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

Abstract

Introduction: 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 bismuthbased
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