risk of urolithiasis? With respect, Alexander (Minsk)

Answer: 1. It is possible, but not necessary. 2. During the antimicrobial treatment of food as usual. In general, depends on the clinical manifestations, ie, the complaints:) 3. Not provided. 4. There are assumptions about the connection with the microbes, but not with these.

Question: The question of doctor-gastroenterologist: I have a few questions: 1) I'll show treatment ljamblii found in the liver, and Helicobacter pylori class lg (more than 8, the rate-up to 0,9). Now I am not at the place of residence, and must be treated. 2) And one more question, I began to itch very eyes, sometimes very strongly and allergist said it was because of this. Maybe this? 3) 2 years ago, went to sea in the Crimea and 3 weeks the whole camp was in bed with their stomachs and drink activated charcoal (for us there was more than 2 thousand people). Epidemic whole. They say the release was rubbish in the sea. Doctor's visit, they said kind of E. coli. It is possible that this is the stick kkotoruyu I find? On arrival, I went to the doctor and saw some pills. Do I need to inform their friends that they also checked. 4) My husband, too, to treat it? 5) whether to take the "breath test" (you constantly refer to it) to verify the diagnosis. 6) if I have diarrhea very often it is because of this infection? All writing that they have serious problems with his stomach, as I am concerned only diarrhea and scabies in her eyes, no pain. Do you think the moment I have nothing serious? (Gastritis is of course, checked by gastroendoskopii year ago). Thank you for your patience. 27.

Answer: 1. It is not clear that the need for treatment (on ljamblii, for example – http://doktor. Ru / qa / gastro / article. Html? Id = 57689). 2. Very doubtful. 3. Perhaps, but without knowing the details about the disease can not be judged. 4. No. 5. In this case, no. 6. No.

Question: Thank you for having responded (http://doktor. ru/qa/13938/qa. html? id = 90214)! The pain began on April 17, burning in my left side, constant belching, often hungry. April 20 evening, adopted the "Almagel-A" one hour after meal 2 scoops at night. April 21 drank the same "Almagel-A in the morning and afternoon on 2 tablespoons of the 21 st in the evening fever (37.8), headache, nausea. Once torn, nausea passed. At night, drank "Antigrippin. (I thought that I ARI) 22 th, the morning temperature was sleeping, abdominal pain, were cutting-burning, and attacks, severe headache. Began to take: "Omez" morning; "Maalox", "Mezim and Detsitel" before meals 3 times a day. Villages on the appropriate diet. By the evening of 22-th temperature 37,00 23rd temperature and headaches are gone. Now, with the treatment which I have described the pain is not severe, but constant, and seizures occur cutting-burning pain on the left side or around the intestines. Belching preserved. Stool normal. In principle, it became a little easier, but nothing more. I forgot to write the last time that I bend the neck of the gallbladder. Many thanks in advance, waiting for your response! Sincerely, Elena

Answer: The questions were: 1) can now be treated independently for the first phase (pariet, Maalox, ditsetal, mezim) to bring myself up, or 2) must be again tested for the presence of helicobacter and Giardiasis? ? 3) whether there is a less expensive analog parieta replaces whether it Omez? Answers: 1) If the temperature is normal, abdomen soft, paroxysmal pain, and not permanent, it can be treated with diet alone, and you mentioned drugs. 2) no. 3) omez perfect substitute (20 mg x 2 pp.).