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H Pylori symptoms and treatment

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SJ66
Posts: 14
Joined: Sat May 19, 2018 4:44 am

H Pylori symptoms and treatment

Post by SJ66 » Tue Jul 31, 2018 8:44 pm

Needing some help, guidance and inspiration, please.

My story: I’ve always tried to live a healthy lifestyle - exercise, eat well and have nutritious food. Had no medical issues for nearly 30 years (I’m now 52), apart from occasional cold/flu. I don’t drink alcohol, smoke, take drugs or pharmaceuticals. I never needed to see a doctor in 12+ years. However, having spent quite a bit of time in Thailand, I became extremely ill there at the end of April this year.

Never in my life have I felt so terribly sick. I cannot write here all the symptoms I was experiencing but they were debilitating to say the least. The pain in my stomach was excruciating, burping, heartburn, acid reflux, thick white tongue, sweating, fever, weak, couldn’t eat, sleep. Felt like I had an ulcer. I was like this for almost a month before I could get the energy to fly back home to UK. I did manage to visit a hospital in Thailand and get some blood tests and one for H Pylori which came back positive.

As soon as I got back to UK in June, I visited my doctor and did a stool test for H Pylori which came back positive. I was given a PPI (Omeprazole) to try for reflux/GERD which made my symptoms worse, so stopped. Then tried another PPI (Lansoprazole) twice and again symptoms worsened and I had horrendous side effects.

I was told by a Pharmacist not to take antibiotics for H Pylori unless I could take a PPI. So I visited my doctor again who asked me to try Ranitidine, then if okay proceed with the antibiotics.

This is now where I am ‘stuck’. Nearly 3 months on and I am still suffering with ill health; have lost ca 15kg, am fatigued, weak, dizzy, nauseous a lot of the time and I have still not begun to start eradicating H Pylori! I have been given:

Ranitidine 150mg 1 x 2 per day
Amoxicillin 500mg 2 capsules x 2 per day
Metronidazole 400mg 1 tablet x 2 per day

7 day treatment.

Can anyone please advise if this is a suitable combination of eradication treatment for H Pylori?

There is so much conflicting information on the web which is adding to my anxiety. Reports state that 7 days of treatment is ineffective and you have to do 14 day Quad therapy to really rid H Pylori!

I really would appreciate your thoughts and comments. Thank you.

Helico_expert
Site Admin
Posts: 2835
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori symptoms and treatment

Post by Helico_expert » Tue Jul 31, 2018 10:09 pm

there is another member in the forum who tried similar treatment.
viewtopic.php?f=12&t=205924

The observation from our patients is that, the stronger the stomach acid is suppressed, the higher the cure rate with antibiotics. The theory is that H2 blocker cannot suppress the acid as efficiently as the PPI. However, that's just theory.

Have you tried other PPI like rabeprazole?

SJ66
Posts: 14
Joined: Sat May 19, 2018 4:44 am

Re: H Pylori symptoms and treatment

Post by SJ66 » Tue Jul 31, 2018 11:45 pm

Thank you so much for your really quick response. I’ve not tried Rabeprazole, just Omeprazole and Lansoprazole, both of which made me feel absolutely dreadful. I really wish I could tolerate them and get this treatment under way. Is Rabeprazole a more tolerable PPI?

Another concern I have is: in July 2017 I took a 7 day course of Amoxicillin and Metronidazole for an infection in my gums, prescribed by my dentist. The side effects of this combination were unpleasant but I finished the course and my gum disease cleared up perfectly. In your opinion, having taken these antibiotics a year ago, do you think this will have a negative effect on trying to eradicate H Pylori? (Previous to last year, I don’t think I’ve taken antibiotics for decades.)

I was also wondering what happens to the digestion of food if we are suppressing stomach acid. Does that give other pathogens/yeasts the opportunity to rear up and cause problems? I guess the priority is to kill the H Pylori first though.

Apologies for the bombardment of questions. I’m so grateful for this site and for your help and advice.

Helico_expert
Site Admin
Posts: 2835
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori symptoms and treatment

Post by Helico_expert » Wed Aug 01, 2018 11:24 am

If you had metronidazole a year ago, I would probably not try metronidazole again. Ask your doctor to give you something else, eg. Clarithromycin.

Rabeprazole is metabolised differently in comparison to omeprazole and lansoprazole. So hopefully you'll find it more tolerable.

the stomach acid has two main function. 1. is to kill off bacteria, and 2. is to get the protein denatured, so the enzyme can break them down more easily.

nevertheless, the PPI will never 100% remove the acid. when you are taking PPI, the pH rise from 1 to about 4-5. So the stomach is still slightly acidic.

After so many years with PPI. it is considered quite safe to take. many people take it for years. some studies suggest that PPI can lead to osteoporosis when taking it for long term. So elderlies will have to be careful of it.

SJ66
Posts: 14
Joined: Sat May 19, 2018 4:44 am

Re: H Pylori symptoms and treatment

Post by SJ66 » Sun Aug 05, 2018 4:41 pm

(Apologies if this is posted twice)

Dear Helico expert

I saw my doctor last Wednesday (1st August) and informed her of my previous prescription 13 months ago (Amoxicillin and Metronidazole) and she said to still go ahead with the treatment she prescribed. In fact, she’s the 2nd doctor I mentioned this to, plus my pharmacist, and they all said go ahead. Not wanting to delay treatment any further, I started the first-line treatment antibiotics (amoxicillin & metronidazole) and Ranitidine 3 days ago.

