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Advice please for the post-antibiotics phase of treatment

The various unpleasant manifestations of Helicobacter can be described here. Remember however that the great majority of persons with Hp have no symptoms that they are aware of and consider themselves normal.

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pisha
Posts: 4
Joined: Thu May 22, 2014 5:28 pm

Advice please for the post-antibiotics phase of treatment

Post by pisha »

By way of a preamble, I will give some context to trying to get rid of h pylori:

I have had stomach pains since January 2014 for which I had been to the doctor in January. Unfortunately, I moved house last year and I wasn't familiar with the practice and I didn't receive good treatment. I was told to come back if it remained bad, which it did, and eventually prescribed omeprazole for 4 weeks and to come back if the problems remained. As I wasn't convinced by this advice, I went to see a nutritionist who asked me about family history and used a 'food allergy' machine to detect intolerances. After this she advised on eliminating gluten, yeast, dairy and prawns as well as taking a probiotic (Saccharomyces Boulardii), linseeds and a bitter aloe vera drink. I followed this while also taking the omeprazole but only about 2 per week. As you can imagine, this wasn't much fun but produced some positive results though not consistently.

I changed practices and GP (which I should have done sooner!) and was told that it might be IBS but that I should be tested for a range of other diseases including coeliac, chrons and h pylori. I would have to stop taking the omeprazole for 4 weeks for the h pylori test to be accurate. Since I was with my girlfriend's family in Spain the week after, they recommended their family doctor in Madrid. I went to see him for a half hour consultation and he went through the above history and listened to my gut with a stethoscope. He said that it sounded very much like IBS and that I should take antispasmodics with meals (duspatalin and flotoril) and above all to cut out the ultra-restrictive diet (but to make note of triggers for symptoms), enjoy myself and not get stressed. He said that I should go back to get tested anyway, but that even if something else is detected, he thought that IBS was a likely cause.

I felt great for a lot of the next 3 weeks before going back for the tests, with some occasional lapses, just taking the antispasmodics.

After taking the tests and returning a week later for the results, I was told that H pylori had been detected (but nothing else). I was prescribed combination therapy with Clarithromycin, Metronidazole and a proton pump inhibitor. I asked about the possible negative effects of the antibiotics and whether to worry about them killing off good bacteria but was told that they were targeted and not to worry.
I felt pretty awful after a few days on the antibiotics (one bout of diarrhoea but mostly normal stools, headaches and a general feeling of being suckerpunched in the gut). I finished the course of antibiotics 9 days ago and I took some probiotic supplements, as well as yoghurt and kefir which felt good while I was eating them. The weekend after ending the antibiotics, I drank the equivalent of four pints or so on Friday, Saturday and Sunday, went on a 30 mile bike ride and generally felt fine. Since Monday evening however, I have had dull abdomen pains (which kept me awake so I have been tired and probably more anxious as a result) and bloating (though with no reduction in appetite). The abdomen pains are around the area of the stomach below the ribs to the waist (hard to locate precisely). I also seem to have a minor yeast infection.

How normal does this sound and what can I do until I wait to finish the treatment? I have stopped drinking coffee, spicy foods (and possibly alcohol) but it is hard to find more advice online without getting overwhelmed by bullshit cures for candida overgrowth and other forms of snake oil cures that appear to be preying on sick people's vulnerability.

Thanks, and best wishes to anyone else dealing with this condition (and three cheers to anyone who has gotten over it)!

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Advice please for the post-antibiotics phase of treatmen

Post by Helico_expert »

I have to be frank we are only able to give useful information in regards to how to eradicate H. pylori. H. pylori is known to associate with many stomach problems and many feels better after eradicating it. However, one must understand that eradicating H. pylori does not solve ALL the stomach problems.

In your case, I am would concentrate in finding out if the H. pylori is truly eradicated. To do that, you'll need to wait 3-4 weeks without any "special" treatment. The idea is to let the survival H. pylori grow in mass and be able to be detected later. All treatment that will reduce the bacterial load will only lead to false negative result down the line.

In terms of PPI, you can follow the following guideline to control your stomach acid prior to breath/stool test. Blood test must not be used in this case.
http://www.imvs.sa.gov.au/wps/wcm/conne ... OD=AJPERES

pisha
Posts: 4
Joined: Thu May 22, 2014 5:28 pm

Re: Advice please for the post-antibiotics phase of treatmen

Post by pisha »

I finished the PPI a week ago.

Could you give some advice please on what I should avoid in order to get an accurate test? I am currently taking probiotics and peppermint oil capsules. How long should I wait before getting the test and which kind of test is preferable?

