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Rabemac

Category: Gastrointestinal

Description

Aciphex is used for treating heartburn or irritation of the esophagus caused by gastroesophageal reflux disease (GERD).

Active Ingredient: Rabeprazole

Aciphex (Rabemac) as known as: Barole, Dexrobel-dsr, Eraloc, Eurorapi, Finix, Gastrodine, Gasul, Happi, Intas, Novo-rabeprazole, Paricel, Prabex, Rabec, Rabee-isr, Rabeloc, Rabemac, Rabeprazol, Rabeprazolum, Rabibit, Rabibit-d, Rabibit-isr, Rabium, Ramprazole, Razo, Rebilex-dsr, Rebilex-isr, Rotec, Rozy-d, Rozy-dsr, Rozydex, Veloz

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Rabemac (Aciphex) Description

Rabemac is a perfect remedy in struggle against heartburn or irritation of the esophagus caused by gastroesophageal reflux disease (GERD).

Rabemac acts as by decreasing the amount of acid produced in the stomach. It is a proton pump inhibitor.

Rabemac is also known as Rabeprazole, Pariet, Rablet.

Generic name of Rabemac is Rabeprazole.

Brand name of Rabemac is Rabemac.

Rabemac (Aciphex) Dosage

Rabemac is available in:

  • 10mg Low Dosage
  • 20mg Standard Dosage

Take Rabemac orally with or without food.

Do not crush or chew it.

Do not stop taking it suddenly.

Rabemac (Aciphex) Missing of dose

Do not take double dose. If you miss a dose you should take it as soon as you remember about your missing. If it is the time for the next dose you should continue your regular dosing schedule.

Rabemac (Aciphex) Overdose

If you overdose Rabemac and you don't feel good you should visit your doctor or health care provider immediately.

Rabemac (Aciphex) Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Rabemac (Aciphex) Side effects

Rabemac has its side effects. The most common are:

Less common but more serious side effects during taking Rabemac:

  • allergy reactions (urticaria, breathing difficulties, rash, and eruption)
  • chest pain
  • fast or irregular heartbeat
  • fever, chills, or sore throat
  • red, swollen, blistered, or peeling skin
  • severe or persistent stomach pain
  • unusual bruising or bleeding
  • unusual tiredness
  • vision changes

Side effects manifestations are not only depend on medicine you are taking but also depend on your health state and on the other factors.

Rabemac (Aciphex) Contra-indications

Do not take Rabemac if you are allergic to Rabemac components.

Do not take Rabemac if you're pregnant or you plan to have a baby, or you are a nursing mother. Rabemac can harm your baby.

Rabemac may interfere with certain lab tests.

Rabemac should be used with extreme caution in Asian patients.

Rabemac should be used with extreme caution in children younger than 12 years old. Safety and effectiveness in these children have not been confirmed.

Do not stop taking Rabemac suddenly.

Rabemac (Aciphex) Frequently asked questions

Q: What is the important Rabemac information?

A: Rabemac is a perfect remedy in struggle against heartburn or irritation of the esophagus caused by gastroesophageal reflux disease (GERD). Rabemac may interfere with certain lab tests. Rabemac should be used with extreme caution in Asian patients. Rabemac should be used with extreme caution in children younger than 12 years old; safety and effectiveness in these children have not been confirmed. Do not take Rabemac in case of allergy to this medicine or to its ingredients. Rabemac cannot be taken if you're pregnant or you plan to have a baby, or you are a nursing mother. If you want to achieve most effective results it is better to avoid alcohol.

Q: What are Rabemac side effects?

A: Rabemac has its common side effects such as: diarrhea; headache. But in case of rejection of Rabemac ingredients you can experience more serious side effects: allergic symptoms (difficulties with breathing, throat closing, swelling, rash, hives), chest pain; fast or irregular heartbeat; fever, chills, or sore throat; red, swollen, blistered, or peeling skin; severe or persistent stomach pain; unusual bruising or bleeding; unusual tiredness; vision changes.

Q: What are generic and brand names of Rabemac?

A: Generic name of Rabemac is Rabeprazole. Brand name of Rabemac is Rabemac.

