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Extremely low stomach acid

After first line treatment, various "second line" treatments can be used. The policy for H.pylori is: Make sure the infection is real (breath test for follow-up). Always give a high dose of PPI (acid blocker) when using amoxicillin. In the second treatment, give a different drug in place of clarithromycin.

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helenrdarrow
Posts: 1
Joined: Tue Jul 21, 2020 5:51 pm

Re: Extremely low stomach acid

Post by helenrdarrow »

From Helico_expert: have you checked if you still have H. pylori? The guideline says, one month after treatment, patients need to get follow up test to find out if they still habe H. pylori.

in most cases, H. pylori "destroys" the acid secretion mechanism, so when a treatment is given, H. pylori number gets down and the acid secretion starts to gradually return and appetite gets better.

if 1% of resistant H. pylori survived through the treatment, it will gradually build up an army and return with all the symptoms. So it is important to find out if you still have H. pylori.

if your treatment is successful, then you'll have to talk to your doctor about symptomatic treatment. find out what you meant by "low acid". perhaps you meant you felt that food is always in the stomach, always feel fullness. Then maybe it is due to slower motility to push the food down from stomach into intestine. There are treatments to improve motility.
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Chonibashi12
Posts: 21
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

Dear Helico Expert, I hope you are doing well. I just wanted to share some information with you as a I am still confused and looking for answers. The good news is I have eradicated H.pylori. However almost 2 months after my stomach acid is almost zero (I know this is not artefact because I am digesting absolutely nothing, even liquids give me problems, I am trying my upmost best to not lose weight by drinking protein shakes) I want to share with you some of the tests that my doctor has done for me:

1. Blood work is fine which included B12, folate, ferritin, CRP, thyroid and coeliac.
2. No calprotectin, MRI of small bowel is fine.
3. H.pylori negative through stool, breath test, RUT, as well as histology staining.
3. Endoscopy of stomach is ok, apart from mild gastritis.
4. Histology of my stomach biopsy is fine, it does not show loss of parietal cells or anything, biopsies taken from all parts or the stomach is ok.

Myself and my doctor are really confused at this stage, we really don’t know what more tests we could possibly do. I really don’t want to lose my gallbladder as It has been giving me issues due to the chronically low stomach acid.

What could the problem be?
Could it be h pylori bio-film?
Have you come across a case like this?
Perhaps it can take a long time for the stomach to recover?
This will probably be my last post, I would really appreciate a reply from you.

Thank you Helico expert

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

Re: Extremely low stomach acid

Post by Helico_expert »

with multiple tests that showed that you are free of H. pylori, it must be true.

then the endoscopy and histology showed that you have little to no abnormality, that is good news.

Some H. pylori can leave permanent damage. Perhaps you need some symptomatic treatment. perhaps need to seek second opinion in your local region where the specialist can check on you physically?

Sunnyday
Posts: 1
Joined: Sat Sep 26, 2020 3:48 am

Re: Extremely low stomach acid

Post by Sunnyday »

I have been following your story, may I have a question what antibiotics combos you took for the last treatment that you eradicated the HP. I just failed 2 treatments. I just got a new combo with Levo and amoxicillin. I haven’t started yet. People are talking about the side effects of the Levof. Thank you so much

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

Re: Extremely low stomach acid

Post by Helico_expert »

Amoxicillin and Levofloxacin are good combination.

However, make sure your doctor give you enough dose of PPI. We normally prescribe 20mg of rabeprazole, 3 times a day.

multiple dose PPI is better than single dose

finally. if you can add bismuth to your treatment, it'll boost the success rate.

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