A Comparative study of L-Glutamine and Azulene Combination as an Add On Therapy to Standard Treatment in H.Pylori infected Gastritis and Peptic Ulcer Disease

BACKGROUND: Helicobacter pylori remains the major cause for chronic gastritis and peptic ulcer disease in developing countries. Triple regimen (two antibiotics and a proton pump inhibitor) is commonly used for its eradication. However, it does not provide acceptable eradication rate. The present study was done to know the efficacy of glutamine and azulene combination in H.Pylori treatment. AIM OF THE STUDY: To evaluate the efficacy of L-Glutamine and Azulene combination in the eradication of H.Pylori infected gastritis and Peptic ulcer disease compared to standard treatment. METHODOLOGY: Patients attending MGE department with gastritis or peptic ulcer disease caused by H.Pylori were selected and randomized into two groups (30 each). Control and test groups received standard triple regimen (C.Amoxicillin 1gm BD, T.Metronidazole 600mg BD and C.Omeprazole 20mg BD) for 2 weeks followed by omeprazole for two weeks. Glutamine 0.67g and azulene 2.01g combination was added to test group for 4 weeks along with the standard treatment. H. pylori eradication was assessed four weeks after therapy using endoscopy and rapid urease test. 2-weeks follow-up done. RESULTS: The symptoms decreased by 80% in test group and 46.7% in control group (p=0.024). Eradication rate by RUT in test group is 83.3% and 56.6% in control group (p=0.024). Endoscopic grading showed significant improvement from grade 3 to grade 1 in the test group compared to control group (p=0.003). CONCLUSION: Combination of L-glutamine and azulene along with triple regimen showed higher eradication rate of H. pylori compared to the standard triple regimen