Triple Drug Therapy with Proton Pump Inhibitor a Better Option for Helicobacter Pylori Eradication

Abstract

H.Pylori is a gram-negative micro organism residing in the stomach of human. It is a important cause of acid
peptic disorders. Bismuth based triple therapy,triple therapy regimens (Tripple PPI) and Quadruple therapy
are the available treatment options to eradicate H. pylori. Controversy still presents regarding the superiority
of treatment modality and results of available studies are variable. Hence this study was undertaken to
evaluate and compare the efficacy of triple PPI, Quadruple therapy, and bismuth-based triple therapy in
treating acid peptic disorders and Helicobacter pylori eradication. Method: This study was a prospective
interventional. After the establishment of a clinical diagnosis of the acid peptic disorder, the patient was
posted for endoscopy. H. pylori status was determined by the rapid urease test and culture examination.
All patients divided into three groups and offered three different medical treatments the first group received
bismuth bases triple therapy, the second group got Tripple PPI therapy and the third one received quadruple
therapy. efficacy and comparison of all these treatment modalities were evaluated and assessed by symptoms,
endoscopic findings, and results of the rapid urease test after 6 weeks. Results: In the present study, 150
patients with upper gastrointestinal symptoms were studied It was found that the maximum number of
subjects belonged to the age group 31-40 yrs. Male outnumbers than females. Maximum patients had pain in
epigastric region and were having gastritis as a commonest diagnosis., Symptomatic relief by Triple therapy
with PPI was maximum than other therapies. Rapid urease test (RUT) was also suggest that treatment with it
gives superior eradication rates. Discussion: In our study, we have found that the treatment regime with PPI
Triple therapy has given maximum symptomatic relief, there is an association of H. Pylori infection in an
acid peptic disorder like duodenal ulcer (86.66%), gastric ulcer (75%), and gastritis (82.85%). the efficacy
of the Rapid urease test is 66% and that of culture is 38.66% in the diagnosis of H. pylori infection in acid
peptic disorder. Conclusion: PPI Triple therapy is most effective in symptomatic relief and healing of the
duodenal and peptic ulcer.