Thanks.

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Advice please for the post-antibiotics phase of treatmen

Post by Helico_expert »

There is no guideline for herbs to avoid before PPI. But in general, anything that you think may kill H. pylori or reduce stomach acid should be avoided.

here is a guideline to what medication you have to stop before urea breath test (or stool test).
http://www.helico.com/sites/default/fil ... ne2013.pdf

you cannot use blood test at this moment.

pisha
Posts: 4
Joined: Thu May 22, 2014 5:28 pm

Re: Advice please for the post-antibiotics phase of treatmen

Post by pisha »

I had a repeat stool test 8 days after finishing the PPI (One month after finishing antibiotics) which came back negative. I am trying to relax and enjoy life with this good news but I am also still coming down with stomach problems which I guess are like gastritis and are intermittent (some days I feel fine). Also, I can't relate to the complaint that many people have after finishing triple therapy viz. a diminished appetite. I have no problem eating a lot, i just feel bloated and with stomach pains (not sure if its related to certain foods but probably to cigarettes and wine of which I've enjoyed a few as I'm on holiday and should probably try cutting out again, although I've felt fine smoking and drinking in the moment and even the day after but maybe there is a time lag - I suspect that it catches up with me).

I guess there are three main concerns that I want to address:

1. How reliable can I take the 2nd stool test to be? Can I safely assume that I am free of h pylori but my stomach needs more time to heal?

2. Assuming that the h pylori is eradicted, what is the risk of reinfection ? If it is such a common infection as they say it is, then what prevents me being reinfected by one of the 40% of the population who have h pylori?

3. What should I be doing to recover and stop feeling these gastritis-type problems? As previously mentioned, I am taking peppermint oil and trying various kinds of probiotics - some people also mention aloe vera in being good for stomach healing. Is there any more advice you would give? Also, is there any way at all of estimating how long the healing process will take?

Thanks.

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Advice please for the post-antibiotics phase of treatmen

Post by Helico_expert »

1. stool test is normally very accurate. However, it depends how negative is negative. sometimes we see borderline readings and were designated as negative. So, we normally ask patients to repeat the test in another one month time.

2. risk of reinfection is normally low. However, that's depending on individual's hygiene. To avoid reinfection, you may try check everyone in the house hold (eg. partner) being carrier of H. pylori. Then, avoid sharing food and drinks with other people; wash hands after toilet; and etc etc.

3. according to the forum people, it can take weeks, months or years for the stomach to recover to normal state. My guess is, eating healthily will improve the recovery time. I am sceptical on the probiotics and herbs claim as they are lack of scientific evidence. Nevertheless, not proven doesnt mean not working. You'll have to try all suggestions until you find one that suits your problem.

pisha
Posts: 4
Joined: Thu May 22, 2014 5:28 pm

Re: Advice please for the post-antibiotics phase of treatmen

Post by pisha »

Thanks for the response,

I went back to the clinic today and was given a referral to a gastroenterologist. The nurse seemed to think that I should be checked up for hiatal hernia. However, most of my symptoms are stomach-related not the upper-abdomen problems associated with HH like reflux, so not sure about that. Still, it is probably worthwhile to have a specialist involved (I am assumed the check would be done via endoscopy). Do you think there is much chance of confusion between HH and h pylori, or any link between the two?

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Advice please for the post-antibiotics phase of treatmen

Post by Helico_expert »

hiatal hernia is a very common condition. by the age of 60, as many as 60% of the population will have it. Unfortunately, it may or may not be related to stomach problems. The truth is, a lot is still unknown for many stomach problem sufferer. These patients with unknown reason for stomach problem are labelled as functional dyspepsia.

When H. pylori was just discovered, most of the stomach problem was related to H. pylori. Then, as the prevalence of H. pylori dropped in most countries, the other stomach problems unrelated to H. pylori becomes more and more popular. Funny enough, we are slowly back to square one, "Must be stress related"; "Smoking"; "Eating and drinking habit"; and etc etc.

For your case, since you are going to do an endoscopy anyway, do ask for another histology test. Check if your inflammation is slowing down.

Castles
Posts: 11
Joined: Wed Oct 22, 2014 12:20 am

Re: Advice please for the post-antibiotics phase of treatmen

Post by Castles »

this was interesting to read, I have just finished the triple therapy and one of my antibiotics was Clarithromycin. I've felt positive results but tonight I woke with shooting pains that made me panic and I had to take long, controlled breaths to stop it. I'm wondering if it's related to the antibiotics being in the system rather than h.pylori? I'd prefer to think that, as I've not personally had the pains before now.


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