{"id":32447,"date":"2024-08-08T13:14:10","date_gmt":"2024-08-08T11:14:10","guid":{"rendered":"https:\/\/www.mgc.es\/?p=32447"},"modified":"2024-07-12T13:16:59","modified_gmt":"2024-07-12T11:16:59","slug":"helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu","status":"publish","type":"post","link":"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/","title":{"rendered":"Helicobacter pylori: un enemic silenci\u00f3s del sistema digestiu"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_82_2 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\"><p class=\"ez-toc-title\" style=\"cursor:inherit\">\u00cdndex de continguts<\/p>\n<\/div><nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Que_son_les_ulceres\" >Qu\u00e8 s\u00f3n les \u00falceres<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Que_es_lHelicobacter_pylori\" >Qu\u00e8 \u00e9s l\u2019Helicobacter pylori&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Per_que_es_tenen_ulceres\" >Per qu\u00e8 es tenen \u00falceres<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Per_que_es_noten_les_ulceres\" >Per qu\u00e8 es noten les \u00falceres<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Principals_simptomes_duna_ulcera\" >Principals s\u00edmptomes d\u2019una \u00falcera<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Que_shi_pot_fer\" >Qu\u00e8 s\u2019hi pot fer<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Com_es_diagnostica\" >Com es diagnostica<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Gastroscopia_amb_biopsies_de_la_mucosa_gastrica\" >Gastrosc\u00f2pia amb bi\u00f2psies de la mucosa g\u00e0strica<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Prova_de_lale\" >Prova de l\u2019al\u00e8<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Mostra_de_sang\" >Mostra de sang<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Mostra_de_femta\" >Mostra de femta<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Qui_sha_de_protegir_i_qui_sha_de_tractar_la_infeccio_per_helicobacter\" >Qui s\u2019ha de protegir i qui s\u2019ha de tractar la infecci\u00f3 per helicob\u00e0cter<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Quins_medicaments_poden_produir_ulcera_i_complicacions_ulceroses\" >Quins medicaments poden produir \u00falcera i complicacions ulceroses?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Com_reduim_el_riscos_que_comporten_les_aspirines_i_els_AINE\" >Com redu\u00efm el riscos que comporten les aspirines i els AINE<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Com_podem_evitar_el_tractament_amb_aspirines_o_AINE\" >Com podem evitar el tractament amb aspirines o AINE<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/www.mgc.es\/ca\/blog\/helicobacter-pylori-un-enemic-silencios-del-sistema-digestiu\/#Un_bon_consell\" >Un bon consell<\/a><\/li><\/ul><\/nav><\/div>\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"880\" height=\"587\" src=\"https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/shutterstock_589010354-880x587.jpg\" alt=\"\" class=\"wp-image-32443\" srcset=\"https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/shutterstock_589010354-880x587.jpg 880w, https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/shutterstock_589010354-440x293.jpg 440w, https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/shutterstock_589010354-768x512.jpg 768w, https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/shutterstock_589010354.jpg 1000w\" sizes=\"auto, (max-width: 880px) 100vw, 880px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Que_son_les_ulceres\"><\/span><strong>Qu\u00e8 s\u00f3n les \u00falceres<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Una \u00falcera \u00e9s una lesi\u00f3 de la capa interna (mucosa) de l\u2019est\u00f3mac o del duod\u00e8 (part superior de l\u2019intest\u00ed prim). La pres\u00e8ncia d\u2019un bacteri anomenat <em>Helicobacter pylori<\/em> es relaciona de manera clara amb l\u2019aparici\u00f3 de les \u00falceres a l\u2019est\u00f3mac o al duod\u00e8, fins al punt que actualment es pensa que el 90-95 % de les \u00falceres del duod\u00e8 i el 70 % de les \u00falceres g\u00e0striques s\u00f3n causades per l\u2019helicob\u00e0cter.