University of Parma, Italy
Marco Manfredi pediatrician and gastroenterologist, carried out his education at Parma University where completed his PhD in Pediatric Gastroenterology in 2004. Currently he is Assistant Manager in General Pediatrics and in Gastroenterology at Pietro Barilla Childrens Hospital, University of Parma, Italy. He has published more than 50 papers, included chapters of textbooks and is a scientific reviewer for several reputed medical journals. He was also Editor of an international book on Helicobacter pylori infection.
From the moment Helicobacter pylori was discovered, gastroenterologists realized that it is not a common bacterial infection and they are looking for therapy to defeat it. At the beginning a triple therapy with anti-H2 antagonists and antibiotics was used. Later the usefulness of PPIs was recognized not only to better reduce gastric acidity than ranitidine, but also because they directly damage H. pylori. Over the years, the triple therapy has been used with different combinations of antibiotics but actually this treatment regimen no longer has acceptable eradication rates. For these reasons, gastroenterologists have tried to vary the combination of antibiotics then the duration of therapy, but it must also be remembered that the longer the therapy is continued, the greater the side effects. In the last years, the addition of natural substances known for their infection-fighting properties as well as for their general benefits to human health has begun to be evaluated, especially in an attempt to reduce the side effects associated with multiple antibiotic therapies. The most adjuvants used are probiotics, but also olive oil and chewing-gum have been studied. Currently, where available, the tailored therapy based on antibiotic susceptibility seems the best therapy to eradicate H. pylori infection and by adding probiotics, we may help the patient to withstand therapy which easily results in unpleasant ailments.