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Just started H. Pylori Treatment...

The cure of Hp usually requires antibiotics. Other things have been tried and have a weaker effect.

Moderators: barjammar, Toni, luci2010, Ondek-Expert, kkimura

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tornado82
Posts: 73
Joined: Tue Jul 01, 2014 2:09 am

Just started H. Pylori Treatment...

Post by tornado82 »

Short backstory: Im a slightly underweight, active 31 year old guy. Never had any medical problems, and take no prescription drugs. 3 Weeks ago I woke up to come to work like normal and noticed I had some chest pain. I didnt pay much attention to it until about 3 days later when it persisted. It was a dull pain, a feeling of pressure, and it felt to be coming from my esophagus. I finally called my doctor but couldn't get in, and they of course told me that with chest pains I should go to the ER. I put off going to the ER until the next day when the pain was still present, and I began to really get anxious about what the heck was going on. I went to the ER reluctantly, scared of how big the bill was going to be. They tested my heart, EKG, Chest Xray, Blood drawn, everything came back fine, my heart was fine. So they sent me home. I followed up with my doctor the following Monday (Went to the ER on a Saturday). Me and the Dr had a good talk about whats going on. I shared information I had researched, we talked about Acid Reflux and GERD, which I was already well read on. She mentioned H. Pylori however in our talk, and until that moment I had never heard of it. I came home and began to research H. Pylori, reading everything I could about it. I began to think it could be the cause for my seemingly "out of no where" pain and symptoms. My constant chest pain finally went away, but weird sensations and feelings persisted: Bloating at times, burping more than normal, light stomach pain, apetite that seemed to drop off. Being someone who has struggled with anxiety in my life (especially when I feel something is wrong that I cant fix) I was worried that my anxiety was amplifying my symptoms even more. I was still just so puzzled where all this stuff came from - I used to could eat anything at seemingly any time of day and it wouldn't bother me. It was as if I woke up one day and my whole gut was different. The Dr. put me on a trial run of Dexilant 60MG (ppi) thinking I was just having GERD symtpons. I had to stop taking it after 3 or 4 days because It seemed to make things much worse - massive indigestion and bloating. I dropped it and didn't take anything for several days and felt somewhat ok, but eventually went on Prilosec OTC because I still felt whatever the problem was, it was still there.

To get to the point of my post however, I finally called my doctor several days after going in the first time and requested to have blood drawn to test for H. Pylori. They drew blood about 8 days ago and I finally got results back today. Positive result for H. Pylori. Of course Im not for certain that the problems with my stomach and esophagus are being caused by H. Pylori, given the nature of the blood test, but It seems very likely to me. My doctor recommended I begin treatment now to eradicate it. I was very scared for this test to come back positive, knowing the treatment involves flooding the body with dual anti biotics. My last experience with antibiotics 1 year ago (clindomyacine) ended with me spending 4 days unable to leave bed and severe diarrhea and vomiting. I still don't know if it was due to food poisoning, or a dreaded colitis episode. If it was colitis, then I could be playing with fire taking antibiotics. I talked with my dr on the phone about these fears, but eventually agreed to proceed with treatment (my dr feels that this previous sickness was food born, and not the clindomyacine) My only concern is that the treatment she put me on to eradicate H. Pylori seems unconventional to the treatments ive read about. This is what she had me do:

Amoxicillin 500mg capsules: 2 capsules twice a day for 5 days(4 capsules total per day: 500mg x4)
Metronidazole 500mg Tablets: 1 capsule twice a day for 5 days (2 capsules total per day: 500mg x2)
Prilosec OTC: 1 pill twice a day (2 pills total per day)

My concern is that this plan involves only 5 days of antibiotics. Most of the treatments I read for eradication are 10 or 14 day episodes. I wanted to get some advice on what my doctor has prescribed. I feel she may have altered my treatment perhaps because of the fear I expressed. However, if I'm going to undergo this treatment id like the best possible chance at eradication. Can this treatment plan eradicate H Pylori? Any thoughts on this would be greatly appreciated.

newhpyloridiag
Posts: 85
Joined: Mon Jun 23, 2014 7:36 am

Re: Just started H. Pylori Treatment...