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Que_es_lHelicobacter_pylori\"><\/span><strong>Qu\u00e8 \u00e9s l\u2019<em>Helicobacter pylori&nbsp;<\/em><\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>L\u2019<em>Helicobacter pylori<\/em> \u00e9s un bacteri molt petit que viu sota el revestiment muc\u00f3s de l\u2019est\u00f3mac. Els grups afectats m\u00e9s sovint pel bacteri s\u00f3n:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>La gent gran.<\/li>\n\n\n\n<li>Els habitants de pa\u00efsos en desenvolupament.<\/li>\n<\/ul>\n\n\n\n<p>Els qui en l\u2019actualitat tenen el bacteri a l\u2019est\u00f3mac se\u2019n van infectar, ben probablement, durant la infantesa. El risc d\u2019agafar la infecci\u00f3 quan som adults \u00e9s m\u00e9s aviat baixa, amb menys de l\u20191 % de casos l\u2019any. En general, el bacteri per si mateix no produeix cap s\u00edmptoma ulcer\u00f3s. Tanmateix, tal com hem explicat, \u00e9s la causa m\u00e9s freq\u00fcent d\u2019\u00falcera d\u2019est\u00f3mac i de duod\u00e8. El bacteri tamb\u00e9 pot tenir algun paper en el desenvolupament del c\u00e0ncer d\u2019est\u00f3mac.<\/p>\n\n\n\n<p>La infecci\u00f3 per <em>Helicobacter pylori<\/em> es pot tractar amb antibi\u00f2tics. Amb aix\u00f2 s\u2019elimina la infecci\u00f3 i es guareix l\u2019\u00falcera en un 80 % dels casos aproximadament. Si el bacteri no s\u2019elimina, l\u2019\u00falcera reapareix en la majoria de pacients al cap d\u2019un curt per\u00edode de temps.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Per_que_es_tenen_ulceres\"><\/span><strong>Per qu\u00e8 es tenen \u00falceres<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Havent dir que la causa m\u00e9s freq\u00fcent de les \u00falceres \u00e9s la infecci\u00f3 pel bacteri <em>Helicobacter pylori<\/em>, la segona causa en ordre de prevalen\u00e7a s\u00f3n les aspirines o els medicaments antiinflamatoris no esteroidals (els AINE: diclofenac o naprox\u00e8n), que es fan servir en casos d\u2019artritis, reumatisme, mal d\u2019esquena, migranya i dolor menstruals. Per aquesta ra\u00f3, recalcarem que nom\u00e9s s\u2019han de prendre sota control i amb prescripci\u00f3 del metge.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Per_que_es_noten_les_ulceres\"><\/span><strong>Per qu\u00e8 es noten les \u00falceres<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Com es percep una \u00falcera varia for\u00e7a d\u2019una persona a l\u2019altra. N\u2019hi ha que no s\u2019arriben a adonar mai que en tenen. D\u2019altres, en canvi, senten dolor o cremor a la part superior de l\u2019abdomen. Els s\u00edmptomes es descriuen sovint com disp\u00e8psia (indigesti\u00f3), coragre o fam dolorosa. Certs pacients noten que, quan mengen, se\u2019ls calmen moment\u00e0niament les mol\u00e8sties, mentre que d\u2019altres experimenten un empitjorament dels s\u00edmptomes. Els c\u00edtrics, els picants i els aliments fumats en poden intensificar el dolor.<\/p>\n\n\n\n<p>Finalment, cal dir que la majoria de la gent amb mal d\u2019est\u00f3mac no t\u00e9 cap \u00falcera.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Principals_simptomes_duna_ulcera\"><\/span><strong>Principals s\u00edmptomes d\u2019una \u00falcera<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Una \u00falcera pot ser potencialment perillosa i cal actuar amb cautela i sota supervisi\u00f3 m\u00e8dica. Els signes d\u2019alarma s\u00f3n:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Dificultat per empassar-se aliments o regurgitaci\u00f3.