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5 Best Homeopathic Medicines for Chikungunya

Homeopathic Medicines for Chikungunya Fever

Homeopathic medicines for chikungunya

The name is peculiar: Chikungunya. It comes from an African tribe and means “that which bends up”. The disease was given its name because it led to the affected persons walking in a stooped posture. Chikungunya Fever is a viral disease caused by Chikungunya virus and is transmitted to humans by the infected Aedes mosquito. The symptoms of Chikungunya viral infection are high fever with severe joint pains. The joints also show swelling and stiffness. Other symptoms include rash on skin and petechiae (red or purple discoloration on skin due to bleeding from vessels under skin). There is also a loss of appetite, nausea, vomiting, conjunctivitis, headache and backache. The fever inChikungunya infection usually subsides within threeto four days, but the joint pains continue for weeks, months and even years in a few persons. The Homeopathic mode of treatment ensures complete relief from the symptoms of Chikungunya Fever. The Homeopathic medicines for chikungunya fever are made of natural substances and have zero side effects. The Homeopathic treatment for chikungunya fever is absolutely safe and can only benefit the patient, never harm.

Homeopathic Treatment for Chikungunya Fever

Chikungunya Fever can be treated very efficiently with natural Homeopathic medicines. The aim of the Homeopathic mode of treatmentis to provide complete symptomatic relief to the patients. The Homeopathic medicines for treating Chikungunya Fever are selected based upon the unique individual symptoms. These unique symptoms include presence or absence of thirst, the desire to cover or uncover oneself in fever, the worsening or relieving of symptoms in joint pains and any peculiar desire to eat or drink, restlessness or the need to lie down.

Top Homeopathic Medicines for Chikungunya Fever Rhus Tox: One Of The Best Homeopathic Medicines for Chikungunya Fever where joint pains get better by motion

Natural Homeopathic medicine Rhus Tox is an excellent remedy to control joint pains in fever. The joints show marked stiffness along with pain. When there is relief from joint pains on moving and the joint painsget worsewhile resting, Rhus Tox is the ideal Homeopathic remedy. The person feels extremely restlessand when lying in bed has to frequently change position because lying still worsens the condition. Chills during fever are also prominent. Backache during fever can also be relieved by Rhus Tox when the peculiar relief by motion is noted.

Bryonia: One of the best Homeopathic Medicines forChikungunyaFever where joint pains worsen with motion

Bryonia is a natural Homeopathic medicine that is of great help in treating excessive joint pains with Chikungunya Fever. The joints are painful, hot and swollen. The person who can benefit byHomeopathic medicine Bryonia usually gets relief from joint pains by resting. More particularly, the patient gets relief by lying on the side of joints that are painful. And even the slightest motion can worsen the joint pains. In addition to joint pains, there is an increased thirst for water with a dry mouth.

Eupatorium Perfoliatum: One of the best Homeopathic Medicines for Chikungunya Fever with severe pain in bones

Eupatorium Perfoliatum is a very beneficial natural Homeopathic remedy for high fever with severe bone pains. Eupatorium Perfoliatum is the ideal Homeopathic medicine when the person specifically feels as if the bones are broken. The person cannot lie in bed because of severe bony pains and is restless. The pain can lead to moaning and crying, and chill is also marked with pains. Relief in the bone pains usually follows perspiration. Vomiting specifically after chill is a significant symptom for using natural Homeopathic remedy Eupatorium Perfoliatum.

Merc Sol: Homeopathic medicine for worsening of pains at night inChikungunyaFever

Merc Sol is the best natural Homeopathic medicine when the bone pains get worse at night with Chikungunya Fever. Chill and heat have an alternating presence. The patient has profuse sweating, but it provides no relief. For using Merc Sol,the individual characteristic symptom to be noted is increased thirst and excessive salivation.

Gelsemium:One Of the Top Homeopathic medicines forChikungunyaFever with extreme drowsiness

Gelsemium is the ideal natural Homeopathic remedy when excessive drowsiness, sleepiness and desire to lie down arefelt by a patient afflicted with Chikungunya Fever. There is also a marked chilliness with shivering. Usually, the thirst for water is absent. Headache with heaviness of eyes is also best treated by Homeopathic medicine Gelsemium.