Post by newhpyloridiag »

Actually the minimum is 7 days. Usually people do 7/10/14 days. 10 days is good enough as the study showed there is no significant difference between the 10 and 14 day treatment. May be she did the 5 days based on your history with antibiotics. The side effects are less compared to clindomyacine. Try asking her for 5 more days and stop it after the 7th day, if you are not able to handle.

Most important thing is to take a follow-up breath test after 4 to 6 weeks. Stop taking Prilosec, at least 1 week before the test.

tornado82
Posts: 73
Joined: Tue Jul 01, 2014 2:09 am

Re: Just started H. Pylori Treatment...

Post by tornado82 »

thanks for the reply and feedback. The more I read the more I feel the 5 day was probably a poor plan. 5 Days may not get rid of the infection it seems. Surely my doctor must know this however. I am going to call them tomorrow I guess and tell them of my concerns. If I knew 5 days would eradicate the infection I wouldn't worry about it, but I've not seen a single case where someone did a 5 day regime.

Is there anyone here who did a short regime with the dosages ive described and had success? Any idea how 5 days vs 10 days of treatment compare? It seems to me that if youre going to undergo this treatment you should hit the bacteria as hard as possible to kill it in one round, rather than end up facing a 2nd round of drugs a month or two later.

Appreciate any additional response or insights. Not noticing any side effects of the antibiotics so far today, just some stomach rolling and agetation. No bad tastes in the mouth or anything.

tornado82
Posts: 73
Joined: Tue Jul 01, 2014 2:09 am

Re: Just started H. Pylori Treatment...

Post by tornado82 »

I also wanted to ask how the combination of Amoxicillen / metronidazole compares to what seems to be the more common clarithromycin / metronidazole. Im not seeing the combination im taking being listed in most places that discuss treatment. Amoxicillen is mixed with clarithromycin sometimes but Im not seeing any cases of amoxicillen and metronidazole being combined for treatment. Any thoughts on this?

newhpyloridiag
Posts: 85
Joined: Mon Jun 23, 2014 7:36 am

Re: Just started H. Pylori Treatment...

Post by newhpyloridiag »

For starters it is either Amoxicillin and Metronidazole (or) Amoxicillin and Clarithromycin, along with an acid inhibitioner.

So your treatment is good.

If there are no symptoms crippling you, go for the 10 day treatment regime.

Try to take some keifer, yogurts to re-introduce the good bacteria.

After 30 days, get the breath test done and if you fail, then the physician will prescribe you a different combination, may be Amoxicillin and Clarithromycin, the next time.

Pylera is the new medicine that is very effective. 10 day supply costs about 600 USD.

tornado82
Posts: 73
Joined: Tue Jul 01, 2014 2:09 am

Re: Just started H. Pylori Treatment...

Post by tornado82 »

Thanks again for the reply. It is reassuring to hear that the treatment I am doing should be sufficient. I havent seen much online regarding this combination. Clarithromycin seems to be much more popular in treatment than Amoxicillen, and most of my research indicates it is often mixed with Metronidazole. My knowledge regarding the various antibiotics is very limited however. I know I have taken Amoxicillen once or twice before years ago for Dental related issues, and I had zero side effects from the amoxicillen at that time. I feel pretty safe with Amoxicillen. Ive never taken Metronidazole however, so this one is new to me. Clindomyacine seemed to be pretty harsh when I had to take it a year ago, and then 2 weeks after I stopped taking it I came down extremely ill with what seemed to be a very bad case of food poisoning. They nearly had to put me in the hospital to get an IV in me. I partly blamed that illness on the clindomyacine but It could have been unrelated.

I took my 2nd round tonight and still have no side effects. Only day one so far however. Going to call Doctor tomorrow and request the 10 day regime and more prescriptions. Hopefully I have no problem getting the doctor to go along with me, because I really feel that a 5 day treatment is pointless after everything I've been researching. Ill try to keep updating the post just in case my experience may help someone else. Any other feedback or information is still welcome as I am still reading and educating myself on this issue- this is all new to me. I rarely even take a Tylenol.