<\/li>\n\n\n\n<li>Basques persistents; v\u00f2mits.<\/li>\n\n\n\n<li>V\u00f2mits de sang fresca o v\u00f2mits amb un contingut similar al solatge del caf\u00e8.<\/li>\n\n\n\n<li>Femta negra (anomenada melena; en realitat \u00e9s una deposici\u00f3 de sang digerida), que s\u2019assembla al quitr\u00e0 o al greix del cotxe.<\/li>\n\n\n\n<li>P\u00e8rdua de pes imprevista i no justificada.<\/li>\n\n\n\n<li>An\u00e8mia (cansament i pal\u00b7lidesa).<\/li>\n\n\n\n<li>Dolors abdominals sobtats, intensos i invalidants.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Que_shi_pot_fer\"><\/span><strong>Qu\u00e8 s\u2019hi pot fer<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Fumar i beure alcohol fan augmentar el risc de desenvolupar una \u00falcera. Tal com hem repetit en aquest blog (i hi tornarem), \u00e9s molt recomanable, o una bona decisi\u00f3, deixar de fumar de manera definitiva i ingerir alcohol amb moderaci\u00f3.<\/li>\n\n\n\n<li>Si, per qualsevol ra\u00f3, es t\u00e9 m\u00e9s risc de patir una \u00falcera, \u00e9s important, abans de prendre aspirines o AINE, de cercar informaci\u00f3 i consell.<\/li>\n\n\n\n<li>En cas que observem s\u00edmptomes d\u2019\u00falcera, ho haur\u00edem de consultar al metge. Potser cal fer-ne un estudi complet, incloent-hi una gastrosc\u00f2pia. Es tracta d\u2019un procediment segur que es practica de manera habitual i ajuda el metge a saber si els s\u00edmptomes s\u00f3n per causa d\u2019una \u00falcera o b\u00e9 d\u2019alguna cosa m\u00e9s.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Com_es_diagnostica\"><\/span><strong>Com es diagnostica<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>El diagn\u00f2stic nom\u00e9s es pot confirmar o excloure de forma definitiva i segura amb una gastrosc\u00f2pia, que permet de veure els revestiments interns de l\u2019es\u00f2fag, l\u2019est\u00f3mac i el duod\u00e8 amb una petita c\u00e0mera de fibra \u00f2ptica o de v\u00eddeo que s\u2019introdueix per la boca sense dificultat. El proc\u00e9s es pot fer amb sedaci\u00f3.<\/p>\n\n\n\n<p>La gastrosc\u00f2pia afavoreix el diagn\u00f2stic si es practica abans de prendre cap medicament que en redueixi l\u2019\u00e0cid.<\/p>\n\n\n\n<p>Tamb\u00e9 es pot fer una <a href=\"file:\/\/\/C:\/Users\/eduar\/OneDrive\/Documentos\/COPIA%20DE%20NETDOCTOR\/www.netdoctor.es\/www.netdoctor.es\/articulo\/rayos-x.html\">radiografia<\/a> (amb suspensi\u00f3 de bari, \u00e9s a dir amb contrast), per\u00f2 no \u00e9s tan fiable ni tan concloent per al diagn\u00f2stic com la gastrosc\u00f2pia. Al marge d\u2019aquest fet, no permet d\u2019extreure mostres de teixit (bi\u00f2psies) per diagnosticar amb el microscopi la infecci\u00f3 i les alteracions de la mucosa g\u00e0strica.<\/p>\n\n\n\n<p>Altres opcions de detectar la infecci\u00f3 per helicob\u00e0cter s\u00f3n:<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Gastroscopia_amb_biopsies_de_la_mucosa_gastrica\"><\/span><strong>Gastrosc\u00f2pia amb bi\u00f2psies de la mucosa g\u00e0strica<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Es practica amb el microscopi i permet de sospesar si el bacteri hi \u00e9s present i hi ha inflamaci\u00f3 i alteracions del teixit. Es pot fer un <a href=\"file:\/\/\/C:\/Users\/eduar\/OneDrive\/Documentos\/COPIA%20DE%20NETDOCTOR\/www.netdoctor.es\/www.netdoctor.es\/articulo\/microscopio-y-cultivo.html\">cultiu<\/a> de la mucosa g\u00e0strica obtinguda amb les <a href=\"file:\/\/\/C:\/Users\/eduar\/OneDrive\/Documentos\/COPIA%20DE%20NETDOCTOR\/www.netdoctor.es\/www.netdoctor.es\/articulo\/biopsia.html\">bi\u00f2psies<\/a> (prova de la ureasa) i confirmar la pres\u00e8ncia del bacteri mitjan\u00e7ant un reactiu.