Kryvy V. Peptic ulcer associated with Helicobacter pylori in combination with iron-deficiency anemia: peculiarities of the combined course, diagnostics and therapy

Thesis for the degree of candidate of medical sciences, specialty 14.01.02 - Internal Diseases. Public institution "Crimea State Medical University named after S.I. Georgievskiy", Simferopol, 2011. The thesis is devoted to the study of comorbidity peptic ulcer and IDA, the effectiveness of eradication of H. pylori, the predictors of failure eradication therapy, individualization of diagnostic and therapeutic strategies. The thesis presents the results of our study using endoscopy, morphological examination of biopsy specimens coolant, pH meters, hydrogen breath test, G-17, PG I, II. The data allowed to determine the following predictors of eradication therapy first line failure: the combination of pronounced, widespread inflammation of the coolant, contamination of the third degree of H. pylori with high levels of PG I, low acid suppression effect of standard doses PPIs, peptic ulcer and IDA comorbidity. The factors reducing the sensitivity of the 13C-UBT: atrophy of the gastric mucosa in combination with a contamination degree of H. pylori. A modification of the standard protocol of 13C-UBT, allowing neutralize the impact of these factors with the ability to evaluate the results already at 15 minutes of research using less reagent. Proved the need for individualization of therapeutic strategies to study the clinical situation, with comorbidity peptic ulcer and IDA and the effectiveness of the modified eradication therapy using probiotic "Latsidofil", double doses PPI and "sequential therapy".