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started second treatment for HP

The most popular treatments consist of two antibiotics (one of which is usually clarithromycin) plus a strong acid blocker such as omeprazole (PriLosec, Nexium, Somac, Zoton, etc.). Treatment is for 7-10 days. Cure rate is about 85%

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xkuku
Posts: 4
Joined: Mon May 07, 2018 3:33 am

started second treatment for HP

Post by xkuku » Mon May 07, 2018 3:50 am

Male 45 YO, birthday today :)

December last year started having Globus (lump in the throat) and insomnia.
DId 3 ENT flexible endoscopies, neck CT, with nothing found. Then end of january had a GI endoscopy which determine I have gastritis and HP.
Started having anxiety and GP put me on antidepresant (lexapro).

In February did 10 days of Pylera and a month later HP still positive by breath test. (I should have read at that time, but later found studies from 2016 suggesting that 10 days of treatment are not sufficient anymore) and 14 days regiments should be prescribed. I am upset on my GI for not giving me 14 days treatment in februari.

In April I did a month of OTC pylori treatment with Pyloricil, Allicillin, ADP (Oregano oil), mastic gum and probiotics. I still have symptoms and didnt want to wait another month for the second breath test.

So yesterday I started a second round of antibiotics ( 1 G Amoxicilin, 500mg Clarythonmicin and 20mg Omeprazone all twice a day - 7am and 7pm) for 14 days this time.

I feel low mood and I am not sure if is possible that HP supposedly acquired in childhood can suddenly cause these many symptoms.
Looking for tips or tricks on adjuvants or other ways to improve the eradication chances of the classic triple therapy.

Read somewhere that Melatonin 3mg at night could improve the eradication rates.
NAC also appeared to have adjuvant effects, tho I haven't seen any studies for this particular antibiotic combination.
Tryptophan also heard that might be helpful.

Would appreciate any tips or suggestion.
Thank you and have a great day.
45 yo with globus and insomnia.
Hp diagnostic by endoscopy.
Unsuccessful 10 days pylera feb 2018.
Classic triple therapy may 2018. Negative breath test in june.
Globus gone, insomnia and flatulence persists. Looking at other possible parasites,

Helico_expert
Site Admin
Posts: 2672
Joined: Wed Mar 02, 2011 7:20 am

Re: started second treatment for HP

Post by Helico_expert » Mon May 07, 2018 11:18 am

Happy Birthday!
Pylera is a strong antibiotic combination. Surprise that it's not working for you.

10 days vs 14 days are just slight improvement. We are talking 90% vs 92% cure rate. Some people said, with the longer side effect experienced on 14 days, it's insignificant improvement. Some people said if it's resistant, doesnt matter how many days of treatment you do, it'll fail anyway. So I think 10 or 14 days are both fine. Dont have to worry too much about it.

Your doctor should have let you tried the classic triple therapy first before going to the stronger antibiotic combination. Nevertheless, let's hope it works.

These are what you can do to boost the cure rate.
1. increase omeprazole dose to 40mg
2. increase amoxicillin dose to 1g 3x a day
3. add bismuth into your treatment. Bismuth can also prevent clostridium difficiles complications.

xkuku
Posts: 4
Joined: Mon May 07, 2018 3:33 am

Re: started second treatment for HP

Post by xkuku » Thu May 10, 2018 12:31 am

Thanks for advises.
I talk to the GI yesterday and he told me the following:

a) no evidence in his view for increasing PPI. And he thinks that PPI has minor influence anyway
b) he claimed that increasing Amoxicillin to 3g per day will produce serious side effects.
c) he said there is no point to use probiotics during the treatment, but rather after the treatment
d) he didn't recommend anything else.

I am thinking myself to add zinc-carnosine 150mg twice a day and continue using the probiotic.
45 yo with globus and insomnia.
Hp diagnostic by endoscopy.
Unsuccessful 10 days pylera feb 2018.
Classic triple therapy may 2018. Negative breath test in june.
Globus gone, insomnia and flatulence persists. Looking at other possible parasites,

Helico_expert
Site Admin
Posts: 2672
Joined: Wed Mar 02, 2011 7:20 am

Re: started second treatment for HP

Post by Helico_expert » Thu May 10, 2018 3:13 pm

You can always talk to another doctor.

A) increase of PPI dose can definitely increase cure rate. Your doctor probably has not been updated with latest literature.
B) Amoxicillin is a very safe drug. You can find many articles out there giving patients 3g a day without problem.
C) Probiotics is subjective. If you feel better, why not. We have no objection trying, since it's harmless. If patient feel better taking it during treatment, please go ahead.
D) We recommend to add bismuth in the treatment to prevent C. diff complication.

xkuku
Posts: 4
Joined: Mon May 07, 2018 3:33 am

Re: started second treatment for HP

Post by xkuku » Sat Jun 23, 2018 1:23 pm

Just got my breath test results today. It says negative. I am so happy.
I started feeling better after finishing the antibiotics. Sleep improved. got more than half of the lost weight back.

I am not fully recovered tho. Hopefully will get there in time.
I am scared not to be infected again. Need to research ways to avoid getting reinfected.
45 yo with globus and insomnia.
Hp diagnostic by endoscopy.
Unsuccessful 10 days pylera feb 2018.
Classic triple therapy may 2018. Negative breath test in june.
Globus gone, insomnia and flatulence persists. Looking at other possible parasites,

Helico_expert
Site Admin
Posts: 2672
Joined: Wed Mar 02, 2011 7:20 am

Re: started second treatment for HP

Post by Helico_expert » Sat Jun 23, 2018 3:58 pm

Congratulation! we need good news like yours more often.

dont worry about reinfection. it's very rare. Get everyone under the same roof checked and treated.

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