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Treatment without the Proton Pump Inhibitor

Posted: Mon Feb 18, 2019 2:15 pm
by Cas
Hi, great to find this forum. I was treated 3 yrs ago for hp infection. Dr in NZ prescribed the 2 antibiotics but not the proton pump inhibitor. Presumably because I was no longer symptomatic as I had been taking Mastic Gum and hypothyroid so low stomach acid anyway.
I believe the treatment was successful but only serology was tested post treatment.
I suspect my infection came back 3-4 months ago, again only mild symptoms, occasional stomach pain and feeling nauseous.
I took a Urea Breath test last week which came back positive 1100 (>200 +ve).
I understand the role of the PPI is to allow healing.
My question is, does not taking the PPI reduce the efficacy of the antibiotic treatment when only mildly symptomatic?
Tried to decide if I should take the ppi this time or leave it out again. Thx

Re: Treatment without the Proton Pump Inhibitor

Posted: Tue Feb 19, 2019 10:26 pm
by Helico_expert
PPI is crucial in the treatment.

Treatment without PPI only has about 20% success rate.

PPI reduces the acid in the stomach, so the antibiotics can work better. Otherwise, the acid is destroying the antibiotics.

Most likely your previous treatment without PPI failed. But because the antibiotics kill most of the H. pylori, your symptoms are reduced. Now that your H. pylori has grown in big numbers, they are likely to be resistant to antibiotics that you previously took. So you will need new antibiotics that you had not try.

You can always repeat Bismuth and Amoxicillin. Because H. pylori cannot become resistant to these two antibiotics.