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Questions about the treatment

Posted: Thu Oct 10, 2019 7:20 am
by Rice
Hello

After 3 months of a strong (sometimes moderate) hunger that appeared whenever it wanted (even after normal meals as lunch and dinner) and to which I had to eat whatever I could to stop it, I did an endoscopy, the biopsy revealed that I have H. Pylori 3 positive and gluten intolerance, and now I'm at my 5th of a 14th days quadruple treatment (12/12h):

1 Pantoprazol 40 mg (1 hour before the others)
1 Amoxicillin 1000 mg
1 Clarithromycin 500 mg (I take it together with Amoxicillon)
2 Metronidazole 250 mg (I take it half hour after the previous two)

So far, the worst contraindication since the 1th day has been insomnia; the metallic taste bothered me the most at the first days but now I'm kinda used to it. Besides this hunger, other symptoms that I had/have include exhaustion, bloating, diziness and burps.

Something that has been helping me fighting this hunger halfway till now is soup; as it is a mix of several vegetables and water and I don't have to chew it (not because of laziness, but because of the hurry to take the hunger away), it became my most important ally in this fight. Besides it, my diet has been bananas, pears, rice, corn crackers, eggs, grilled fish/chicken and turkey steak.

Questions about the treatment:

1 - Is it okay to take the meds with soup as I been doing? As it is a liquid meal, I fear that it doesn't stay that long at the stomach as solid food would and so the pills effect pass unnoticed through the local H. Pylori.

2 - Since I started the treatment I'm noticing that the hunger, when it comes, come stronger as it didn't in many weeks (since I changed my diet to no processed food and gluten free in August) and I find it strange cuz the treatment is to get rid of it. Is it normal to still feel the hunger (even stronger) with the treatment going on? Today (5th day) it was weaker since I took the pills at 9am, but around 8pm it came full force.

Thanks.

Re: Questions about the treatment

Posted: Fri Oct 11, 2019 9:00 am
by Helico_expert
It is true that when H. pylori is eradicated, your stomach becomes healthier, and your appetite can improve.

It's ok to take the antibiotics with soup.

you are doing great. make sure you finish the tablets. It's ok to take multiple smaller meal.

Re: Questions about the treatment

Posted: Fri Oct 11, 2019 9:35 pm
by Rice
Thank you for the reply, Helico_expert. I have two other questions:

1 - Is it okay to take Amoxicillin and Clarithromycin pills together as I'm doing? I'm afraid that one may be blocking the other's effect.

2 - When am I suppose to stop feeling these strong hunger pangs? I'm halfway through the treatment (7th day) and they still appear every single day.

Re: Questions about the treatment

Posted: Sat Oct 12, 2019 5:09 pm
by Helico_expert
you can certainly take amoxicillin and clarithromycin together.

once your stomach is healthy again, you can retrain yourself to have food at certain time. Anyway, it may be a good idea to have smaller meal more frequently.

Re: Questions about the treatment

Posted: Wed Oct 16, 2019 10:18 pm
by Rice
Thank you, Helico_expert

I'm now two days away from the end of the treatment and from last Sunday till Tuesday I didn't have hunger pangs and I thought that it was a sign that it was all over, but since then I feel a softer/weaker hunger (let's say than on a scale of 1-10 I'm feeling a 4 these days; before the meds was a 8/9).

Being so close to the end and still with symptoms, what should I make of this?

Re: Questions about the treatment

Posted: Thu Oct 17, 2019 4:31 am
by Bree033
Hello all! I felt like this discussion was right in line with my questions about h. Pylori. First, you should know that I am allergic to flagyl and sulfa. I also have a primary immune deficiency disorder called hypogammaglobulinemia and self administer 12g of Gammagard liquid immunoglobulin subcutaneously every week. I have tested positive for h.pylori 4 times. I have been successfully treated for it in the past but the last three times have proven unsuccessful. This time, my GI doctor has prescribed Levofloxican 500mg 1/day for 14 days, Amoxicillin 1,000mg 3/day for 14 days and omeprazole 40mg 2/ day for 14 days.