Arnica: Top Homeopathic remedy for petechieal haemorrhages in skin

Homeopathic remedy Arnica is the best herbal remedy for chikungunya, when petechiae are present under skin along with pains and other symptoms. The skin shows blue or blackish petechial spots. Along with this, the joints are very painful. Even a slight touch is unbearable on joints as it increases the pain. Apart from specific joint pains, there is a sore-bruised feeling in the entire body. The person also complains that the bed on which he or she lies seems too hard and he or she needs to constantly change the position. In addition to these symptoms, the hands and feet are markedly cold.

Homeopathic Medicines for Chikungunya feverwhich provides symptomatic relief

The natural Homeopathic medicines for symptomatic relief in Chikungunya Fever are prescribed after carefully noting down the unique individual symptoms.

Ipecac: Homeopathic medicine for relieving nausea and vomiting inChikungunyaFever

Ipecac is considered the best natural Homeopathic remedy for providing relief from nausea and vomiting. Ipecac can be taken by all those persons who have persistent nausea and vomiting during Chikungunya Fever. Homeopathic medicine Ipecac always shows its worth in providing relief from nausea and vomiting. The tongue is usually found to be almost clean in most cases.

Euphrasia: Natural Homeopathic medicine for conjunctivitis inChikungunyaFever

Euphrasia is the perfect Homeopathic medicine for treating conjunctivitis in a person with Chikungunya infection. The symptoms of redness, watering, itching in eyes get relieved by using Euphrasia.

Homeopathic Medicines for headache relief in Chikungunya Fever

The best natural Homeopathic medicines for relief from headache are Belladona, Gelsemium, Silicea and Spigelia. These Homeopathic medicines for chickungunya are always selected as per the symptoms unique to each individual. Belladona is the top Homeopathic medicine for headache in sides of head (temples). Relief by tight bandage is a sign for using Belladona. Gelsemium is the ideal natural Homeopathic remedy when the headache is settled in the back of head. Silicea and Spigelia are Homeopathic medicines of great help when the person suffers from right and left-side headache.

Phosphoric Acid: Homeopathic remedy for weakness during or after Chikungunya Fever

Phosphoric Acid is a natural Homeopathic remedy frequently used to treat excessive weakness during or after Chikungunya Fever. Excellent results are obtained with the use of Phosphoric Acid for treatment of debilitating weakness. The weakness in both mental and physical spheres can be corrected with the intake of Homeopathic medicine Phosphoric Acid.

Fill the Comment Form below -You can write about your problem To Dr. Sharma and receive a reply on How Homeopathy can help in treating your illness.

Write To Dr. Sharma Click here to cancel reply.

IFTEKHAR AHMED CHOUDHURY says:

Respected Dr. Sharma,
I suffered from chickengunia on 3.12.2015, thereafter I have been suffering from severe joints pain. I consulted allopatheic doctor. The doctor prescribed me Tab. Medrol but that not suited me. Now I am regularly taking pain killer but I am not getting relief. I would request you to suggest some homeopathy medicine to get rid from joint pain (both wrists, knees & ankle). Awaiting for your valuable reply.
With warm regards,

R Baskaran says:

I have a limited Dysphagia ie. a little difficulty in swallowing food. But I always feel a lump in my throat as if something is blocking my throat. I am getting acid reflux as well as food reflux since last many years. An upper endoscopy of my food pipe revealed granule like formations in my food pipe with the surface being rough. This granular surface is probably blocking smooth flow of food. An ENT specialist told me this granular surface was formed due to acid reflux. He prescribed medicine RABEMAC for 25 days which resulted in increase in Pulse rate and BP. I stopped it. Then I took homoeopathy medicine given by a Pune doctor for one month. Though there is some relief in Reflux, full relief is not there so far.

I want to know if there is any procedure for removing the granular formations in food pipe through surgery or any other method for free flow of food. If it can be removed through surgery, what may be approximate cost. Please also let me know if I will get permanent relief through homoeopathy medicine. Thanks for early reply.

Rabeprazole Itopride drug information

Rabeprazole + Itopride information from DrugsUpdate

Information Not Available

Rabeprazole is a PPI that suppresses gastric acid secretion by inhibiting the gastric H+/K+ ATPase at the secretory surface of the gastric parietal cell. Itopride increases acetylcholine (ACh) concentrations by inhibiting dopamine D2 receptors and acetylcholinesterase. Higher ACh increases GI peristalsis, increases the lower oesophageal sphincter pressure, stimulates gastric motility, accelerates gastric emptying, and improves gastro-duodenal coordination.