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Prova_de_lale\"><\/span><strong>Prova de l\u2019al\u00e8<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>L\u2019aire expirat es pot analitzar despr\u00e9s d\u2019inhalar una petita quantitat d\u2019urea marcada radioactivament (en forma cristal\u00b7lina). Segons quanta urea s\u2019hi detecti, es pot estimar si el bacteri \u00e9s present a l\u2019est\u00f3mac o no.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Mostra_de_sang\"><\/span><strong>Mostra de sang<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Es pot saber si s\u2019ha tingut infecci\u00f3 per helicob\u00e0cter per la pres\u00e8ncia d\u2019anticossos espec\u00edfics a la sang (prote\u00efnes fabricades per l\u2019organisme contra el bacteri).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Mostra_de_femta\"><\/span><strong>Mostra de femta<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>\u00c9s una t\u00e8cnica relativament nova que esbrina si hi ha DNA (c\u00e0rrega gen\u00e8tica) del bacteri en una mostra de femta.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"400\" src=\"https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/estomago2.jpg\" alt=\"\" class=\"wp-image-32445\" srcset=\"https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/estomago2.jpg 800w, https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/estomago2-440x220.jpg 440w, https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/estomago2-768x384.jpg 768w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Qui_sha_de_protegir_i_qui_sha_de_tractar_la_infeccio_per_helicobacter\"><\/span><strong>Qui s\u2019ha de protegir i qui s\u2019ha de tractar la infecci\u00f3 per helicob\u00e0cter<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Aquestes q\u00fcestions encara es continuen debatent, per\u00f2 sembla clar que:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Les persones de m\u00e9s de 45 anys, amb s\u00edmptomes ulcerosos, poden optar per la prova de l\u2019al\u00e8 i estalviar-se la gastrosc\u00f2pia. Si la prova surt positiva, cal tractar el pacient amb antibi\u00f2tics per erradicar-li el bacteri.<\/li>\n\n\n\n<li>Tots els pacients amb \u00falceres d\u2019est\u00f3mac o de duod\u00e8 comprovades s\u2019han de fer examinar i han de seguir un tractament que erradiqui el bacteri quan s\u2019identifiqui.<\/li>\n\n\n\n<li>Els pacients diagnosticats de limfoma g\u00e0stric (un proc\u00e9s no gaire freq\u00fcent) han de passar un estudi i, si se\u2019ls troba el bacteri, han de rebre tractament per al limfoma i un tractament complementari d\u2019erradicaci\u00f3.<\/li>\n\n\n\n<li>Els malalts diagnosticats de c\u00e0ncer d\u2019est\u00f3mac en fase primerenca s\u2019han de fer examinar i han de seguir un tractament amb antibi\u00f2tics suplementari al tractament oncol\u00f2gic del tumor.<\/li>\n\n\n\n<li>Gaireb\u00e9 tots els pacients amb un historial previ d\u2019\u00falcera duodenal demostrada tenen l\u2019<em>Helicobacter pylori<\/em>; en conseq\u00fc\u00e8ncia, s\u2019ha proposat que es tracti aquest grup directament sense fer-ne cap estudi.<\/li>\n\n\n\n<li>En el cas dels pacients amb s\u00edmptomes ulcerosos, si el resultat de la gastrosc\u00f2pia \u00e9s normal, segurament no es beneficiaran del tractament d\u2019erradicaci\u00f3.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Quins_medicaments_poden_produir_ulcera_i_complicacions_ulceroses\"><\/span><strong>Quins medicaments poden produir \u00falcera i complicacions ulceroses?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Les aspirines i els medicaments antiinflamatoris no esteroidals (\u00e9s a dir els AINE com el diclofenac i el naprox\u00e8n) poden produir \u00falceres, per\u00f2 \u00fanicament un petit percentatge dels qui en prenen desenvolupen \u00falceres. Malgrat tot, hi ha centenars de persones a Espanya que es moren cada any com a conseq\u00fc\u00e8ncia de complicacions ulceroses associades amb l\u2019\u00fas d\u2019aquests medicaments.