My question is what is the best way to take this medication? The omeprazole label says I must take it at least 1 hour before meals. The levofloxican says not to take it within 2 hours of any antacids. I take ALOT of other meds, usually at bedtime. Mostly I am just worried about the antibiotics making me puke. Any suggestions? I need this regimen to work, which means I need to take all of it and not throw any of it up! HELP Pleaseeeee!

Re: Questions about the treatment

Posted: Thu Oct 17, 2019 4:38 pm
by Helico_expert
Rice wrote:
Wed Oct 16, 2019 10:18 pm
Thank you, Helico_expert

I'm now two days away from the end of the treatment and from last Sunday till Tuesday I didn't have hunger pangs and I thought that it was a sign that it was all over, but since then I feel a softer/weaker hunger (let's say than on a scale of 1-10 I'm feeling a 4 these days; before the meds was a 8/9).

Being so close to the end and still with symptoms, what should I make of this?
It's fine that the symptoms stay the same. For now, just focus on getting rid of H. pylori. A month later, complete the follow up breath test to find out if your H. pylori has been eradicated. Your symptoms will gradually improve after H. pylori is gone. Or, more precisely, when your stomach is healing. The healing is depending on the damage done. Some young people, with good health, the healing is fast. For people with poorer health, usually above 40, the healing can be slower.

Re: Questions about the treatment

Posted: Thu Oct 17, 2019 4:44 pm
by Helico_expert
Bree033 wrote:
Thu Oct 17, 2019 4:31 am
Hello all! I felt like this discussion was right in line with my questions about h. Pylori. First, you should know that I am allergic to flagyl and sulfa. I also have a primary immune deficiency disorder called hypogammaglobulinemia and self administer 12g of Gammagard liquid immunoglobulin subcutaneously every week. I have tested positive for h.pylori 4 times. I have been successfully treated for it in the past but the last three times have proven unsuccessful. This time, my GI doctor has prescribed Levofloxican 500mg 1/day for 14 days, Amoxicillin 1,000mg 3/day for 14 days and omeprazole 40mg 2/ day for 14 days.

My question is what is the best way to take this medication? The omeprazole label says I must take it at least 1 hour before meals. The levofloxican says not to take it within 2 hours of any antacids. I take ALOT of other meds, usually at bedtime. Mostly I am just worried about the antibiotics making me puke. Any suggestions? I need this regimen to work, which means I need to take all of it and not throw any of it up! HELP Pleaseeeee!
Interesting. Have you done an endoscopy to see your stomach condition? I am interested to know if you have inflammation in the stomach. Usually the stomach symptom arise because of the inflammation. Since you are sort of immuno deficient, perhaps, there is no inflammation.

anyway, I think it is better to add bismuth to your treatment. Dont worry about when to take the tablets. The only rule is to take them as evenly as possible. For example, PPI, twice a day, so every 12 hrs. Amox, three times a day, so every 8 hours.

lastly, if possible, talk to your doctor about switching omeprazole to rabeprazole 20mg 3x a day. Rabeprazole avoids the CYP metabolism problem omeprazole has.

Re: Questions about the treatment

Posted: Sat Oct 19, 2019 5:44 pm
by Rice
Bree033, the H. Pylori treatment are the only meds that I've been taking so I can't tell how it must feel to mix it with others, as it is your case. From my experience, all I can say about this one is that it isn't as difficult as it seems; during the first three days the metallic taste and insomnia suddenly popped up and I had to adapt, but after that things got better. I wish you good luck.

Helico_expert, yesterday was my 14th treatment day (aka last day), but there are still pills on the pills pack (for two more days). When my doctor prescribed the treatment it was said that it would be for 14 days, but usually when it comes to antibiotics a patient must take a whole pack, no? Should I ignore them?

Even though I still feel the hunger, it has been weak these days (3 or 4 in a scale of 10, as I said). Let's hope for the best and see how the next doctor's appointment will go.

Thanks.

Re: Questions about the treatment

Posted: Sat Oct 19, 2019 11:02 pm
by Helico_expert
14 days is enough. you an ignore the rest of the pills. you can try multiple small meals to help with your hunger problem.