In this time, I’ve been reading the NICE (National Institute for Health and Care Excellence) clinical guideline published 3 September 2014 nice.org.uk/guidance/cg184 section 1.9 Helicobacter pylori testing and eradication. Under the First-line treatment 1.9.4, it clearly states ‘...take into account previous exposure to clarithromycin or metronidazole’.

Based on what I’ve read, I now can’t help wondering if this 7 day treatment I’ve been prescribed is a waste of time!

Other concerns I have is about the length of treatment. I read another report www.ncbi.nlm.nih.gov/pubmedhealth ‘Ideal length of treatment for Helicobacter pylori eradication’. Published December 11, 2013 by John Wiley & Sons, Ltd, Chichester, UK. In the report it says ‘current data suggest that increasing the length of treatment to 14 days of a PPI plus amoxicillin and clarithromycin or amoxicillin and a nitroimidazole significantly increases the eradication rate’.

Based on what I’ve read, should I go back to my doctor and ask to extend this current line of treatment to 10 or 14 days (amox, metron, Ranitidine)? Also, should I be adding in liquid Pepto Bismol (pink liquid) to boost eradication or is this unnecessary?

I sincerely would appreciate your thoughts/opinions.

Thank you so much.

Ps: Pharmacist suggested adding in a probiotic once per day (about 4 hours after taking antibiotics). I have Prescript Biotics (soil based organisms) which contain:
Bifidobacterium Bifidum
B. Lichenformis
L. Acidophilus
L. Lactis
L. Casei
B. Subtilis
L. Rhamnosus
L. Plantarum

Not sure if it’s wise to take while doing the treatment. Obviously I don’t want to take anything that could interfere with the efficacy of the antibiotics.

Helico_expert
Site Admin
Posts: 2835
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori symptoms and treatment

Post by Helico_expert » Sun Aug 05, 2018 11:32 pm

if you already started the treatment, you should and must continue until the treatment is complete.

I trust your doctor and pharmacist that they know the local HP strains better than I do. So you should follow their instruction. However, the longer the treatment, the higher the success rate.

In addition, if you can get bismuth, you can also take that together with your antibiotics. Bismuth can increase cure rate too.

SJ66
Posts: 14
Joined: Sat May 19, 2018 4:44 am

Re: H Pylori symptoms and treatment

Post by SJ66 » Mon Aug 06, 2018 1:14 am

Dear Helico expert

Thank you for such a prompt reply, it is very much appreciated. And, absolutely, I am continuing with my doctor’s prescribed treatment. I will not give up or give in to H Pylori!

Regarding HP strains, I was in Thailand for quite some time when I became ill with HP back in April. I had a private blood test done there and it came back positive and a local doctor there suggested I take Amoxicillin and Clarithromycin (no PPI or H2 Blocker!!!) and go buy the antibiotics from a local pharmacy!!! That’s when I decided to get back home to UK, see the doctor, get a stool test done at the hospital, and get a proper treatment plan.

So, having read your reply about local HP strains, does it matter that I’m taking Metronidazole and not Clarithromycin?

And BISMUTH - Is it PEPTO BISMOL (bought in the pharmacy, pink liquid/oral suspension Bismuth Subsalicylate 17.5mg/ml). I don’t know what bismuth is and need to find out if it’s safe to take for people who have had/have ulcer(s). Not much info coming up on Google!

May I ask for your advice again, please? Do you think I should go back to the doctor and get my current treatment extended to 10 or 14 days and ask about including Bismuth in my treatment plan?

Thank you so much for answering my questions. I cannot praise this site enough. It’s outstanding. THANK YOU again.

Helico_expert
Site Admin
Posts: 2835
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori symptoms and treatment

Post by Helico_expert » Mon Aug 06, 2018 5:12 pm

yup. pepto bismol will do. it'll work for people with or without ulcer. it also prevent C. diff infection during antibiotic treatment.

PPI + Amox + Metro + Bismuth. This is a good combination.

You can definitely go back to your doctor and ask for longer treatment. Also, you may also want to ask for higher dose of PPI. We find higher PPI dose increase cure rate too.

SJ66
Posts: 14
Joined: Sat May 19, 2018 4:44 am

Re: H Pylori symptoms and treatment

Post by SJ66 » Mon Aug 06, 2018 7:35 pm

Thanks, Helico_expert

I’ve got the Pepto Bismol now and just taken my first dose of it. Pharmacist says I can use it throughout the day, 3 or 4 times up to 30ml (526mg) each time.

However, I’m still concerned about my HP regime. I’ve tried several times to take PPIs on their own (Lansaprazole and Omeprazole) and sadly I cannot tolerate them because of horrendous side effects. So the doctor prescribed me Ranitidine last week to take with the 2 antibiotics:

RANITIDINE 150mg 1 tablet x 2 per day. (300mg each day)

My HP TREATMENT is this:

H2Blocker + AMOX + METRO + BISMUTH

Please could you advise if this is a combination that would work to eradicate HP? Or am I doomed because I can’t take the PPI?!

I’ve 4 more days to go on 7 day therapy but aiming to get back to doctor tomorrow (Tuesday) to state my case (based on facts and evidence) that 14 day therapies have a higher eradication %.

As always, I truly appreciate your help and advise. Many thanks to you for answering all my questions.

Helico_expert
Site Admin
Posts: 2835
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori symptoms and treatment

Post by Helico_expert » Mon Aug 06, 2018 10:43 pm

good question. I have no clue. Let's hope that the treatment will work. Your treatment success will give new hope to people who cannot tolerate PPI.

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