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How long does gastritis stay around after triple therapy?

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hani
Posts: 2
Joined: Sat Oct 10, 2020 5:36 am

How long does gastritis stay around after triple therapy?

Post by hani »

I completed triple therapy (Amoxicillin, Metronidazole and omeprazole for 7 days) just over 5 weeks ago.

However, I'm still getting gastritis symptoms - basically the exact same as before. I've had to start taking omeprazole everyday to prevent this so I can continue to function. The problem now is that I cannot get retested for H Pylori without stopping omeprazole as it interferes with the test. I don't want to stop taking it because I can't do anything (i.e. work, study, etc) if I have gastritis pain.

I've seen 'helico expert' on here helpfully suggest taking Ranitidine if one is in this situation. However, the FDA in the US (and the NHS in the UK) has recalled Ranitidine due to contamients that may cause cancer. I can't even get it if I tried.

My questions are:

1) Is it possible that I have eradicated the H Pylori but it will take longer than 5 weeks to feel any noticeable difference?

2) Is there an alternative to omeprazole that will allow me to have an accurate stool test for Pylori (that is not Ranitidine)?

Interested to hear others experiences with this.
Last edited by hani on Fri Dec 11, 2020 5:04 am, edited 1 time in total.

Helico_expert
Site Admin
Posts: 3995
Joined: Wed Mar 02, 2011 7:20 am

Re: How long does gastritis stay around after triple therapy?

Post by Helico_expert »

There are many alternatives for ranitidine. eg. famotidine.

yes, it's important to get the follow up test done to make sure you are free of h. pylori.

yes, you can have the symptoms even after eradication of H. pylori. This is because most of your symptoms are actually due to inflammation. The inflammation doesnt just go away overnight. It takes time to slowly retreat.

hani
Posts: 2
Joined: Sat Oct 10, 2020 5:36 am

Re: How long does gastritis stay around after triple therapy?

Post by hani »

Thats great to know that there are alternatives to Ranitidine. I will try to get some Famotdine to replace the Omeprazole and go and take a test.

Thank you very much for your reply helico expert. I also wanted to thank you for all the amazing information you provide here everyday. It has really helped me on this journey.

CheerfulSatchel
Posts: 20
Joined: Fri Oct 30, 2020 9:40 pm

Re: How long does gastritis stay around after triple therapy?

Post by CheerfulSatchel »

Hey hani, I am currently at 30 days after treatment, and I just did my breath test an hour ago.

I still feel the pain in my abdomen, mainly upper center and right quadrants. My stools had black specks throughout the whole eradication process, all the way until about 2 days ago it has stopped and I hope it stays that way. I've also got fun accompanying back pain. Hopefully it isn't caused by anything super scary.

My sister's friend's mother also had an H. Pylori infection and it took her 3 months to feel better post-eradication. So, I am using that as a reference point lolol. One could expect to feel better after roughly 3 months post eradication. :D

AMERC
Posts: 34
Joined: Mon Dec 07, 2020 5:23 am

Re: How long does gastritis stay around after triple therapy?

Post by AMERC »

I have been suffering from Stomach issues since beginning of June this year

Main symptoms are:

Tightness or pain in the middle upper abdominal (just below the rib cage). Particularly a when the stomach is empty or some time after eating food.

sometime get the feeling of something stuck in the throat.

These symptoms keep coming and going and vary in intensity

I have a few goods days but others are not so good.

Since June the GP put him on omeprazole 20mg daily

In July he did stool test for H pylori bacteria which was *negative* . But was on omeprazole then.

Because symptoms did not improve they did endoscopy on 21 October.

I had gradually reduced omeprazole dose before endoscopy and was completely off omeprazole for 12 days before the endoscopy with no symptoms

During the endoscopy appeared normal - no ulcer or gastritis but the biopsy now releaved H pylori bacteria *positive* this time.

They put me on 2 heavy antibiotics and Pantoprazole 40mg twice a day course for 7 days which was completed on 29 October.

Since completing the course the acidity has restarted.

Initially it was very bad so i took omeprazole 20mg for 2 weeks again and with some improvement I have now been on omeprazole 10mg for last 3 weeks

The problem i have with 20mg is constipation which is not an issue with 10mg but 10mg is less effective.

