Helicobacter pylori forum. Bismuth Subsalicylate and H. pylori: Unraveling the Mechanism of Action
How does bismuth subsalicylate suppress Helicobacter pylori infection. What role do the bismuth and salicylate components play in combating H. pylori. Can salicylate’s effect on bacterial flagella explain its efficacy against H. pylori.
The Serendipitous Discovery of Bismuth Subsalicylate’s Effect on H. pylori
In a recent study published in Open Forum Infectious Diseases, Geng et al. reported an unexpected observation regarding the suppression of drug-resistant Helicobacter pylori infection using bismuth subsalicylate. This finding has sparked interest in the scientific community, prompting further investigation into the mechanisms behind this effect.
Bismuth: The Traditional Culprit in H. pylori Suppression
Historically, the bismuth component of bismuth subsalicylate has been credited with its antimicrobial properties. Bismuth compounds have long been used in the treatment of various gastrointestinal disorders, including H. pylori infections. They are known to disrupt bacterial cell walls and inhibit essential enzymes, thus exhibiting bactericidal effects.
How does bismuth target H. pylori?
- Inhibits bacterial adhesion to the gastric mucosa
- Interferes with bacterial energy metabolism
- Prevents biofilm formation
- Reduces bacterial virulence factors
While the efficacy of bismuth against H. pylori is well-established, the potential role of the salicylate component in bismuth subsalicylate has been largely overlooked.
Salicylate: The Unsung Hero in H. pylori Suppression?
Recent research suggests that the salicylate component of bismuth subsalicylate may play a crucial role in suppressing H. pylori infection. This hypothesis is based on salicylate’s ability to affect bacterial flagella, which are essential for H. pylori’s motility and colonization of the gastric mucosa.
Salicylate’s effect on bacterial flagella
Studies have shown that salicylate can reversibly block the synthesis of flagellin and flagella in enteric gram-negative bacteria. This effect may extend to H. pylori, potentially inhibiting its ability to colonize the stomach lining effectively.
The Importance of Flagella in H. pylori Infection
H. pylori’s flagella play a crucial role in its ability to colonize the human gastric mucosa. These whip-like structures allow the bacteria to move through the thick mucus layer of the stomach and reach the epithelial cells, where they can establish infection.
Why are flagella essential for H. pylori?
- Enable motility through gastric mucus
- Facilitate adhesion to epithelial cells
- Contribute to the bacteria’s ability to evade host immune responses
- Aid in the delivery of virulence factors
Given the importance of flagella in H. pylori pathogenesis, targeting these structures could be an effective strategy for combating infection.
Immunological Responses to Bacterial Flagella
The human immune system has evolved various mechanisms to detect and respond to flagellated bacteria, including H. pylori. Understanding these immune responses provides insight into potential therapeutic approaches.
Key components of the immune response to flagella
- Toll-like receptor 5 (TLR5): Senses flagellin, the primary protein component of bacterial flagella
- NOD-like receptor 4 (NLRC4): Activates the inflammasome upon detection of flagellin
- Adaptive immune responses: Production of antibodies against flagellar antigens
These immune mechanisms highlight the potential of targeting flagella as a therapeutic strategy against H. pylori infection.
Salicylate as an Anti-Inflammatory Agent in H. pylori Infection
Beyond its potential effects on bacterial flagella, salicylate may also contribute to suppressing H. pylori infection through its anti-inflammatory properties. Chronic H. pylori infection is characterized by persistent inflammation of the gastric mucosa, which can lead to various complications.
How might salicylate’s anti-inflammatory effects benefit H. pylori treatment?
- Reduce gastric inflammation, potentially creating a less favorable environment for H. pylori
- Modulate the host immune response, possibly enhancing bacterial clearance
- Mitigate tissue damage associated with chronic infection
- Potentially lower the risk of H. pylori-associated gastric cancer
The dual action of salicylate on both bacterial flagella and host inflammation could provide a synergistic effect in combating H. pylori infection.
Implications for Future H. pylori Treatment Strategies
The potential role of salicylate in suppressing H. pylori infection opens up new avenues for research and drug development. Understanding the mechanisms by which salicylate affects H. pylori could lead to more targeted and effective treatments.
