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Undergoing 1st Line of treatment in India

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subhajit
Posts: 9
Joined: Sun Mar 12, 2023 2:52 am

Undergoing 1st Line of treatment in India

Post by subhajit »

Hello Everyone,
I'm new here and posting for the first time.
I have been suffering from chronic gastric issues, bloating, flatulence, and feeling hungry after 3-4 hrs of finishing my lunch breakfast and dinner. I visited the doctor for 6times in last 2 months, before he suggested colonoscopy and OGD.
During the Colonoscopy a small nodularity was observed by the doctor in terminal illeum and he took a biopsy sample. Also, her observed some small hemorrhoids and took sample for biopsy as well. The biopsy hepatopathology results didn't indicate and neoplastic changes or abnormal cell growth. Does this mean it's a benign polyp? Doctor told me to ignore the biopsy results on the day of sample collection and said he'll review it after 2weeks.
In OGD, the doctor found slat peper apperance like inflammation in the stomach lining and showed me the same, he noted this as Pan-gastritis in the report but no mention of ulcer.
I've been prescribed a Bismuth quadruple-1g Amoxylicin, 2times - with Clarithormycine 500mg 2time day- with Delayed release PPI- Pantoprazole in the morning and 40mg Pantoprazole before dinner for 14days, with PPI continuing for 8weeke straight. He told me to review after 14days and visit him.
He also told me about side effects like - metalic taste, some gurgling in the stomach, he told me side effects might be more if bacterial load is high. When I asked him for diet plan, he simply said have everything except strictly no milk, coffee and tea and reduce intake of fish and non-vegetarian foods except egg white. I'm still not sure what diet plan to follow during the treatment. I'm now at 5and 1/2 day in the 14day treatment.
When I started the treatment, first 2days I was feeling weak and lathergic, but symptoms were very less (except my stool colour turned dark). so I took full 1 egg for 2days and had fish, after which fro yesterday some gurgling sound is coming from my stomach and some burping and flatulence, though less than how it was before treatment. Now, the weakness isn't there, but the sounds and occasional burping+flatulence is still there, plus the hunger after 3-4hrs of meal is still continuing. I'm now thinking that the antibiotics are not working as it should, the symptoms should have been gone by 5th day at least. Not sure to to do except continuing treatment for remaining days and visiting the doctor.
I've booked appointment on Monday, with another specialist gastro, who is the HOD of gastro at that hospital for a 2nd opinion on the line of treatment and management plan.
I've multiple office visits coming up from next month to abroad and and it'll be very difficult to take leave during that time plus staying on proper diet. I feel a good diet plan and hygiene will be needed during the trip, but what if my symptoms still persisting? Should I go for those trips then or decline those and get lower rating in office at the end of the year!!! The load in personal and professional life is becoming unmanageable now, with constantly worrying about if the 1st line treatment good enough or not!!!
I'm also now worried if I should get my partner tested for this infection, doctor didn't say anything on this.
I'm praying that I come out strong and get well soon and wish the same for everyone else.

subhajit
Posts: 9
Joined: Sun Mar 12, 2023 2:52 am

Re: Undergoing 1st Line of treatment in India

Post by subhajit »

I was doing some reading, and understood Dr. Marshal I infected himself with a less virulent strain of the bacteria to prove his hypothesis. And started antibiotics therapy immediately after 10days of ingestion of the bacteria. However, for us common people who don't have access to research labs, how do we know what form a mutations of the bacteria we are infected with and how to tailor antibiotic therapy based on the result? I'm not sure where in Bangalore, India, I can opt for something like that!!! However,this kind of testing assures a higher rate of eradication with the first line therapy as I understood.
Not sure if Dr. Marshall still visits this forum, but getting some expert opinion would be very helpful from the moderators or helico_expert.