<\/p>\n\n\n\n<p>Els pacients amb sensibilitat a les aspirines i als AINE no haurien de prendre aquesta medicaci\u00f3 i cal que el metge recomani qu\u00e8 \u00e9s m\u00e9s adequat en cada cas. Els pacients amb m\u00e9s risc s\u00f3n:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Les persones de m\u00e9s de 60 anys. El risc augmenta amb l\u2019edat.<\/li>\n\n\n\n<li>El risc \u00e9s elevat quan hi ha antecedents d\u2019\u00falcera.<\/li>\n\n\n\n<li>El perill augmenta de manera palesa amb dosis altes d\u2019aspirina o d\u2019AINE.<\/li>\n\n\n\n<li>Si es prenen anticoagulants (f\u00e0rmacs o subst\u00e0ncies per disminuir la capacitat de coagulaci\u00f3 de la sang) \u00e9s m\u00e9s probable de tenir hemorr\u00e0gies, i que siguin m\u00e9s greus.<\/li>\n\n\n\n<li>Els corticoesteroides orals (com ara la prednisolona) fan augmentar el risc de patir gastritis i \u00falceres.<\/li>\n\n\n\n<li>Tamb\u00e9 \u00e9s m\u00e9s alt en tractaments de llarga durada.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Com_reduim_el_riscos_que_comporten_les_aspirines_i_els_AINE\"><\/span><strong>Com redu\u00efm el riscos que comporten les aspirines i els AINE<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Si s\u2019hi t\u00e9 predisposici\u00f3, el risc disminueix quan aquests medicaments es prenen:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Amb l\u2019est\u00f3mac ple.<\/li>\n\n\n\n<li>Dissolts, en p\u00edndoles masticables o en forma recoberta (recobriment ent\u00e8ric).<\/li>\n\n\n\n<li>Per altres vies, com ara els supositoris o les solucions injectables.<\/li>\n<\/ul>\n\n\n\n<p>Els medicaments que redueixen l\u2019\u00e0cid g\u00e0stric (inhibidors dels receptors H<sub>2<\/sub>, com ara la ranitidina, i sobretot la famotidina o la nizatidina, o els inhibidors de la bomba de protons, com l\u2019omeprazole) disminueixen el risc d\u2019\u00falcera associada amb les aspirines i els AINE.<\/p>\n\n\n\n<p>Un altre medicament que tamb\u00e9 \u00e9s potencialment benefici\u00f3s perqu\u00e8 protegeix la mucosa g\u00e0strica \u00e9s el misoprostol. Pot ocasionar diarrea, tot i que aquesta tend\u00e8ncia varia d\u2019una persona a l\u2019altra.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Com_podem_evitar_el_tractament_amb_aspirines_o_AINE\"><\/span><strong>Com podem evitar el tractament amb aspirines o AINE<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>En certs casos, les aspirines es poden substituir per altres medicaments que no predisposin a les \u00falceres p\u00e8ptiques i ofereixin el mateix efecte terap\u00e8utic, com ara el paracetamol. Tant si fa la funci\u00f3 d\u2019antipir\u00e8tic com d\u2019analg\u00e8sic, el paracetamol \u00e9s igual d\u2019efica\u00e7 i no causa \u00falceres. Quan es prescriu l\u2019aspirina amb dosis baixes (de 75 a 300 mg) per reduir el risc cardiovascular (complicacions que es deriven de l\u2019enduriment de les art\u00e8ries o de l\u2019arterioesclerosi), cal considerar el risc de contreure malalties card\u00edaques o arterials i \u00falceres gastroduodenals.<\/p>\n\n\n\n<p>El risc relatiu de cadascuna d\u2019aquestes condicions i la manera d\u2019abordar-les varia d\u2019una persona a l\u2019altra i, per tant, \u00e9s important de comentar-ho tot amb el metge.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Un_bon_consell\"><\/span><strong>Un bon consell<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Cal anar al metge tan bon punt es t\u00e9 la m\u00ednima sospita d\u2019\u00falcera. \u00c9s una malaltia for\u00e7a f\u00e0cil de diagnosticar (amb una gastrosc\u00f2pia o la detecci\u00f3 del bacteri) i, normalment, es guareix sense problemes.