Potential areas for future research
- Developing salicylate-based compounds specifically targeting H. pylori flagella
- Investigating the optimal ratio of bismuth to salicylate for maximal efficacy
- Exploring combination therapies that leverage both bismuth and salicylate’s mechanisms of action
- Studying the long-term effects of salicylate-based treatments on gastric health
These research directions could pave the way for more effective and potentially less resistance-prone treatments for H. pylori infections.
Challenges in Attributing Efficacy to Salicylate or Bismuth
While the hypothesis that salicylate plays a significant role in suppressing H. pylori infection is intriguing, it’s important to note that the efficacy of bismuth subsalicylate may result from the synergistic action of both components. Determining the relative contributions of bismuth and salicylate presents several challenges.
Obstacles in isolating the effects of salicylate and bismuth
- Difficulty in separating the antimicrobial effects of bismuth from the potential anti-flagellar effects of salicylate
- Potential interactions between bismuth and salicylate that may enhance or alter their individual effects
- Variations in local concentrations of each component in the gastric environment
- Differences in pharmacokinetics and bioavailability between bismuth and salicylate
Overcoming these challenges will require carefully designed studies that can isolate and compare the effects of each component individually and in combination.
The Potential of Flagella-Targeted Vaccines Against H. pylori
The importance of flagella in H. pylori pathogenesis has also led to research into flagella-targeted vaccines. Studies in mouse models have shown promising results, with immunization against H. pylori flagella significantly reducing colonization.
Advantages of flagella-targeted vaccines
- Highly specific to H. pylori, potentially reducing side effects
- Target a critical component of bacterial virulence
- May provide long-lasting immunity
- Could potentially prevent initial colonization
While still in the experimental stages, flagella-targeted vaccines represent another promising approach to combating H. pylori infections, complementing traditional antibiotic treatments and bismuth-based therapies.
The Broader Implications of Salicylate’s Anti-Flagellar Effects
The potential anti-flagellar effects of salicylate extend beyond H. pylori to other flagellated bacteria. This broader application could have significant implications for treating various bacterial infections and understanding bacterial pathogenesis.
Potential applications of salicylate’s anti-flagellar effects
- Treatment of other flagellated pathogens such as Escherichia coli and Pseudomonas species
- Development of novel anti-virulence strategies that don’t rely on traditional antibiotics
- Understanding the role of flagella in bacterial colonization and biofilm formation
- Exploring the interplay between bacterial motility and host immune responses
These broader implications highlight the importance of continued research into the mechanisms of action of commonly used compounds like bismuth subsalicylate.
Conclusion and Future Directions
The serendipitous observation of bismuth subsalicylate’s efficacy against drug-resistant H. pylori has opened up new avenues for research and potential treatment strategies. While the precise mechanisms remain to be fully elucidated, the potential role of salicylate in suppressing H. pylori infection through its effects on bacterial flagella presents an intriguing hypothesis.
Future research should focus on:
- Conducting in vitro and in vivo studies to isolate the effects of salicylate on H. pylori flagella
- Investigating the potential synergistic effects of bismuth and salicylate
- Exploring the development of novel salicylate-based compounds for H. pylori treatment
- Furthering our understanding of the role of flagella in H. pylori pathogenesis
- Evaluating the potential of flagella-targeted vaccines and therapies
As antibiotic resistance continues to pose challenges in treating H. pylori infections, understanding and leveraging the mechanisms of action of compounds like bismuth subsalicylate becomes increasingly important. The potential dual action of salicylate on both bacterial flagella and host inflammation offers a promising avenue for developing more effective and targeted treatments for H. pylori infections.
Ultimately, unraveling the complex interplay between H. pylori, its flagella, and host responses will not only improve our ability to combat this persistent pathogen but also contribute to our broader understanding of bacterial pathogenesis and host-microbe interactions. As research in this field progresses, we may see the emergence of new therapeutic strategies that harness the power of compounds like salicylate to provide more effective and sustainable treatments for H. pylori infections and potentially other flagellated bacterial pathogens.
