Effective Treatment Strategies for Gastrointestinal Diseases: From H. pylori to IBS

Introduction: The Diversity of GI Problems

Gastrointestinal (GI) diseases, such as chronic gastritis, peptic ulcer disease, irritable bowel syndrome (IBS), and Helicobacter pylori (H. pylori) infection, are widespread and significantly reduce patients' quality of life. Modern approaches to their treatment face a number of challenges, including growing antibiotic resistance, drug side effects, and the limited efficacy of certain standard therapies [3, 5, 7]. This stimulates the search for new, more effective, and safer methods, as well as the integration of traditional and modern approaches.

Combating Helicobacter pylori and Chronic Gastritis

H. pylori infection is one of the main causes of chronic gastritis, dyspeptic symptoms, and precancerous gastric conditions [3, 5]. Standard eradication therapy, including antibiotics, often faces the problem of decreased efficacy due to bacterial resistance [5]. In this context, additional treatment methods are actively being researched:

• Probiotics: A study showed that supplementation with high-dose Lacticaseibacillus paracasei HP7 (HP7) (5.0 × 10^9 CFU/day) significantly reduces H. pylori activity (according to the ¹³C-urea breath test) and improves upper GI symptoms in adults with confirmed infection. It also contributed to an improved quality of life [5].
• Traditional Chinese Medicine (TCM): Qingyoufang decoction (QYFD) has proven effective as an adjunctive therapy in H. pylori-positive chronic atrophic gastritis (CAG), especially in patients with spleen-stomach damp-heat syndrome. The addition of QYFD to standard bismuth quadruple therapy improved symptoms and reduced levels of inflammatory markers such as interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α) [3].
• Acupuncture: As one of the key TCM techniques, acupuncture is actively studied in the treatment of chronic gastritis. Mechanisms of its action include improving gastric mucosal function, normalizing metabolism, modulating the gut microbiota, regulating gastrointestinal hormones, and reducing apoptosis, inflammation, and oxidative stress [7].
• Association with Reflux: H. pylori infection may also be associated with laryngopharyngeal reflux (LPR). LPR patients infected with H. pylori more frequently exhibited symptoms such as dysphagia (difficulty swallowing) and vocal cord edema compared to HP-negative patients [6].

Treatment of Peptic Ulcer Disease: Enhancing Efficacy

Peptic ulcer disease (PUD) often requires a comprehensive approach. Standard triple therapy, including omeprazole, clarithromycin, and amoxicillin, is the basis of treatment [1]. However, studies show that its efficacy can be improved by adding traditional herbal preparations.

A retrospective study showed that adding the Anwei Qingyou recipe (TCM) to standard triple therapy significantly increases the overall clinical efficacy of ulcer treatment to 97.57% compared to 82.50% using standard therapy alone. In addition, the combined approach led to improved ulcer healing quality, increased levels of epidermal growth factor (EGF) and prostaglandin E2 (PGE2), and a reduced recurrence rate at 6 months [1].

Irritable Bowel Syndrome with Diarrhea (IBS-D): New Perspectives

Irritable bowel syndrome with diarrhea (IBS-D) is a chronic condition for which effective treatment methods remain limited [2].

A study of Japanese Kampo medicine (traditional medicine) showed that Hangeshashinto (HST) may be beneficial for patients with IBS-D. Administration of HST for 2–3 weeks led to an improvement in general symptoms, as well as a decrease in stool frequency, improved stool consistency, and reduced abdominal pain. Furthermore, a positive change in the gut microbiota composition was noted after HST treatment [2].

Impact of Acid-Suppressive Therapy and General Approaches

Proton pump inhibitors (PPIs) are widely used to reduce gastric acidity in various GI conditions. However, their long-term use can affect the composition of the gut microbiota [8]. A retrospective study showed that PPI use may be associated with an increased risk of treatment escalation and Clostridioides difficile infection in patients with inflammatory bowel disease (IBD) compared to H2-receptor antagonists. This highlights the importance of a personalized approach to selecting acid-suppressive therapy and monitoring its long-term effects on the microbiota [8].

Overall, modern studies emphasize the value of an integrative approach to the treatment of GI diseases, which combines the achievements of conventional medicine with proven methods of traditional and complementary therapy, such as herbal medicine and probiotics. This approach not only increases treatment efficacy but also improves therapy tolerability, reduces side effects, and enhances patients' quality of life.

Sources

1. [1] Clinical effect of Anwei Qingyou prescription on peptic ulcer and its influence on EGF and PGE2 levels: A retrospective study. PubMed
2. [2] Effect of Hangeshashinto on symptoms and gut microbiota in diarrhea-predominant irritable bowel syndrome: A retrospective analysis. PubMed
3. [3] Efficacy and safety of adjuvant Chinese herbal decoction in the treatment of Helicobacter pylori-positive chronic atrophic gastritis: A real-world retrospective study. PubMed
4. [4] Quality of life outcomes in patients with pulmonary hypertension receiving prostacyclin therapy: Impact of anxiety, depression, sociodemographic characteristics, and treatment-related factors. PubMed
5. [5] Lacticaseibacillus paracasei HP7 attenuates Helicobacter pylori activity and improves upper gastrointestinal symptoms: A double-blind, randomized, placebo-controlled clinical trial. PubMed
6. [6] A preliminary study of symptoms and signs in laryngopharyngeal reflux patients infected with Helicobacter pylori. PubMed
7. [7] Research progress on the efficacy and mechanism of acupuncture in the treatment of chronic gastritis. PubMed
8. [8] Selection of acid-suppressive therapy and the risk of treatment escalation in inflammatory bowel disease: A comparative real-world retrospective study to inform personalized management. PubMed

Disclaimer: The information provided in the article is for reference purposes only and does not replace professional medical advice. Self-medication can be dangerous.