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

Re: Undergoing 1st Line of treatment in India

Post by Helico_expert »

Hi,
Sorry for the slow response.
I think your doctor gave you a very good treatment.
The endoscopy examination is probably also very good as there is no report of other abnormalities.

so in summary,
have you done a follow up test to find out if you still the H. pylori? you'll need to stop PPI for a month before doing the test.

It's a good idea to get your wife and anyone living under the same roof checked for H. pylori. Treat those that are positive. That will prevent re-infection.

subhajit
Posts: 9
Joined: Sun Mar 12, 2023 2:52 am

Re: Undergoing 1st Line of treatment in India

Post by subhajit »

Thank you for your response.
I'm still at 7th day out of the 14day treatment, after which I suppose my doctor may suggest taking the test again.
Yesterday I checked my overall health and blood marker. Everything seems to be ok, eosinophils slightly elevated, which could be due to the infection.
But my eGFR rate dropped to 87, suddenly while it was 104 last month. Serum creatinine is 1.1 and uric acid is 8.74. I had hyoperurecemia but have been doing lot of work out to keep it in check, it was fine last month at 6.5. but suddenly it has also increased. Could this be attributed as a side effect of the medicines? Lat year I was taking febuxostat 40mg for high uric acid. Took it for 1month only. Then it was normal after 3months.
Should I now take 40mg of febuxostat,? Is there any chance of drug interactions with HP medicines?
Thank you again.

subhajit
Posts: 9
Joined: Sun Mar 12, 2023 2:52 am

Re: Undergoing 1st Line of treatment in India

Post by subhajit »

Hi Helico expert, I'm now on 13th day of my 14day antibiotics course.
From last week I was having severe constipation and weakness. My doctor gave me Hepagress as a supplement probiotic., And said that it'll help clear the bacteria and releave some of the symptoms. After starting the probiotic my constipation issue resolved, but then from yesterday I started having lot of flatulence and cramps on the bottom right abdomen. I'm so confused now if taking the probiotics was right!!!
It feels like the symptoms might be coming back, since my antibiotics course is also getting over I'm quite stressed on how to go about it. Pls suggest if this is common or something unusual.

subhajit
Posts: 9
Joined: Sun Mar 12, 2023 2:52 am

Re: Undergoing 1st Line of treatment in India

Post by subhajit »

I'm also avoiding spicy and oily foods, red meats, alcohol, sweets, citrus food and having simple diet free of dairy and caffeine.
So not sure what could be causing the flatulence.

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

Re: Undergoing 1st Line of treatment in India

Post by Helico_expert »

Sorry for the late respond. How are you feeling today? I believe today is the last day of your treatment.
If probiotics had been working, I think it is good to continue.

your other symptoms are probably due to the side effects of the antibiotics. The side effects usually decline quickly.

subhajit
Posts: 9
Joined: Sun Mar 12, 2023 2:52 am

Re: Undergoing 1st Line of treatment in India

Post by subhajit »

Thank you for your response. Felling ok, but lot of flatulence suddenly from yesterday. Started the probiotics only 3days back, and then from the next days afterwards started having flatulence. Not sure if probiotics can cause this or it is due to the HP still there.

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

Re: Undergoing 1st Line of treatment in India

Post by Helico_expert »

probiotics could be the culprit.
but there are so many brands out there. You can experiment with a few brands to see which is most suitable for you.

subhajit
Posts: 9
Joined: Sun Mar 12, 2023 2:52 am

Re: Undergoing 1st Line of treatment in India

Post by subhajit »

Thank you for your response again and your time. I've been on PPI as my Gastro suggested and started taking VSL3 probiotics. Post which the problem improved, also having Psyllium Husk to improve constipation issue. Constipation isn't there once I started Psyllium husk 1 week back, but since yesterday I started passing fouling smelling gas. Today it was quite a lot (15-20) no major burping though (may be 3-4times). I had PPI as usual and Gaviscon as SOS.
Not sure what is causing this issue now, could this be a sign that HP is still active and causing the foul smelling flatulence?
In diet I had boiled oat meal, plain lentils and rice with fruits during whole day.

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