Suppression of Helicobacter pylori Infection With Bismuth Subsalicylate: Was It the Bismuth or the Salicylate?
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Open Forum Infect Dis. 2022 Aug; 9(8): ofac413.
Published online 2022 Aug 11. doi: 10.1093/ofid/ofac413
Author information Article notes Copyright and License information Disclaimer
To the EDITOR—I read with great interest the publication by Geng et al [1] on their serendipitous observation that bismuth subsalicylate suppressed gastric infection in a patient with drug-resistant Helicobacter pylori. The purpose of this communication is to consider which of the components of the combination, or both, might be responsible for the efficacy of bismuth subsalicylate. The authors have reviewed the potential effects of bismuth. This letter focuses on the ability of the salicylate component to suppress flagella. There is convincing evidence that the motility of H pylori flagella has a key role in the colonization of the human gastric mucosa [2]. Mice immunized with a vaccine targeting H pylori flagella significantly reduced colonization [3]. The immune system has an extensive array of protective mechanisms to corral colonic flagellated microbiota [4]. These include the Toll-like receptor 5 that senses flagellin and the NOD-like receptor 4. On detection of flagellin, this receptor protein activates the inflammasome. Salicylate reversibly blocks the synthesis of flagellin and flagella in enteric gram-negative bacteria and may protect against an inflammatory response [5].
This supports the notion that the salicylate component of bismuth subsalicylate is an active ingredient against H pylori. This hypothesis is offered to stimulate further work in this important field.
Potential conflicts of interest.
The author: No reported conflicts.
The author has submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
1.
Geng C, Prokesch BC, Vemulapali R. Successful suppression of drug-resistant Helicobacter pylori infection with bismuth subsalicylate. Open Forum Infect Dis 2022; 9:ofac165. [PMC free article] [PubMed] [Google Scholar]
2.
Spohn G, Scarlato V. Motility, chemotaxis, and flagella. In: Mobley HLT, Mendz GL, Hazell SL, eds. Chapter 21: Helicobacter pylori: physiology and genetics. Washington, DC: ASM Press; 2001. [PubMed] [Google Scholar]
3.
Skene C, Young A, Every A, Sutton P. Helicobacter pylori flagella: antigenic profile and protective immunity. FEMS Microbiol Immunol 2007; 50:249–56. [PubMed] [Google Scholar]
4.
Ley RE, Gewirtz AT. Corralling colonic flagellated microbiota. N Engl J Med 2016; 375:85–7. [PubMed] [Google Scholar]
5.
Kunin CM, Tong HH, Bakaletz LO. Effect of salicylate on expression of flagella by Escherichia coli and Proteus, Providencia, and Pseudomonas spp. Infect Immun 1995; 63:1796–9. [PMC free article] [PubMed] [Google Scholar]
Articles from Open Forum Infectious Diseases are provided here courtesy of Oxford University Press
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Open Forum Infectious Diseases, Volume 9, Issue 8, August 2022, ofac413, https://doi. org/10.1093/ofid/ofac413
Published:
11 August 2022
Article history
Received:
29 July 2022
Editorial decision:
05 August 2022
Accepted:
09 August 2022
Published:
11 August 2022
Corrected and typeset:
22 August 2022
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To the EDITOR—I read with great interest the publication by Geng et al [1] on their serendipitous observation that bismuth subsalicylate suppressed gastric infection in a patient with drug-resistant Helicobacter pylori. The purpose of this communication is to consider which of the components of the combination, or both, might be responsible for the efficacy of bismuth subsalicylate. The authors have reviewed the potential effects of bismuth. This letter focuses on the ability of the salicylate component to suppress flagella. There is convincing evidence that the motility of H pylori flagella has a key role in the colonization of the human gastric mucosa [2]. Mice immunized with a vaccine targeting H pylori flagella significantly reduced colonization [3]. The immune system has an extensive array of protective mechanisms to corral colonic flagellated microbiota [4]. These include the Toll-like receptor 5 that senses flagellin and the NOD-like receptor 4. On detection of flagellin, this receptor protein activates the inflammasome. Salicylate reversibly blocks the synthesis of flagellin and flagella in enteric gram-negative bacteria and may protect against an inflammatory response [5].
