4 therapies failed, need advise
Posted: Thu May 23, 2019 10:04 am
Hi Helico,
First of all thanks to the forum for this noble service.
I am 34 from India, Bangalore, I had burning sensation in all parts of my digestive system, diagnosed with H.pylori since 6 months with Endoscopy RUT positive and no ulcer or other abnormalities detected. I am not sure if this was right diagnostic, since I did not just had burning sensation in upper abdomen but also lower abdomen.
1st therapy - My GI first prescribed Sompraz HP
Amoxycillin (500mg) + Clarithromycin (500mg) + Esomeprazole (40mg) - daily twice for 14 days
UBT was positive after 1 month from stopping antibiotic therapy (some new kind of Helico Ammonia Test, not same as C 14/13, link https://www.news-medical.net/HELIC-Ammo ... r-from-AMA)
I had similar burning sensation all over the digestive system not just in the upper abdomen.
2nd therapy - Then same GI prescribed below
Amoxycillin (750mg) - twice daily for 14 days
Clarithromycin (500mg) - twice daily for first 7 days
Levofloxacin (500mg) - twice daily for next 7 days
UBT was positive again after 1 month from stopping antibiotic therapy.
My symptoms were back again after stopping PPI for 3 days.
3rd therapy - This time I consulted other Doctor and he did endoscopy RUT positive and histology showed mild gastritis and no other abnormalities, he prescribed below
Amoxycillin (1g) - twice daily for first 7 days
Clarithromycin (500mg) & Levofloxacin (500mg) - twice daily for next 7 days
Pantodac 40 - twice daily for 14 days
This time I was feeling all right without symptoms for almost a 2 months after stopping my antibiotic therapy, but from last 3 weeks again I started feeling burning sensation in mostly upper abdomen and sometimes lower abdomen, not severe compared to first two times. My stool test was negative but I was tested positive again with UBT after almost 10 weeks from 3rd therapy.
Now my GI was on long vacation, I consulted another senior GI in same hospital, he prescribed below
4th Therapy
Amoxycillin (1g) - twice daily for 28 days
Tetracycline (500mg) - twice daily for next 28 days
Providac (probiotic) - thrice daily for 28 days
Pantodac 40 - twice daily for 28 days
Now I have started with this 4th therapy, I dont have much side effects to worry except bad taste on tongue, fatigue sometimes. I have following questions
1. Is it safe to take antibiotics for 28 days, as my GI told its WHO guidelines to prescribe for 28 days after multiple therapy failures.
2. Is the 4th therapy prescription is correct ? considering Bismuth or Pylera is not available in India
3. Bacterial culture and antimicrobial susceptibility test not available in my city, can you please tell me where in India this is done. I heard in AIIMS Delhi and JIPMER in Pondicherry does research on this decease and they may do bacterial culture.
4. I cannot import Bismuth from US with foreign prescription, what is the best way to obtain Pylera into India.
5. My GI told not to get UBT test done again after therapy, unless the symptoms are back, is it safe to have H.pylori without symptoms ?
I really appreciate your help.
Thanks
First of all thanks to the forum for this noble service.
I am 34 from India, Bangalore, I had burning sensation in all parts of my digestive system, diagnosed with H.pylori since 6 months with Endoscopy RUT positive and no ulcer or other abnormalities detected. I am not sure if this was right diagnostic, since I did not just had burning sensation in upper abdomen but also lower abdomen.
1st therapy - My GI first prescribed Sompraz HP
Amoxycillin (500mg) + Clarithromycin (500mg) + Esomeprazole (40mg) - daily twice for 14 days
UBT was positive after 1 month from stopping antibiotic therapy (some new kind of Helico Ammonia Test, not same as C 14/13, link https://www.news-medical.net/HELIC-Ammo ... r-from-AMA)
I had similar burning sensation all over the digestive system not just in the upper abdomen.
2nd therapy - Then same GI prescribed below
Amoxycillin (750mg) - twice daily for 14 days
Clarithromycin (500mg) - twice daily for first 7 days
Levofloxacin (500mg) - twice daily for next 7 days
UBT was positive again after 1 month from stopping antibiotic therapy.
My symptoms were back again after stopping PPI for 3 days.
3rd therapy - This time I consulted other Doctor and he did endoscopy RUT positive and histology showed mild gastritis and no other abnormalities, he prescribed below
Amoxycillin (1g) - twice daily for first 7 days
Clarithromycin (500mg) & Levofloxacin (500mg) - twice daily for next 7 days
Pantodac 40 - twice daily for 14 days
This time I was feeling all right without symptoms for almost a 2 months after stopping my antibiotic therapy, but from last 3 weeks again I started feeling burning sensation in mostly upper abdomen and sometimes lower abdomen, not severe compared to first two times. My stool test was negative but I was tested positive again with UBT after almost 10 weeks from 3rd therapy.
Now my GI was on long vacation, I consulted another senior GI in same hospital, he prescribed below
4th Therapy
Amoxycillin (1g) - twice daily for 28 days
Tetracycline (500mg) - twice daily for next 28 days
Providac (probiotic) - thrice daily for 28 days
Pantodac 40 - twice daily for 28 days
Now I have started with this 4th therapy, I dont have much side effects to worry except bad taste on tongue, fatigue sometimes. I have following questions
1. Is it safe to take antibiotics for 28 days, as my GI told its WHO guidelines to prescribe for 28 days after multiple therapy failures.
2. Is the 4th therapy prescription is correct ? considering Bismuth or Pylera is not available in India
3. Bacterial culture and antimicrobial susceptibility test not available in my city, can you please tell me where in India this is done. I heard in AIIMS Delhi and JIPMER in Pondicherry does research on this decease and they may do bacterial culture.
4. I cannot import Bismuth from US with foreign prescription, what is the best way to obtain Pylera into India.
5. My GI told not to get UBT test done again after therapy, unless the symptoms are back, is it safe to have H.pylori without symptoms ?
I really appreciate your help.
Thanks