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Symptoms After Treatment

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msybb
Posts: 32
Joined: Mon Jan 04, 2021 10:24 am

Re: Symptoms After Treatment

Post by msybb »

Helico_expert wrote:
Wed Jan 13, 2021 9:42 am
粪便检测时,有停用胃酸抑制剂或其他抗生素吗?
必须停药2-3周才能做检测。

当幽门螺杆菌被杀灭后,炎症会逐渐消去。在这段期间,可能还会有症状。
有些病患,康复后,偶尔还会有症状。可能几个星期或几个月就复发一次。
这都是正常的。只要确认没有幽门螺杆菌,病情就不会逐渐恶化下去。
谢谢 Helico_expert

很高兴看到中文回信 :) 。 我抗生素已停了,我记不清粪便检测时我是否在吃PPI. 三联药治疗后,我有症状时才吃PPI, 每次都是逐渐停药。我感觉三联药治疗几个月后好像胃酸分泌更多了,开始还能喝一些甜的像蜂蜜水,后来喝一点甜的就激惹胃,严重的时候稍微吃一点点甜的胃就很酸。这与HP胃炎后遗症有关吗?

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

Re: Symptoms After Treatment

Post by Helico_expert »

嗯。有这样的解说。
杀灭幽门螺杆菌后,为越来越健康。所以就胃酸分泌就多一些。
很多人是杀灭幽门螺杆菌后,胃口越来越好。体重增加。

你可以再过一段时间,复查幽门螺杆菌多一次。

msybb
Posts: 32
Joined: Mon Jan 04, 2021 10:24 am

Re: Symptoms After Treatment

Post by msybb »

谢谢 Helico_expert

我感觉胃酸多时,胃很容易被激惹,然后就有症状食物很难消化,吃PPI能缓解下来。我现在就是在这个时期,已吃了omeprazole一个星期,打算吃一个月然后逐渐停药。是不是不需要吃一个月? 我有acid reflux, 已经吃吃停停omeprazole 5-6年。我读到过亚裔人长期吃omeprazole会引起胃酸分泌降低导致萎缩性胃炎。所以我尽量不吃这个药。 可另一方面又说omeprazole比较安全。怎样用这个药能够减少胃酸对胃的刺激又比较安全呢?

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

Re: Symptoms After Treatment

Post by Helico_expert »

的确很纠结。
胃酸太多可能导致食道癌。
胃酸不够可能导致胃癌。

omeprazole 是比较早期的PPI。它在生产的过程中,有一半的成分是没有意义的。所以当你服用20mg, 其实只有10mg是有作用的。
esomeprazole是优化了omeprazole。把那一半的杂质去掉了。所以20mg 就是20mg的作用。
后来发现,有些人对omeprazole的代谢很快。尤其我们亚裔,有一半的人对omeprazole/esomeprazole有高代谢。也就是说需要更高的剂量才有相对的效果。
所以后来又出了其他的PPI,比如 pantoprazole 和rabeprazole。这些是通过不同的代谢机制,也许更适合某个群众。

因为你有胃酸倒流的症状,是建议你服用PPI。如果omeprazole有效,就继续服用。若效果不好,可以加剂量或更换牌子。

虽然说胃酸不够会导致胃癌,但是这些PPI并不是真的把胃酸降到零。你的胃酸还是保持在4-6之间。还是有一定的保护作用。
那些患了萎缩性胃炎的,是根本无法分泌胃酸。这些病人患胃癌的风险就大些。根据其萎缩的严重度,会建议每年或每两年,做胃镜复查。

msybb
Posts: 32
Joined: Mon Jan 04, 2021 10:24 am

Re: Symptoms After Treatment

Post by msybb »

谢谢 Helico_expert, 很有帮助的信息 :-)

msybb
Posts: 32
Joined: Mon Jan 04, 2021 10:24 am

Re: Symptoms After Treatment

Post by msybb »

Hi everyone

After the treatment, I have a symptom which is quite frustrating me. When I feel better and my stomach digestion function improves, I can eat a reasonable amount of breakfast (still half of my normal amount), a couple of hours later I feel hungry then I have my morning tea, then a hour or two later I feel hungry again and I have a small bite. Oh-oh, after the small bite, I feel indigestion again which can last a few days. I have had this pattern happened several times. Does anyone experience a similar symptom?

msybb
Posts: 32
Joined: Mon Jan 04, 2021 10:24 am

Re: Symptoms After Treatment

Post by msybb »

Hi Helico_expert and all

I have had gastritis over a year and triple therapy was done 8 months ago. A month after the treatment, I did feel much better until I ate a large slice toast and symptoms started again. Since then this episode has repeated many times and my stomach has been forward and backword over the last 7 months. When I had symptoms, I had to eat less. The episodes seem last shorter than in the beginning. But I feel my stomach become weaker and weaker. Is it a common pattern for people like me after repeat episodes?

When I felt better, I tried to eat more in order to practice my stomach. But as long as I ate a bit more volumes or a bit of different food, my stomach couldn’t cope and episode started again. I don’t want the symptoms keep coming back , either I don’t want my stomach become weaker and weaker. I feel very frustrated.

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

Re: Symptoms After Treatment

Post by Helico_expert »

Perhaps you should see a immunologist or dietician to find out if you are allergic to certain food.

msybb
Posts: 32
Joined: Mon Jan 04, 2021 10:24 am

Re: Symptoms After Treatment

Post by msybb »

Thanks Helico_expert for your quick reply.

I am usually not allergic to any food. My digestion function was very good before the gastritis. My stomach now seems only can cope a small amount of food, about half amount of the normal volume I was use to eat. Whenever I eat a little bit more volume, it cause indigestion and the food take longer time to digest, especially when the food is not easy to digest. In the first couple of months after triple therapy, I could eat more than now. Seems after repeat episodes, my stomach become weaker and weaker.

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

Re: Symptoms After Treatment

Post by Helico_expert »

talk to your doctor about trying domperidone or mosapride. They can help with the food passing the stomach faster.

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