Rabeprazole + Itopride Adverse Reactions / Rabeprazole + Itopride Side Effects

Headache, diarrhoea, dizziness, rash.

Potentially Fatal: Anaphylaxis, agranulocytosis.

Itopride should be used with caution because it enhances the action of acetylcholine Rabeprazole should be used with caution in patients with severe hepatic impairment. Pregnancy.

Other Drug Interactions

Rabeprazole increase elimination T1/2 of digoxin, decreases effects with aminoglutethimide, carbamazepine, phenytoin and rifampin and reduces absorption of ketoconazole and itraconazole.
Anticholinergic agents reduces the action of itopride.

Food Interaction
Avoid alcohol (may irritate gastric mucosa). Rabeprazole has delayed absorption but unaltered Cmax and AUC with high-fat meals.

Oral
Gastro-oesophageal reflux disease
Adult: Per capsule contains rabeprazole 20 mg and itopride 150 mg: 1 capsule once daily.

List of Contraindications

Rabeprazole + Itopride and Pregnancy

Caution when used during pregnancy

Rabeprazole + Itopride brands in India Abepra-ISR Acera-IT Antuc-IT Anurub-DSR Asterab-IT Beerab-ISR Bizo-IT Brazo-IT Cool-Rab-IT Cyra-IT Domol-ISR Furab-IT Gasorab-TXR Itopie-RD Itoplus Itopraz Itorab Itorbe-SR Jeprab-ITO Kool-IT Mac-IT Novorab Plus Nura-IT Pepraz-I Peptard-IT Pepzera-IT Perab-IT Rabby-IT Rabcid-IT Rabcro-ISR Rabden-IT Rabee -ISR Rabelite-IT Rabemac-ITR Rabemas-IT Rabeq-IT Rabeto Plus Rabetome-ISR Rabez-IT Rabibit-ISR Rabicare-IT Rabicent Rabicure-IT Rabidac-ISR Rabidol-IT Rabifine Plus Rabilok-IT Rabimor-ISR Rabin-IT Rabinta-IT

Sutent (Sunitinib Malate) Drug Information: Description, User Reviews, Drug Side Effects, Interactions - Prescribing Information at RxList

Hepatotoxicity has been observed in clinical trials and post-marketing experience. This hepatotoxicity may be severe, and deaths have been reported. [See WARNINGS AND PRECAUTIONS ]

DRUG DESCRIPTION

SUTENT, an oral multi-kinase inhibitor, is the malate salt of sunitinib. Sunitinib malate is described chemically as Butanedioic acid, hydroxy-, (2S)-, compound with N-[2-(diethylamino)ethyl]-5-[(Z)-(5-fluoro1,2-dihydro-2-oxo-3H-indol-3-ylidine)methyl]-2,4-dimethyl-1H-pyrrole-3-carboxamide (1:1). The molecular formula is C22 H27 FN4 O2 • C4 H6 O5 and the molecular weight is 532.6 Daltons.

The chemical structure of sunitinib malate is:

Sunitinib malate is a yellow to orange powder with a pKa of 8.95. The solubility of sunitinib malate in aqueous media over the range pH 1.2 to pH 6.8 is in excess of 25 mg/mL. The log of the distribution coefficient (octanol/water) at pH 7 is 5.2.

SUTENT (sunitinib malate) capsules are supplied as printed hard shell capsules containing sunitinib malate equivalent to 12.5 mg, 25 mg, 37.5 mg or 50 mg of sunitinib together with mannitol, croscarmellose sodium, povidone (K-25) and magnesium stearate as inactive ingredients.

The orange gelatin capsule shells contain titanium dioxide, and red iron oxide. The caramel gelatin capsule shells contain titanium dioxide, red iron oxide, yellow iron oxide and black iron oxide. The yellow gelatin capsule shells contain titanium dioxide and yellow iron oxide. The white printing ink contains shellac, propylene glycol, sodium hydroxide, povidone and titanium dioxide. The black printing ink contains shellac, propylene glycol, potassium hydroxide and black iron oxide.

What are the possible side effects of sunitinib (Sutent)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using sunitinib and call your doctor at once if you have a serious side effect such as:

  • headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
  • feeling short of breath (even with mild exertion), swelling in your ankles or feet;
  • sudden numbness or weakness, problems with vision, speech, or balance;
  • numbness or tingly feeling around your mouth;
  • slow.
What are the precautions when taking sunitinib malate (Sutent)?