This supports the notion that the salicylate component of bismuth subsalicylate is an active ingredient against H pylori. This hypothesis is offered to stimulate further work in this important field.
Notes
Potential conflicts of interest. The author: No reported conflicts.
The author has submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
References
1
Geng
C
,
Prokesch
BC
,
Vemulapali
R
.
Successful suppression of drug-resistant Helicobacter pylori infection with bismuth subsalicylate
.
Open Forum Infect Dis
2022
;
9
:
.
2
Spohn
G
,
Scarlato
V
. Motility, chemotaxis, and flagella. In:
Mobley
HLT
,
Mendz
GL
,
Hazell
SL
, eds.
Chapter 21: Helicobacter pylori: physiology and genetics
.
Washington, DC
:
ASM Press
;
2001
.
3
Skene
C
,
Young
A
,
Every
A
,
Sutton
P
.
Helicobacter pylori flagella: antigenic profile and protective immunity
.
FEMS Microbiol Immunol
2007
;
50
:
249
–
56
.
4
Ley
RE
,
Gewirtz
AT
.
Corralling colonic flagellated microbiota
.
N Engl J Med
2016
;
375
:
85
–
7
.
5
Kunin
CM
,
Tong
HH
,
Bakaletz
LO
.
Effect of salicylate on expression of flagella by Escherichia coli and Proteus, Providencia, and Pseudomonas spp
.
Infect Immun
1995
;
63
:
1796
–
9
.
© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact [email protected]
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90,000 Helicobacter pylori. Who had it, how was it treated?
Helicobacter pylori. At …
31 replies
Last –
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#1
900 02 #2
#3
#4
Guest
All this nonsense! Every second suffers from helix. Treatment is not required! more organism suffers from antibiotics!
#5
#6
9 0055 June 18, 2018 06:11 PM
#7
Guest
By the way, even the doctor told me this. You stuff yourself with strong antibiotics, and the next day you pick up this bacteria again in a cafe … With this helik, in general, everything is still not completely clear.
#8
#9
90 077 30 August 2018, 00:26
#10
Irina
Today I had an endoscopy, they did a test for Helicobacter pylori and it turned out to be sharply positive (three pluses). After tomorrow I will go to the gastroenterologist with the analysis, probably. prescribe antibiotics. Who faced similar? How was the treatment? What were the symptoms? Did your hair fall out? 9Hello! I was diagnosed with gastritis at the age of 10, and no one had heard of Helicobacter at that time. I constantly suffered from the stomach: pain, nausea, heartburn, etc. After giving birth, my stomach condition only worsened ((very severe pain and constantly nauseous. After 2 years, I decided to take Helicobacter pylori (I looked for a lot of information on the Internet and found out that it is necessary to take it for immunoglobulin ji – this is a sluggish form of Helicobacteriosis, i.e. .. you need to take it for “Helicobacter pylori IgG”, I handed it over in the synlab in our Minsk). CARL!!!! , and this is just 2 months of treatment. Thanks to the herbs. I wish you a speedy recovery. If someone wants to ask a question – write, I will be happy to answer: my mail is ocean-super@mail. ru 9January 11, 2019 Every second suffers from helix. Treatment is not required! more organism suffers from antibiotics!
#13
#14
Evgenia
hello! I was diagnosed with gastritis at the age of 10, and no one had heard of Helicobacter at that time. I constantly suffered from the stomach: pain, nausea, heartburn, etc. After giving birth, my stomach condition only worsened ((very severe pain and constantly nauseous. After 2 years, I decided to take Helicobacter pylori (I looked for a lot of information on the Internet and found out that it is necessary to take it for immunoglobulin ji – this is a sluggish form of Helicobacteriosis, i.e. .. you need to take it for “Helicobacter pylori IgG”, I handed it over in the synlab in our Minsk). CARL!!!! , and this is just 2 months of treatment. Thanks to the herbs. I wish you a speedy recovery. If someone wants to ask a question – write, I will be happy to answer: my mail is ocean-super@mail. ru
#16
#17
Y awn
All this nonsense! Every second suffers from helix. Treatment is not required! more organism suffers from antibiotics!
