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  Česky / Czech version Čes. a slov. Gastroent., 2000, roč. 54, č. 1, s. 24 - 34.
 
Helicobacter Pylori and Peptic Ulcer. Recent Develop- ments? 
Martínek J., Špičák J., Pantoflíčková D.* 

 


Summary:

       The author summarizes the most important therapeutic advances in the sphere of H. pylori and peptic ulceration. Recently it was revealed that H. pylori and non-steroid antirheumatic drugs do not potentiate their gastrotoxic action, on the contrary, eradication of the bacteria might retard healing of gastric lesions caused by non-steroid antirheumatic drugs without reducing the risk of relapses. The greatest effectiveness of omeprazole, as compared with other drugs in the treatment and prevention of ulcers and erosions, associated with the use of non-steroid antirheumatics was also confirmed. New so-called COX-2 selective non-steroid antirheumatics are also gastrotoxic. New data on possible negative effects associated with treatment of H. pylori change the approach to treatment of the infection in asymptomatic and dyspeptic subjects where the favourable effect of eradication treatment remains controversial. The combination of three drugs containing one proton pump inhibitor (PPI) and two antibiotics, remain the treatment of first choice for eradication of H. pylori. Last not least, the authors discuss also the problem of medicamentous treatment in haemorrhage from peptic lesions where the favourable effect of drugs reducing acid secretion was not confirmed so far.

        Key words: Helicobacter pylori – peptic ulcer – non-steroid antirheumatics – Zollinger-Ellison syndrome
       

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