Before taking sunitinib, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, heart problems (e.g. congestive heart failure), high blood pressure, liver problems, thyroid disease, diabetes.

Sunitinib may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can infrequently result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

Last reviewed on RxList: 9/14/2015
This monograph has been modified to include the generic and brand name in many instances.

Rabeprazole Pharmacology - Usage Details

Rabeprazole Pharmacology Rabeprazole

About Rabeprazole Benzimidazole derivative, Proton Pump Inhibitor, Antiulcer. Mechanism of Action of Rabeprazole Rabeprazole sodium is a proton pump inhibitor. It is a prodrug. After administration it diffuses in to the parietal cell of the stomach and accumulates in the secretory canaliculi. In the acidic medium Rabeprazole is converted to sulfenamide. This sulfenamide covalently interacts with sulfhydryl (SH) group in the proton pump (H+ K+ATPase) and inhibits the exchange of extracellular K+ for intracellular H+ ion. Rabeprazole sodium irreversibly inhibits proton pumps activity and decreases gastric acid secretion. Rabeprazole produces fastest acid suppression and helps in mucin synthesis. Pharmacokinets of Rabeprazole Absorption: Rabeprazole sodium is well absorbed after oral administration and its bioavailability is about 50% since it undergoes first pass metabolism. Distribution: It is widely distributed in the body in protein bound form. Metabolism: Rabeprazole sodium is extensively metabolised in the liver. Excretion: It is excreted mainly in the urine and small amount in faeces. Onset of Action for Rabeprazole 1hour Duration of Action for Rabeprazole 1 day Half Life of Rabeprazole 1 - 2 hours Side Effects of Rabeprazole 1. Diarrhoea
2. Nausea
3. Headache
4. Vomiting
5. Abdominal pain
6. Dizziness
7. Flatulence
8. Constipation
9. Dyspepsia
10. Flu like syndrome
11. Insomnia
12. Back pain
13. Cough
14. Rhinitis
15. Pharyngitis
16. Rash

Contra-indications of Rabeprazole 1. Hypersensitivity to Rabeprazole sodium Special Precautions while taking Rabeprazole 1. Hepatic impairment
2. Monitor gastric malignancy

Pregnancy Related Information Contraindicated Old Age Related Information Use with caution Breast Feeding Related Information Contraindicated Children Related Information Contraindicated
NEONATES: Contraindicated Indications for Rabeprazole 1. Active Duodenal ulcer
2. Benign Gastric ulcer
3. Zollinger- Ellison syndrome
4. Erosive Gastroesophageal reflux disease
Interactions for Rabeprazole Ketoconazole. Coadministration of rabeprazole sodium results in a 33% decrease in ketoconazole levels.
Digoxin. Increase in trough digoxin levels in normal subjects.
Typical Dosage for Rabeprazole Oral
Adult: 10 - 20 mg / day drug to be taken before breakfast.
Duodenal ulcer: 20 mg / day in the morning for 1 month if needed dose can be continuing for 1more month.
Benign Gastric ulcer: 20 mg / day in the morning for 6 weeks if needed dose can be continuing for 6 more weeks.
Zollinger- Ellison syndrome: Initial dose: 60 mg / day if needed increase the dose up to 120 mg / day in 2 divided doses.
Erosive Gastroesophageal reflux disease: 20mg / day for 1-2 months.
Gastroesophageal reflux disease long term management: 10-20 mg once daily before breakfast for 1 year

Children: not recommended
Schedule of Rabeprazole H Storage Requirements for Rabeprazole Store at 15 - 30 degree C in a tightly closed container. Protect from light. Effects of Missed Dosage of Rabeprazole Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose. Effects of Overdose of Rabeprazole Give supportive measures and symptomatic treatment.

Home Delivery for Rabeprazole in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including rabeprazole.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for rabeprazole and other medicines and health products. Home delivery services for rabeprazole may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take rabeprazole only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for rabeprazole before they complete the sale. You can get this information while placing the order for rabeprazole with the pharmacy.

Rabeprazole is a generic medicine name and there are several brands available for it. Some of the brands for rabeprazole might be better known than rabeprazole itself. If the pharmacy that's willing to deliver medicines to your home doesn't have rabeprazole in stock, you can ask for one of the branded alternatives for rabeprazole .