#18
Guest
I had. Revealed with a strong exacerbation of gastritis. It is necessary to treat. They prescribed antibiotics and a bunch of other drugs. It has been 6 years without recurrence, I am very pleased that I have treated it qualitatively.
#19
#20
Y awn
I had. Revealed with a strong exacerbation of gastritis. It is necessary to treat. They prescribed antibiotics and a bunch of other drugs. It has been 6 years without recurrence, I am very pleased that I have treated it qualitatively. 15 August 2022 I was diagnosed with gastritis at the age of 10, and no one had heard of Helicobacter at that time. I constantly suffered from the stomach: pain, nausea, heartburn, etc. After giving birth, my stomach condition only worsened ((very severe pain and constantly nauseous. After 2 years, I decided to take Helicobacter pylori (I looked for a lot of information on the Internet and found out that it is necessary to take it for immunoglobulin ji – this is a sluggish form of Helicobacteriosis, i. e. .. you need to take it for “Helicobacter pylori IgG”, I handed it over in the synlab in our Minsk). CARL!!!! , and this is just 2 months of treatment. Thanks to the herbs. I wish you a speedy recovery. If someone wants to ask a question – write, I will be happy to answer: my mail is ocean-super@mail. ru 9Hello! I was diagnosed with gastritis at the age of 10, and no one had heard of Helicobacter at that time. I constantly suffered from the stomach: pain, nausea, heartburn, etc. After giving birth, my stomach condition only worsened ((very severe pain and constantly nauseous. After 2 years, I decided to take Helicobacter pylori (I looked for a lot of information on the Internet and found out that it is necessary to take it for immunoglobulin ji – this is a sluggish form of Helicobacteriosis, i.e. .. you need to take it for “Helicobacter pylori IgG”, I handed it over in the synlab in our Minsk). CARL!!!! , and this is just 2 months of treatment. Thanks to the herbs. I wish you a speedy recovery.
If someone wants to ask a question – write, I will be happy to answer: my mail is ocean-super@mail. ru 9Hello! I was diagnosed with gastritis at the age of 10, and no one had heard of Helicobacter at that time. I constantly suffered from the stomach: pain, nausea, heartburn, etc. After giving birth, my stomach condition only worsened ((very severe pain and constantly nauseous. After 2 years, I decided to take Helicobacter pylori (I looked for a lot of information on the Internet and found out that it is necessary to take it for immunoglobulin ji – this is a sluggish form of Helicobacteriosis, i.e. .. you need to take it for “Helicobacter pylori IgG”, I handed it over in the synlab in our Minsk). CARL!!!! , and this is just 2 months of treatment. Thanks to the herbs. I wish you a speedy recovery. If someone wants to ask a question – write, I will be happy to answer: my mail is ocean-super@mail. ru
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Guest
Yes. A friend was treated with strong antibiotics for a month. It seems to have recovered, as the tests showed. And a month later, a new one. Whether from the husband has caught, whether from the child. I was already crying… fictional stories
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#28
Guest
“My friend was treated with strong antibiotics for a month.”
And that her friend did not have the mind to be treated with propolis tincture? Propolis is much more effective than all antibiotics and without any side effects!
Doctors won’t prescribe you propolis, of course. They stuff you with different things
#29
Guest
Good afternoon! And how to be treated with propolis tincture? What are the proportions?
#30
Guest
Yes. A friend was treated with strong antibiotics for a month. It seems to have recovered, as the tests showed. And a month later, a new one. Whether from the husband has caught, whether from the child. I was already bursting into tears ….
Attention
#31
Guest
You will be prescribed everything by a doctor .. There are antibiotics and a bunch of other drugs. Treatment for a month – then repeat. It is necessary to treat the whole family – to be honest, because. eat and drink from the same glasses. Do not treat – the next stage is cancer..
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#1
9000 3
#2
#3
#4
#5
robicheva
I was treated with both de-nol and ulcavis, but I did not see any difference in effect.
