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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.

Moderators: barjammar, Toni, luci2010, Ondek-Expert, kkimura

Chonibashi12
Posts: 14
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

Thank you for your reply, my last question would be:

1. How long would it take for acid levels to return to normal range following successfully eradicating of H.pylori?

Many thanks

Helico_expert
Site Admin
Posts: 3641
Joined: Wed Mar 02, 2011 7:20 am

Re: Extremely low stomach acid

Post by Helico_expert »

first of all, not everyone infected with H. pylori will have low acid. in fact only a small portion of people with low acid. About 20% of people will have higher acid secretion, which ultimately leads to stomach ulcer.

Usually only when the damage is very severe, usually at older age, the acid secretion cells are destroyed, and the acid level drop. And for these people, the acid cells may never return. This is known as the atrophic gastritis.

Chonibashi12
Posts: 14
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

So you are telling me that once my H.pylori has been eradicated I will have higher acid secretion? I’m totally confused because I have been diagnosed with Hypochlorhydria which is caused by the H.pylori :(

Helico_expert
Site Admin
Posts: 3641
Joined: Wed Mar 02, 2011 7:20 am

Re: Extremely low stomach acid

Post by Helico_expert »

not everyone has higher acid after HP eradication.
For those that have elevated acid secretion, they tend to have better appetite and will gain weight.

As for you, try focus in getting rid of H. pylori, make sure it is really gone, then only you can work on the recovery.

Chonibashi12
Posts: 14
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

Hello Helico expert,

I’m really upset I failed 2 triple therapies, I keep losing weight, extremely low stomach acid lost 20kg as of yet, nothing is digesting, I am really frustrated how can such a bug cause a human to have such low stomach acid is just beyond my imagination.

Gastro doctor put me on a new treatment for 14 days:

Amoxicillin 1g
Lansoprazole 20g
Tetracycline 500mg
Pepto bismol liquid solution

My doctor said if this does not work he will culture my biopsy but said something like it being 50% successful did not understand what he meant.

Do you have any words of hope for me? Because right now I can only see myself passing away god forbid. I just can’t digest anything my stool is pale coloured.

Helico_expert
Site Admin
Posts: 3641
Joined: Wed Mar 02, 2011 7:20 am

Re: Extremely low stomach acid

Post by Helico_expert »

I am not a fan of PPI + Bismuth + Amox + Tetra

the report of this regime is conflicting. Some reported good outcome and the other dont.

Perhaps you can try the following instead

Rabeprazole 20mg TID (important to have high dose PPI to increase cure rate. We like rabeprazole better because some people are more resistant to other PPI and require higher dose to be effective. Rabeprazole is less likely to have that issue)

Bismuth 240mg QID

Tetracycline 500mg QID

Metronidazole 400mg TID

14 days treatment

The dosage are slightly higher than others. but the cure rate is good, especially among people who are carrying resistant strain.
There are studies that shown that metronidazole resistant can be overcome by having it together with tetracycline.

lastly, remember to avoid sunlight when taking tetracycline.

Chonibashi12
Posts: 14
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

Thank you for your reply,

Since this is my third therapy, if I fail this therapy what would you advice next? I have already lost 20kg and anything more than this is going to be seriously harming to my body. Would you recommend some good advice? My gastro doctor said that If I fail again he will do a antibiotic resistance test. I’m extremely desperate for some stomach acid. :(

Thank you for your help

Helico_expert
Site Admin
Posts: 3641
Joined: Wed Mar 02, 2011 7:20 am

Re: Extremely low stomach acid

Post by Helico_expert »

keep us posted with your outcome.

Chonibashi12
Posts: 14
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

Breath test positive, I am starting a new cocktail:

Omeprazole 40mg
Rifabutin 150mg
Levofloxacin 500mg
Doxycycline 100mg
Nitazoxanide 500mg
Amoxicillin 1g
Bismuth 525 mg

All of the above twice daily for 14 days, please can you give any advice or if you recommend any changes to the cocktail above?

Thank you

Helico_expert
Site Admin
Posts: 3641
Joined: Wed Mar 02, 2011 7:20 am

Re: Extremely low stomach acid

Post by Helico_expert »

I think that's a bit too much.

prof Marshall doesnt like omeprazole because some people digest it very quickly and need higher dose. Rabeprazole on the other hand is not affected by the metabolic rate.

why not you try the following.

rabeprazole 20mg TID.
Amoxicillin 1g TID
bismuth 240mg QID
rifabutin 150mg BID (I assume you had not taken this before).

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