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Question for Helico expert

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charlie_tummypain
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Joined: Fri Oct 18, 2019 10:39 am

Question for Helico expert

Post by charlie_tummypain » Sun Oct 20, 2019 5:22 am

Hi,

Age 31. Symptoms started after kissing, she had decayed tooth. Soon after (within 2 hours) I got laryngitis, she did too. My sore throat lasted more than a month, no fever, just itchy throat with minor clear sputum. After 1 month, took Amoxicillin for 5 days followed by Augmentin for 10 days. During the 10 days of Augmentin, I started Metronidazole on 2nd or 3rd day concurrently with the Augmentin. I continued the Metro for 10 days but only 8 days overlapped with Augmentin. Also while I was on Amox, doctor did a throat culture and was negative, nothing grew. I was suspecting strep or anaerobic throat infection.

I talked to a friend who also had exact same experience, sore throat after kissing and then later on started developing gastritis symptoms. I currently have gnawing pain when stomach is empty, have lost weight and appetite. GI doc suggested endoscopy/colonoscopy since I have a history of colon polyps, they will check for H Pylori. Doctor did not bother doing other H Pylori tests - UBT, stool or blood. The endoscopy/colonoscopy is not until Nov, should I wait

1. Should I get these other tests to confirm H Pylori? Or should I just start the antibiotics treatment empirically assuming it is H Pylori since the endoscopy is still 1 month away I do not want to wait and not do anything?
2. Will the H Pylori have become resistant to Amox/Augmentin & Metro since I already took is for my throat infection?
3. Also, should I ask my doctor to do antibiotics culture & sensitivity testing after collecting gastric brushings during endoscopy? This way I would know which antibiotics are resistant & which are susceptible?

Helico_expert
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Re: Question for Helico expert

Post by Helico_expert » Sun Oct 20, 2019 9:18 pm

First, I think you caught a cold virus.

Then, since you dont sound like you have other gastric symptoms and most importantly, you are still young, I think you can do a UBT to find out if you have H. pylori without endoscopy. You can always get endoscopy later if you are found H. pylori positive by breath/stool test.

It's not good to take antibiotics without a proper diagnosis.

It's very hard for H. pylori to become resistant to amoxicillin. But you may have to replace Clarithromycin and/or metronidazole for something else.

Lastly, if your doctor can do bacterial culture, then an antibiotic sensitivity test is definitely a good idea.

charlie_tummypain
Posts: 8
Joined: Fri Oct 18, 2019 10:39 am

Re: Question for Helico expert

Post by charlie_tummypain » Mon Oct 21, 2019 11:17 am

Hi Helico expert, thank you for your reply. In addition to the gnawing pain in abdomen, I am having other gastritis symptoms too like pain in the mid back at times, gas, bloating, stool smells very different. Some of these symptoms are completely new. Maybe I am not experienced full blown symptoms because I regularly take probiotic, a yogurt drink (like kefir) and I drink good teas with ginger/turmeric/green tea. My diet is not super carb heavy.

Also, your comment about cold virus. I am not sure, this one felt much different than previous cold/flu virus sicknesses I've had. The only symptom this time was an itchy throat which felt better after a salt gargle and worsened after eating sugary stuff. And it came on upon after kissing and drinking alcohol, within like 2 hours.

I will try to get UBT and stool test done.

Since I did not take Clarithromycin in my previous regimen, should I recommend the doctor give it to me if I am positive for H Pylori? I only took Amox, Augmentin & Metro for my throat. Also, I did get side effects from Levofloxacin once upon a time, so I am scared to take Cipro. That leaves us with Furazolidone. Are there any other antibiotics besides these?

Regarding the antibiotics sensitivity test, the sample would have to be collected via gastric brushings during an endoscopy correct? Below is the link of a Quest Diagnostics test, is this the one?

https://testdirectory.questdiagnostics. ... ?cc=MASTER

Helico_expert
Site Admin
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Re: Question for Helico expert

Post by Helico_expert » Mon Oct 21, 2019 11:54 pm

If you never had Clarithromycin, you can ask your doctor for it.

Just increase the PPI dose. We prescribe Rabeprazole 20mg three times a day.

Your doctor would tell you what is the sensitivity test if he can do it.

charlie_tummypain
Posts: 8
Joined: Fri Oct 18, 2019 10:39 am

Re: Question for Helico expert

Post by charlie_tummypain » Thu Oct 31, 2019 2:33 am

I still have to get the stool test done tomorrow, I was waiting for some time to pass since I had just finished Augmentin/Metro for sore throat 2 weeks ago. As I have stopped taking my probiotic pill and kefir (yogurt drink) which I normally used to take as part of my normal diet, my gnawing pain and other symptoms have gotten worse. I purposely went off probiotic and kefir so that they would not interfere with the stool test.

If suppose I am positive for H Pylori via the stool test, should I start antibiotics or wait for the endoscopy to confirm the result and then start antibiotics?

what dosage do you recommend on the Amoxicillin, 1g tid or 500mg tid? Since I have already taken Amox for 5 days followed by Augmentin for 10 days, maybe I should take the higher 1g dosage to overcome any resistance? Also, I am assuming Clarithromycin would be 500mg bid and rabeprazole 20mg tid? I will specifically request for the Rabeprazole with my doctor.

Also, do you recommend Augmentin over Amoxicillin? I read somewhere that the beta-lactamase inhibiting feature of Augmentin did produce better results over Amoxicillin although Augmentin could cause more side effects.

Helico_expert
Site Admin
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Re: Question for Helico expert

Post by Helico_expert » Thu Oct 31, 2019 11:07 am

Hi,

I suppose the following would be a good treatment if you had never taken clarithromycin

Rabeprazole 20 mg TID
Bismuth 220mg QID
Amoxicillin 1g TID
Clarithromycin 500mg BID

H. pylori doesnt have the b-lactamase. So the inhibitor, clavulanic acid, is probably not very useful.

charlie_tummypain
Posts: 8
Joined: Fri Oct 18, 2019 10:39 am

Re: Question for Helico expert

Post by charlie_tummypain » Tue Nov 05, 2019 10:36 pm

Stool test came out negative, I did the stool test after 2 weeks and 3 days after stopping antibiotics (Amox, Augmentin & Metro). What are the chances of false negative with stool test since I just finished antibiotics? Is it worth doing a blood test at this point or just wait to do the colonoscopy endoscopy in 2-3 weeks from now?

Helico_expert
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Re: Question for Helico expert

Post by Helico_expert » Wed Nov 06, 2019 8:51 am

stool test is usually very accurate. But all tests are depending on the technician who run the test.

blood test is no good as it will remain positive for months or years. That's normal. It's your immune system having a memory of the infection. They will give you a small protection from getting reinfected.

Let's wait till after your colonoscopy and see if your symptoms improved and then decide if you need another stool test.

charlie_tummypain
Posts: 8
Joined: Fri Oct 18, 2019 10:39 am

Re: Question for Helico expert

Post by charlie_tummypain » Fri Nov 08, 2019 8:34 am

My endoscopy colonoscopy is coming up in 2-3 weeks, what all foods/supplements will interfere with the endoscopy colonoscopy result? I take yogurt drink (similar to kefir), probiotic pill, ginger turmeric tea etc. I would like to know what all do I need to stop and how many days before the procedure do I need to stop taking

Helico_expert
Site Admin
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Re: Question for Helico expert

Post by Helico_expert » Fri Nov 08, 2019 2:11 pm

although there is no direct evidence, you can stop all supplements to avoid any interference.

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