#6 0647 September 07, 2016, 02:41 PM
#8
Guest
20% propolis was advised. .. The tests were in the clinic..positive. Also ginger 2 hours before meals with tea.. Nothing else helps.. Again it comes back.
#9
#10
9 0002 #11
Guest
The same yaytsa, only in profile, not even import substitution.
The active substance is identical, the difference in the amount is 0.3%.
The problem is rather the presence of resistant strains, and a shorter “therapeutic window” than SOME bismuth-free drugs used in multicomponent regimens or as mono(-antimicrobial-) therapy.
Helic is an opportunistic pathogen, in minimal quantities it is present in 90% of those living near rivers, wetlands.
If there is a lot of it, bismuth preparations and other AMHT have the function of “buying time” (treatment of the main metabolic defect, chronic burn or frostbite of the upper gastrointestinal tract, etc. .).
The term “eradication therapy”, which has taken root in medicine, is somewhat incorrect; eradication is significant in terms of removal from the bloodstream, submucosal layers, cellular spaces in various microbial associations, and not just from the body (intestinal lumen, mucosal surface).
#12
Guest
20% propolis advised… Tests were in the clinic..positive Also ginger 2 hours before meals with tea.. Nothing else helps. .It comes back again.
#13
robicheva
The doctor prescribed de-nol for me, but after completing the course of treatment with this medicine, I didn’t get rid of the problems, because as it turned out, helicobacter was only a complex of drugs , including antibiotics can be cured. Already again after a few months, when it became clear that I had not got rid of the problem, I was prescribed De-nol, only in combination with antibiotics and an inhibitor. And in the pharmacy, my favorite pharmacist advised Ulcavis, it is much cheaper.
#14
#15
roksana.visloukhova
Significantly, as much as almost 2 times.
#16
#17
roksana.visloukhova
Significantly, as much as almost 2 times.
#18
Lyusechka Ionova
Is it possible to save on health?
#19
roksana.visloukhova
Yes, look at the composition: bismuth tripotassium dicitrate 303.03 mg, excipients: corn starch ny – 72. 17 mg; povidone K30 – 18 mg; potassium polycrilin – 23.8 mg; macrogol 6000 – 6 mg; magnesium stearate – 2 mg
And for denol: bismuth tripotassium dicitrate 304.6 mg, excipients: corn starch; povidone K30; potassium polyacrylate; macrogol 6000; magnesium stearate
#20
Lusechka Ionova body substances: corn starch – 72.17 mg; povidone K30 – 18 mg; potassium polycrilin – 23.8 mg; macrogol 6000 – 6 mg; magnesium stearate – 2 mg
And for denol: bismuth tripotassium dicitrate 304.6 mg, excipients: corn starch; povidone K30; potassium polyacrylate; macrogol 6000; magnesium stearate
Really almost identical medicines…. But de-nol has more bismuth!
#21
#22
robicheva
The main thing is that it helps!
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#23
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#25
#26
Lyusechka Ionova
As far as I know, you still need to follow a strict diet in addition to drugs
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Lyusechka Ionova
Has your sister been tested?
#29
September 12, 2016, 20:42
How could they prescribe medicines for her without the necessary tests?
#31
#32
#33
#34
Lyusechka Ionova
It’s good! Only now I doubt that I only need Ulcavis, especially in the analyzes this terrible bacterium! It is necessary to clarify with the doctor again how we will destroy it!
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How to stop communicating with her husband’s relatives often?
8 answers
#39
#40
#41
Guest
Proton pump inhibitor + metronidazole + antibiotic. Wash all utensils with soap and disinfect daily. I drank a week, or 10 days, I forgot about a ten-year gastritis. I read the treatment regimen on the Internet, since the gastroenterologist, an old aunt, does not read anything except serials, and I have never heard about the treatment of Helicobacter. It was in 2008.
#420003
robicheva
The doctor prescribed de-nol for me, but after completing the course of treatment with this medicine, she didn’t get rid of the problems, because as it turned out, Helicobacter can be cured only with a complex of drugs, including antibiotics.