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The Relationship of Serotonin and Parameters of Psychological Personality Profile in Patients with Gastroesophageal Reflux Disease ( Young Scientist U

Young Scientist USA The Relationship of Serotonin and Parameters of Psychological Personality Profile in Patients with Gastroesophageal Reflux Disease

by Grishechkina, I. A.

Grishechkina IA (2014). The Relationship of Serotonin and Parameters of Psychological Personality Profile in Patients with Gastroesophageal Reflux Disease. In Young Scientist USA (p. 165). Auburn, WA: Lulu Press.

Keywords:gastroesophageal reflux disease, psychology, serotonin.

Currently, GERD is primarily regarded as acid-related disease that develops in the setting of upper gastrointestinal tract dysfunction, whereupon lower esophageal sphincter impairment (LES) is considered to be the main reason [2].

General mechanisms of the LES involve central nervous system and a number of hormones, neurotransmitters, receptors, among which significant part is assigned to serotonin and its 5HT3 and 5HT4 receptors [3]. This is confirmed by immunohistochemical studies of neuroendocrine cells of LES mucous membrane. Psychological stressors affecting through the limbic-reticular complex and frontal cortex can also affect general mechanisms of the LES through the release of a whole range of neuropeptides, hormones and neurotransmitters, including serotonin [4].

Study objective: To investigate the relationship of serum serotonin levels with psychological factors and esophageal pH level in patients with GERD.

Study objective: We have conducted a cross unmasked study of patients of BHIOR RCH gastroenterological in-patient clinic. The study included 71 patients with GERD aged 17 to 62 (38 men and 33 women, 52,4 % and 45,8 % respectively), of which 42 patients had non-erosive reflux disease (NERD) and 29 had reflux esophagitis (RE) of varying severity. The average age of patients was 36 years (LQ = 21, UQ = 46,5) and duration of the disease was 3 years (LQ = 2, UQ = 9,5 years). The diagnosis was determined on the basis of history taking, clinical study, fibrogastroduodenoscopy (Olimpus, Japan) and step-by-step pH-metry of the esophagus and stomach (acidogastrometer EV-74, Russia).

The study included patients with NERD and RE who have completed all the questionnaires and signed a voluntary consent to participate in the study in accordance with the Declaration of Helsinki.

The study excluded patients with concomitant diseases of the gastrointestinal tract and other organs and systems, patients with psychiatric diagnoses and borderline disorders.

Psychological personality profile was studied through psychological tests and central blood serotonin level determination by the immunofluorescent assay. Psychological parameters were studied using Ch.D. Spielberg state and trait anxiety scale in the modification of Yu.L. Hanin (1980), A. Buss and A. Darkey method of diagnosing the indicators and forms of aggression as adapted by A. K. Osnitsky, clinical questionnaire for the identification and evaluation of neurotic states (K. K. Jachin, D. M. Mendelevich), the Toronto Alexithymia Scale proposed by G. Taylor (1985) and adapted in the V. M. Bekhterev Psychoneurological Institute (1994), the method of studying the level of subjective control (LSC) that is based on J. B. Rotter scale (1999), LOBI. The total duration of esophageal pH of less than 4.0 units was estimated.

Results and discussion:

Then we evaluated the relationship of psychological factors, serotonin level and the duration of esophageal pH reduction below 4.0 units among all GERD patients and separately in groups: in patients with RE and NERD.

Data obtained in the study of the relationships of the psychological profile and serum serotonin level in patients groups are presented in Tables 1 and 2. The incidence and severity of neurotic reactions and behaviors against the background of the disease did not differ among groups of patients with NERD and RE.

Table 1. Analysis of the relationships between emotional parameters and serotonin level

Based on these data, we can make an assumption about the relationship of serotonin and cognitive and emotional parameters and its protective effect on the course of GERD, more significant with NERD, and we can distinguish separate pathogenic variant of the disease, characterized by reduced serotonin level and emotional and cognitive anomalies of patients.

