Modern problems of treatment of Helicobacter-associated diseases in children: opportunities of adjuvant therapy
Background. The relevance of research is related to a significant spread of the pathology of the upper digestive tract in children, which in most cases is caused by the pathogenic effect of Helicobacter pylori (Hp). Modern eradication strategies require adjuvant therapy. The aim of the study was to evaluate the clinical effectiveness of the Lactiale symbiotic as an adjuvant therapy for eradication schemes in children of different ages with the pathology of the upper digestive canal. Materials and methods. Seventy children with Hp-associated pathology of the upper digestive tract aged 5 to 18 years were under observation. Patients were divided into 2 groups depending on the use of the symbiotic. The diagnosis was verified using fibrogastroscopy, endoscopic pH-metry, determination of Hp-infection, morphological examination. The results were statistically processed. Results. The results of using Lactiale symbiotic in patients of group 1 as an adjuvant therapy for standard pediatric Hp eradication schemes suggest the expediency and high effectiveness of such treatment. The dynamics of complaints, absence of side effects and good tolerabi-lity of drugs against the background of reception of a symbiotic were positive. The increase in eradication efficiency by 10 % compared with standard schemes corresponds to the results of other studies. The positive influence of the symbiotic on the processes of qualitative healing of ulcers and a significant increase in anti-inflammatory effect in patients of the main subgroup with peptic ulcer of the duodenum was determined. The low result of eradication, obtained in patients with functional disorders, can be considered predictable. This is evidenced by the latest conciliatory conclusions of experts: the effectiveness of eradication in patients with functional dyspepsia does not exceed 15–30 %. Conclusions. The use of the Lactiale symbio-tic as an adjuvant therapy for eradication schemes in children of different ages with Hp-associated pathology of the upper digestive tract is advisable, significantly increases the effectiveness of eradication, improves the tolerability of drugs, adhe-rence of patients to the treatment.
Full Text:PDF (Українська)
Belousova OYu. About risk factors for upper digestive pathology development and optimization of eradication therapy schemes in pediatric practice once more. Zdorovia Ukrainy. 2016 September;3(38):24-6. (In Russian).
Belousova OYu, Pavlenko NV, Voloshyna LH, Babadganyan EN, Voloshina LG. Combined pathology of the upper gastrointestinal tract in children: current trends. Likarska sprava. 2014;11:85-8. (In Russian).
Shadryn O.H. Нelicobacter рylori in children: current approaches to diagnosis and ways for therapy optimization. Sovremennaya Pediatriya. 2014;5(61):119-127. doi 10.15574/SP.2014.61.119. (In Russian).
Koletzko S, Jones NL, Goodman KJ, et al. Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr. 2011 Aug;53(2):230-43. doi: 10.1097/MPG.0b013e3182227e90.
Malfertheiner P, et al. The European Helicobacter Study Group (EHSG). Management of Helicobacter pylori infection — the Maastricht IV. Florence Consensus Report. Gut. 2012 May;61(5):646-64. doi:10.1136/gutjnl-2012-302084.
Fadeenko GD, Belousova OYu, Pavlenko NV, et al. Vіkovі osoblivostі perebіgu zahvorjuvan' shlunkovo-kishkovogo traktu, asocіjovanih z Nelicobacterpylori ta їh racіonal'na korekcіja: metodichnі rekomendacії [Age features of gastrointestinal diseases associated with Нelicobacter pylori and their correction: Textbook. Kyiv, 2015. 32 p. (In Ukrainian).
Pro zatverdzhennja unіfіkovanih klіnіchnih protokolіv medichnoї dopomogi dіtjam іz zahvorjuvannjami organіv travlennja: Nakaz MOZ Ukraїni vіd 29.01.2013 r.№ 59 [Elektronnij dokument] [About approval of unified clinical protocols on medical care for children with gastrointestinal diseases: Order of Ministry of Health of Ukraine dd 29/01/2013 N 59. E-document]. Available at: http://www.moz.gov.ua/ (In Ukrainian).
Bahrami B, Macfarlane S, Macfarlane GT. Induction of cytokine formation by human intestinal bacteria in gut epithelial cell lines. J Appl Microbiol. 2011 Jan;110(1):353-63. doi: 10.1111/j.1365-2672.2010.04889.x.
Hurduc V, Plesca D, Dragomir D, Sajin M, Vandenplas Y. A randomized, open trial evaluating the effect of Saccharomyces boulardii on the eradication rate of Helicobacter pylori infection in children. Acta Paediatric. 2009 Jan;98(1):127-31. PMID: 18681892. doi: 10.1111/j.1651-2227.2008.00977.x.
Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006 Aug;101(8):1900-20. doi: 10.1111/j.1572-0241.2006.00630.x.
Goel A, Aggarwal R. Probiotics as adjunctive therapy for eradication of Helicobacter pylori infection (Protocols). Cochrane Database of Systematic Reviews. 2013. Issue 10. Art. No.: CD010776. doi: 10.1002/14651858.CD010776.
Hsieh PS, Tsai YC, Chen YC, The SF, Ou CM, King VA. Eradication of Helicobacter pylori infection by the probiotic strains Lactobacillus johnsonii MH-68 and L. salivarius ssp. Salicinius AP-32. Helicobacter. 2012. Dec;17(6):466-77. doi: 10.1111/j.1523-5378.2012.00992.x.
Rizzelo V, Bonaccorsi I, Dongarra MN, et al. Role of natural killer and dendritic cell crosstalk in immunomodulation by commensal bacteria probiotics. J Biomed Biotechnol. 2011;2011:473097. doi: 10.1155/2011/473097.
Szajewska H, Albrecht P, Topczewska-Cabanek A. Randomized, double-blind, placebo-controlled trial: effect of lactobacillus GG supplementation on Helicobacter pylori eradication rates and side effects during treatment in children. J Pediatr Gastroenterol Nutr. 2009 Apr; 48(4):431-6. doi: 10.1097/MPG.0b013e318182e716.
Le Moal VL, Fayol-Messaoudi D, Servin AL. Compound(s) secreted by Lactobacillus casei strain Shirota YIT9029 irreversibly and impair the swimming motility of Helicobacter pylori and Salmonella enterica serovar Typhimurium, respectively. Microbiology. 2013 Sep;159(Pt 9):1956-71. PMID: 23873784. doi: 10.1099/mic.0.067678-0.
Efrati C, Nicilini G, Cannaviello C, O’Sed NP, Valabrega S. Helicobacter pylori eradication: sequential therapy and Lactobacillus reuteri supplementation. World JGastroenterol. 2012 Nov 21;18(43):6250-4. PMID: 23180945. doi: 10.3748/wjg.v18.i43.6250.
Copyright (c) 2020 O.Yu. Belousova, N.V. Pavlenko, K.V. Voloshin, K.V. Savytska, O.L. Slobodianiuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2020