Also is it possible that the bacteria has caused all this even if there was no evidence of any ulcer or inflammation in the biopsy?

How long do the symptoms carry on after a successful first therapy treatment has finished,?

I am managing with 10mg omeprazole with the intention to gradually stop omeprazole so I can do the second test in January. The grawling pain and acidity is worse when the stomach is empty. And when I eat I get full quickly

Helico_expert
Site Admin
Posts: 3995
Joined: Wed Mar 02, 2011 7:20 am

Re: How long does gastritis stay around after triple therapy?

Post by Helico_expert »

Perhaps you can consider changing omeprazole to something else, eg. rabeprazole, or esomeprazole?
what happen when you were taking pantoprazole?

These are all PPI that stop acid making. However, due to the slight difference in their structure, your body can be sensitive or resistance to it.

H. pylori causes inflammation in the stomach and attract the inflammation cells. It is the inflammation that causes the symptoms. As H. pylori is gone, the inflammation will gradually heal. However, depending on the damage done. some scars can be permanent. Usually the older you are, the harder to go back to normal.

So, I encourage you to get a proper follow up to make sure that you are truly free of H. pylori after treatment.

AMERC
Posts: 34
Joined: Mon Dec 07, 2020 5:23 am

Re: How long does gastritis stay around after triple therapy?

Post by AMERC »

Thanks for the response

The issue is that the endoscopy did not show ulcer or gastritis or at least it was not mentioned in the report that was given to me. So not sure if there was any damage to heal. But I agree there must be some inflammation that is giving me the pain and tightness

The GI did not say to continue with any ppi but I decided to do so myself. He just said I have h pylori and non ulcer dyspepsia which has no cure.

Why does the acidity flares up when the stomach is empty and occasionally after eating. The burning pain can sometimes be very intense.

The other thing is I had symptoms well under control before taking the triple therapy treatment. In fact I was off ppi for 12 days without symptoms but since the therapy it has all been messed up again.

Does it sounds like h pylori may still be present,?

Not sure if I should go back to omeprazole 20mg but i will have to stop ppi before the second test.

I can't really say about Pantoprazole because I had a very high dose for only a week with the antibiotics so had a temperature diarrhoea.

AMERC
Posts: 34
Joined: Mon Dec 07, 2020 5:23 am

Re: How long does gastritis stay around after triple therapy?

Post by AMERC »

Hi Helico Expert

Is it possible for endoscopy to find h pylori but not inflammation or ulcer? This is what they said to me.

I am 46 living in UK and had no previous history of stomach issues. Its been over 5 weeks since I completed triple therapy course for h pylori eradication but the acidity issues still remains

Why does the stomach pain when its empty and also an hour or so after eating

Helico_expert
Site Admin
Posts: 3995
Joined: Wed Mar 02, 2011 7:20 am

Re: How long does gastritis stay around after triple therapy?

Post by Helico_expert »

sometimes, the stomach is infected and is trying to adjust to fit. While adjusting to the infection (or inflammation), it can lead to all sort of symptoms. So what is exactly written in the endoscopy report? did the doctor get a biopsy for histology? or rapid urease test?

endoscopy is just visual examination. It can only see abnormality that naked eyes can see. to see more details, you will need biopsies.

you can take famotidine while waiting for the breath/stool test. famotidine will not affect the test results.

AMERC
Posts: 34
Joined: Mon Dec 07, 2020 5:23 am

Re: How long does gastritis stay around after triple therapy?

Post by AMERC »

Hi.

The report says

Commodities: none

FINDINGS: Normal OGD to the second part of the Duodenum. No HH or Oesophagitis. COLTEST positive. (What is a Coltest)

Recommendation: PPI from time to time for non ulcer dyspepsia

They did the biopsy which found the h pylori. I think it was the rapid one because I got the results within 15mins as I waited there.

The GI did not mention anything about inflammation. He just wanted to get me out quickly so he could see the next patient

But as you said there must be some damage to cause the symptoms otherwise where is the pain coming from?

Also I find it difficult to believe that I have out of the blue just developed non ulcer dyspepsia. Never had any history of stomach issues

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