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欧洲幽门螺杆菌治疗共识 5

H Pylori and Low stomach acid

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

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

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H Pylori and Low stomach acid

Post by kumaran » Sun Sep 16, 2018 11:06 am

Hello All,
I m a 24 yo male from India. Last year I was diagnosed with vitamin b12 deficiency. Although the methylcobalamin injections helped alleviate most of the symptoms, bad quality of sleep remained as it is.

So I started drinking lemon water every morning. It helped me with the sleep problems and I finally started to feel really good. This convinced me I had hypochloridia(low stomach acid). And When I stopped drinking lemon water, I started getting excruciating pain in the stomach, a lot of burping, bloating, flatulence and indigestion. After an endoscopy, doctors discovered I had H Pylori related non atrophic gastritis with duodenal ulcers and erosions.

I started the triple therapy, Amoxycillin + Clarithromycin + Esomeprazole twice a day and a 5 ml probiotic suspension with antibiotic resistant bacteria once a day for 14 days.
During the course of the treatment, I didn't experience a single side effect that people generally do.
The treatment ended, I felt really great but I still burped a lot. On the 15th day, I had another endoscopy. Ulcers and erosions had disappeared. Doc prescribed me a PPI containing Levosulpiride + Esomeprazole for 30 days.

Knowing that PPIs can cause permanent damage to the acidity of the stomach made me paranoid, I stopped talking PPIs after 12 days. Today is the 3rd day post stopping the PPIs. I have a few compliants,

1. I still burp a lot
2. The b12 symptoms have resurfaced
3. I don't feel hungry

Should I resume the PPIs?
Is it normal to not feel hungry?
Does the acidity of the stomach increase after the treatment? If so will the b12 problems disappear?
Is my b12 problem related to Helicobacter?

Thank you

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Re: H Pylori and Low stomach acid

Post by Helico_expert » Sun Sep 16, 2018 11:16 am

PPI is quite safe. so you can take it if you feel like it (or make you feel better).
PPI reduce the acid, but not reduce burping.

usually after H. pylori treatment, your appetite would be better and you'll have more food. usually patients gain weight after eradicating H. pylori. Perhaps you are still in the process of recovering.

H. pylori is indeed associated with B12 and iron deficiency. many patient's B12 and iron level return to normal after eradicating H. pylori.

the acidity is hard to tell. when infected with H. pylori, some people has less acid and some people has more. I think it's related to the cells being damaged by H. pylori.

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Re: H Pylori and Low stomach acid

Post by kumaran » Mon Sep 17, 2018 1:36 am

Hello Helico_expert,
Thanks a lot for your reply. I m really grateful for what you are doing here.

I have 2 queries.
1. I m planning to get a retest done in 2 weeks time to confirm eradication.

The Lab near me offers 4 H Pylori tests.

Which one should I take?

2. Do natural supplements like Manuka Honey/Mastic Gum/Cruciferous Vegies help inhibit H Pylori if not eradicate it?
Is it wise to take these as a precautionary measure to prevent of reinfection?

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Re: H Pylori and Low stomach acid

Post by Liza » Mon Sep 17, 2018 1:44 pm

Why don't you ask a doctor

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Re: H Pylori and Low stomach acid

Post by Helico_expert » Mon Sep 17, 2018 2:51 pm

out of the four, you can only do stool antigen test. the blood test is most likely to be positive and will stay positive for months or years. it's part of the nature of immune system. your immune system will remember what infection you had before.

stool antigen test is to test for current infection. it will only be positive if you currently have H. pylori.

to date, no supplement has been shown to be able to eradicate H. pylori. some people claims that certain supplement works. but those claims are yet to be proven.

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Re: H Pylori and Low stomach acid

Post by museaddict » Wed Sep 19, 2018 9:37 pm

If you have a low stomach acid stop immediately taking PPI it will destory you believe me !
this meds ruined my stomach acid and every time I eat something I start feeling a lot of strong cramps in my stomach it sometimes cuts my breath and my stools are filled with undigested food
if you don't have heartburn and reflux you don't need PPI if you have a low stomach acid take Betaine HCL with pepsin it's the best that you can do

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Re: H Pylori and Low stomach acid

Post by kumaran » Wed Oct 17, 2018 6:05 pm

2 days back, I took the antigen stool test and the results came out as NEGATIVE!! I m thrilled.

The symptoms of bloating and burping have completely disappeared. My stomach feels GREAT. Only complaint I have is that I m constipated at times.

The cherry on top is that my B12 level has reached 600 ng/L. This makes me believe that the low stomach acid problem has reversed.

One disappointment, I was hoping that my TSH levels would lower post treatment but it still remains at 4.5 mU/L. ( Because I read that H Pylori causes hashimotos which in turn causes hypothyroidism)

I would like share the tips that worked for me during recovery/treatment: (These are the tips I followed, Not sure which ones helped and which ones didn't)
1. Avoiding caffeine and alcohol.
2. Avoiding spicy and salty food
3. Avoiding acidic foods such as citrus fruits, tamarind, onions.
4. Chewing food thoroughly.
5. Not drinking water 40 mins before and after food.
6. Consuming lots and lots of home made curd and taking a 5 ml probiotic suspension containing Bacillus Clausii once a day.
7. Limiting the consumption of proteins.
8. Avoiding gluten

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Re: H Pylori and Low stomach acid

Post by Helico_expert » Thu Oct 18, 2018 12:49 pm

Congratulation! your successful treatment and the elevation of B12 are encouraging.

keep up the good work.

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