Only registered users are allowed to post. To register, please click here

Should you have any problem in posting, registering, or login, please do not hesitate to contact the admin at Marshall.centre(at)gmail(dot)com. In the subject, please use "Help needed for www.helico.com"

Advertisement is not allowed. While we encourage discussion, please try not to promote your website, goods, or unproven treatment here.

This is a non-profit website. We will try our best to help anyone that has question about H. pylori and their treatment. We shall provide the most accurate answer about H. pylori. You can help us by clicking here to keep this forum alive.

Some useful guides
How to post in the forum?
Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report
The 5th Chinese Helicobacter treatment consensus
How long should I wait before doing follow up breath/stool test?

If you are confirmed with H. pylori, in your convenient time, please help us with the symptoms survey that you are experiencing.
Symptoms survey
(contributed by frostyfeet)


此网站免费然您阅读。若想分享心得或提问,请先注册
若有困难注册,请联络站长 Marshall.centre(at)gmail(dot)com。标题请用 "Help needed for www.helico.com"
此网站不允许打广告。我们欢迎任何的讨论。但尽量不要推销没医学根据的网站,商品或治疗方案。
此网站是非盈利网站。我们会尽最大能力提供任何有关幽门螺杆菌的讯息。您的捐款可以让我们继续帮助更多的病人。

指南
如何贴文?
欧洲幽门螺杆菌治疗共识 5
第五次全国幽门螺杆菌感染处理共识报告
用药后,多久以后可以再做吹气测试?

Just diagnosed w 2 small ulcers - Need advice

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

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

Post Reply
berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

Just diagnosed w 2 small ulcers - Need advice

Post by berttt1 »

Hi. Just had endoscopy. They found 2 small ulcers. Biopsy comes back on Tuesday but - from what I read online - pylori must be the cause.

My question is whats the best possible first line treatment? (I may be allergic to amoxicillen - gonna have to get tested) My doctor wasnt very informative - which is a bit disconcerting.

Thanks for your help.

berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

Re: Just diagnosed w 2 small ulcers - Need advice

Post by berttt1 »

One further question.

I may not go on treatment for like a week (til I check out allergic status). Is there a problem going on a PPI until then to try to get some relief?

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Just diagnosed w 2 small ulcers - Need advice

Post by Helico_expert »

You can try the classic triple therapy PPI + Clarithromycin + Metronidazole. If possible, add bismuth into the combination to make it a quadruple therapy. That will boost the success rate.

It's ok to start taking PPI now and start treatment later.

by the way, HP is not the only cause of stomach ulcer. NSAIDs (ibuprofen, aspirin, etc) can also cause stomach ulcer.

berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

Re: Just diagnosed w 2 small ulcers - Need advice

Post by berttt1 »

So a biopsy could still come back negative for Pylori even with ulcers.

berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

Re: Just diagnosed w 2 small ulcers - Need advice

Post by berttt1 »

Im confused. With a stomach ulcer caused by Pylor - one would do a 2 week treatment. Then stop PPI? And get tested a month later?
So you would be off the PPI - not treating the ulcer until test time?

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Just diagnosed w 2 small ulcers - Need advice

Post by Helico_expert »

So how does the diagnostic test work?
1. it's measuring the activity of the urease enzyme produced by the H. pylori.
2. the more H. pylori, the more urease enzyme available.

The urease enzyme only works when the environment is acidic.
because H. pylori is very smart. it'll turn off the enzyme if there is no acid around. It doesnt want to create more ammonia which will make the environment too alkaline to survive.

So if you take PPI, the acid will be low, the enzyme will be turned off, and you'll get a false negative.

in addition, when you take PPI, the acid will be low, other bacteria start to grow in the stomach, competing with H. pylori.
H. pylori is a very slow growing organism. It will quickly be out compete by other microbes.
However, out compete doesnt mean complete eradication. The other microbes may keep the H. pylori number low.

So, PPI will not only reduce the acid level, will also indirectly reduce the bacteria load.
That's why you will get false negative from diagnostic tests.

*************************************************************
How H. pylori cause ulcer and why PPI can help?

H. pylori causes some damages in the stomach lining.
the stomach cells are unhappy and send out signals to attract immune cells.
H. pylori has the ability to hide away from immune cells.
So the immune cells got stress out because they cannot find the pathogen.
Then the immune cells causes huge amount of inflammation to kill off everything, including the mucous producing cells in the stomach.
The immune cells hope that the mass destruction can kill off the pathogen.
As the mucous deplete, the acid start digesting your own stomach. That's how you get ulcer.

if you take PPI, your acid is reduced. the ulcer will heal. But the mucous is still not there because of inflammation.
that is why in old time, if the patient stop taking PPI, without killing the H. pylori, the ulcer always come back.
Prof Marshall proved that after killing off H. pylori, the ulcer almost never comes back.

**************************************************************

So in your case, it doesnt matter when you take PPI. The idea is to stop the acid and so your ulcer will heal.
you will need to take antibiotics to kill off H. pylori and that will subsequently reduce the inflammation.
Then depending on your healing ability (younger = better healing ability), the symptoms will gradually improve.

if the antibiotic only kill off 99% of the bacteria. you will need at least 2 weeks for the 1% resistant H. pylori to grow up in numbers. So you will be able to detect it.

berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

Re: Just diagnosed w 2 small ulcers - Need advice

Post by berttt1 »

Thanks for the info. Appreciate it. Re - younger heal faster, Im 60 so. We shall see.....

Post Reply

Return to “Treatment for Helicobacter 幽门螺杆菌治疗”