A 1-H TOPICAL THERAPY FOR THE TREATMENT OF HELICOBACTER-PYLORI INFECTION

Objective: A novel topical therapeutic methodology for the treatment o f Helicobacter pylori infection was developed and studied in 25 patien ts with H. pylori to evaluate safety and efficacy. Methods: The patien ts had been given lansoprazole (30 mg, hs) orally and pronase (18,000 tyrosine units, b.i.d.) for the 2 days before topical therapy. One hun dred milliliters of solution with 80 mi of 7% sodium bicarbonate and 2 0 mi of contrast medium meglumine sodium amidotrizoate containing bism uth subnitrate (1 g), amoxicillin (2 g), metronidazole (1 g), and pron ase (36,000 tyrosine units) were instilled into the stomach through a nasally introduced 16-Fr intestinal tube with a balloon at its radiopa que tip, which was inflated with approximately 25 mi of air and lodged postbulbarly at the superior duodenal angle under fluoroscopy, thus p reventing leakage of the solution distally into the jejunum. The solut ion was kept in the stomach for 1 h, and the patient's position was ch anged every 15 min from the sitting to the supine, prone, and right la teral position to expose the entire gastric mucosa. The solution was s uctioned at the end of the procedure. Results: H. pylori infection was successfully cured in 24 (96%) patients, confirmed 4 wk after the the rapeutic procedure by negative smear, culture, and histology of the an tral and corpus biopsy specimens. No side effects were observed except for loose stools in one case. Conclusion: This l-h topical therapy is a safe, effective, and well tolerated procedure for the treatment of H. pylori infection. With further improvements and modifications of th e method itself, as well as of the drug regimens, this method may beco me a highly efficient modality for anti-H. pylori therapy.