<\/p>\n\n\n\n<p>Quan en l\u2019historial cl\u00ednic hi consta disp\u00e8psia o problemes d\u2019est\u00f3mac, el pacient nom\u00e9s pot prendre aspirines i AINE si el metge ho recomana. En cas d\u2019antecedents d\u2019hemorr\u00e0gia per \u00falcera p\u00e8ptica, cal evitar completament les aspirines i els AINE.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Qu\u00e8 s\u00f3n les \u00falceres Una \u00falcera \u00e9s una lesi\u00f3 de la capa interna (mucosa) de l\u2019est\u00f3mac o del duod\u00e8 (part superior de l\u2019intest\u00ed prim). La pres\u00e8ncia d\u2019un bacteri anomenat Helicobacter pylori es relaciona de manera clara amb l\u2019aparici\u00f3 de les \u00falceres a l\u2019est\u00f3mac o al duod\u00e8, fins al punt que actualment es pensa que el [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":32443,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[],"class_list":["post-32447","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-salut"],"featured_image_src":"https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/shutterstock_589010354.jpg","author_info":{"display_name":"Revista Inter\u00e8s Mutu","author_link":"https:\/\/www.mgc.es\/ca\/blog\/author\/interesmutu\/"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Helicobacter pylori: un enemic silenci\u00f3s del sistema digestiu - MGC M\u00fatua<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.mgc.es\/blog\/helicobacter-pilori-un-enemigo-silencioso-del-sistema-digestivo\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Helicobacter pylori: un enemic silenci\u00f3s del sistema digestiu - MGC M\u00fatua\" \/>\n<meta property=\"og:description\" content=\"Qu\u00e8 s\u00f3n les \u00falceres Una \u00falcera \u00e9s una lesi\u00f3 de la capa interna (mucosa) de l\u2019est\u00f3mac o del duod\u00e8 (part superior de l\u2019intest\u00ed prim). La pres\u00e8ncia d\u2019un bacteri anomenat Helicobacter pylori es relaciona de manera clara amb l\u2019aparici\u00f3 de les \u00falceres a l\u2019est\u00f3mac o al duod\u00e8, fins al punt que actualment es pensa que el [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.mgc.es\/blog\/helicobacter-pilori-un-enemigo-silencioso-del-sistema-digestivo\/\" \/>\n<meta property=\"og:site_name\" content=\"MGC M\u00fatua\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/mgcmutua\" \/>\n<meta property=\"article:published_time\" content=\"2024-08-08T11:14:10+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.mgc.es\/wp-content\/uploads\/2024\/07\/shutterstock_589010354.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1000\" \/>\n\t<meta property=\"og:image:height\" content=\"667\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Revista Inter\u00e8s Mutu\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@mgcmutua\" \/>\n<meta name=\"twitter:site\" content=\"@mgcmutua\" \/>\n<meta name=\"twitter:label1\" content=\"Escrit per\" \/>\n\t<meta name=\"twitter:data1\" content=\"Revista Inter\u00e8s Mutu\" \/>\n\t<meta name=\"twitter:label2\" content=\"Temps estimat de lectura\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minuts\" \/>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Helicobacter pylori: un enemic silenci\u00f3s del sistema digestiu - MGC M\u00fatua","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.mgc.es\/blog\/helicobacter-pilori-un-enemigo-silencioso-del-sistema-digestivo\/","og_locale":"ca_ES","og_type":"article","og_title":"Helicobacter pylori: un enemic silenci\u00f3s del sistema digestiu - MGC M\u00fatua","og_description":"Qu\u00e8 s\u00f3n les \u00falceres Una \u00falcera \u00e9s una lesi\u00f3 de la capa interna (mucosa) de l\u2019est\u00f3mac o del duod\u00e8 (part superior de l\u2019intest\u00ed prim). 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