I looked up Kefir and read a little on it but it seems somewhat expensive and I dont know of any place around here that would sell it. I live in the country. Id have to buy it online or drive a bit to find it I think. I have however been eating Danon Activia yogurt everyday. Not sure how much it will actually help, but I have been doing that at least. I've never been a yogurt eater. Is there a better yogurt option that is found in most grocery stores? I sat studying the yogurts the other day in the store but couldnt find anything that shouted Probiotics or anything aside from Activia. The activia tastes good, but I know its not nearly as good as kefir would be. Maybe it will help some, who knows. Ill be on the look out next time Im in the store.

newhpyloridiag
Posts: 85
Joined: Mon Jun 23, 2014 7:36 am

Re: Just started H. Pylori Treatment...

Post by newhpyloridiag »

Keifer is found in all the grocery stores, like raplhs, vons, albertsons, safeway, trader joes, sprouts etc. Not just yogurt, you need yogurt with active cultures (Pro-Biotics) in it. Since you also talked about GERD, eat less quantities but do something like 5 times instead of the 3 times a day. It will take a while to return to your old appetite.

tornado82
Posts: 73
Joined: Tue Jul 01, 2014 2:09 am

Re: Just started H. Pylori Treatment...

Post by tornado82 »

Yea I dont have any of those stores anywhere near me. Danon Activia is labeled as probiotic yogurt, but it only has like one active probiotic culture that I'm aware of: Bifidus Regularis (Bifidobacterium lactis). Ill continue to eat it every day in the hopes it does at least something. Its cheap and easy for me to buy. Ill keep my eye open for something better though. Thanks for the recommendations.

Took round 3 this morning, feeling pretty good this morning actually. Finally noticed the metallic taste in the mouth last night when I went to bed. I understand this is from the Metronidazole. I woke up with no stomach gnawing and light pain that I had been most mornings, and felt well rested. Calling doctor in a bit here to try and increase regime from 5 days to 10 days.
Last edited by tornado82 on Wed Jul 02, 2014 1:42 am, edited 1 time in total.

tornado82
Posts: 73
Joined: Tue Jul 01, 2014 2:09 am

Re: Just started H. Pylori Treatment...

Post by tornado82 »

Well something has now happened that is really confusing me about my doctor. The doctor called me just now and said that apparently my dosage that I was told to take is now incorrect. I had contacted them about increasing my regime from 5 days to 10 days and the doctor told me that for a first time H. Pylori infection my dosage should be:

500mg amoxicillen twice a day for 10 days( 2 pills per day- 1,000mg total per day for 10 days)
500mg Metronidazole twice a day for 5 days (2 pills per day - 1,000mg total per day for 5 days)

What I was initially prescribed was for 2,000 mg amoxicillen per day (2 500mg pills twice a day, 4 pills total per day)

This makes no sense to me. Amoxicillen for 10 days but Metronidazole for only 5 days? She explained that for day 6-10 I would take only amoxicillen. She even pulled out her medical book when I was on the phone with her, because I sort of challenged her on this regime, insisting that everything I had read suggested BOTH antibiotics should be taken for 10 days duration.Everything I have read and researched contradicts what the doctor told me. Can anyone tell me what the proper dosage for first time infection is supposed to be? 1,000mg per day for 10 days? 2,000mg per day for 10 days? Metronidazole for 5 days and Amoxicillen for 10 days? Both for 10 days? I'm starting to get really frustrated with this....Why is this turning out to be so difficult....Is a 5 day regime likely to have a much higher failure rate than a 10 day regime, or would it likely be fairly small? As it stands now I only have enough antibiotics to last me 5 days. My actual doctor I see is supposed to call me tomorrow, as the one I spoke to today wasnt my doctor, but works with my doctor in the same practice. Should I push the point of a full 10 day regime or just follow what my doctor is saying, despite everything I read?

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

Re: Just started H. Pylori Treatment...

Post by Helico_expert »

Thank you newhpyloridiag for being very helpful.

In our clinic, we prescribe 1g of amoxicillin, 3 times a day for 10 days. This dosage is prescribed in many cases and proven safe.

For metronidazole, we prescribed 400mg, 3 times a day for 10 days. The dosage of Metronidazole is dependent on user's body weight. Also, some research suggests that h. pylori resistance to metronidazole can be overcome by higher concentration of metronidazole.

I think you should ask your doctor to give you another 5 days worth of metronidazole to make it a 10 days treatment.

Then, remember to do a breath test 1 months later to confirm the eradication.

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