A number of works was performed by this method in relation to GERD. When comparing different clinical forms of the disease and functional heartburn in one of these works, the authors have found increased levels of anxiety, depression, specific stressful conditions of development in childhood, more significant in patients with NERD and functional heartburn, compared with a group of patients with RE. When comparing the state of patients before and after addition of citalopram 20 mg daily for 8 weeks to standard therapy, the authors of the study observed a reduction of symptoms such as a lump in the throat, heartburn, epigastric pain, depression, anxiety and alexithymia under the influence of treatment [7]. Another study noted deviant autonomic functions and depressed mood and reduced quality of life, which also declined after the addition of prosulpin to standard rabemac therapy [8].

But despite the evidence of the effect, mediated through ANS, of psychological factors on the course of GERD, the nature of this effect is still controversial. Since there is a number of studies which indicated that patients with high levels of anxiety and depression, neurotic disorders had resistance to treatment by pantoprazole, gaviscon and other acid inhibitors much more often [9]. Other studies did not confirm this effect, however, noted the prevalence of high levels of anxiety and depression among patients with GERD [10], the relationship between the intensity of psychological symptoms and poor quality of life [11] and increased perception of symptoms of reflux disease, which could affect the efficiency of conservative and surgical treatment [12].

Conclusion. Given the identified relationship of serotonin and cognitive and emotional parameters and esophageal pH level below 4.0 units in our study, we can distinguish separate pathogenic variant of the course of gastroesophageal reflux disease requiring correction.

8. Alaviya F. A. Correction of vegetovascular dystonia syndrome in patients with gastroesophageal reflux disease / Russian Journal of Gastroenterology, Hepatology and Coloproctology. Materials of the 15th Russian Gastroenterological Week. 2009, 5 (4): 4

11. Cardin F. Ambrosio F. Amodio P. [et al.] Quality of life and depression in a cohort of female patients with chronic disease / BMC Surg. 2012; 12 Suppl. 1:S10.

Triple Therapy For Helicobacter Pylori

TRIPLE THERAPY FOR HELICOBACTER PYLORI

Helicobacter pylori is a Gram-negative bacterium that can inhabit various areas of the stomach and duodenum. It causes a chronic inflammation of the stomach lining and may causes development of duodenal and gastric ulcers and stomach cancer.

H. pylori weakens the protective mucous coating of the stomach and duodenum and allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause an ulcer.

H. pylori is able to survive in stomach acid as it secretes enzymes that neutralize the acid. This mechanism allows H. pylori to make its way to the "safe" area the protective mucous lining. 1

Triple Therapy for Helicobacter Pylori: 2,3

Once H. pylori is detected in patients with a peptic ulcer, the normal procedure is to eradicate it and allow the ulcer to heal.

The standard therapy is a one week triple therapy consisting of a proton pump inhibitor such as Omeprazole and the antibiotics Clarithromycin and Amoxicillin. Variations of the triple therapy have been developed over the years, such as using a different proton pump inhibitor, as with Pantoprazole or Rabeprazole, or replacing amoxicillin with Tinidazole for people who are allergic to Penicillin. Such a therapy has revolutionized the treatment of peptic ulcers and has made a cure to the disease possible.

Pylori peptic ulcers are treated with drugs that kill the bacteria, reduce stomach acid, and protect the stomach lining. Antibiotics are used to kill the bacteria. Acid-suppressing drugs might be proton pump inhibitors.

Proton pump inhibitors suppress acid production by halting the mechanism that pumps the acid into the stomach. Proton pump inhibitors have been prescribed alone for years as treatments for ulcers. But used alone, these drugs do not eradicate H. pylori and therefore do not cure H. pylori-related ulcers.

Treatment usually involves a combination of antibiotics and acid suppressors. Antibiotic regimens recommended for patients may differ across regions of the world because different areas have begun to show resistance to particular antibiotics.

Two antibiotics are generally recommended; this reduces the risk of treatment failure and antibiotic resistance.

The use of only one medication to treat H. pylori is not recommended.

Advantages of the Therapy: 4

  • The antibiotics acts against bacteria and proton pump inhibitors reduces the acid in the stomach and helps to heal the ulcer. Hence, the combination is more effective than single antibiotic or single proton pump inhibitor.
  • Triple therapy with Rabiprazole. clarythromycin, and tinidazole or Lansoprazole is indeed highly effective for both cure of H. pylori infection and for healing of peptic ulcers.
  • It is easy to perform,
  • It is cheap, and,
  • It is without clinically significant side effects, even in a larger population.
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