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欧洲幽门螺杆菌治疗共识 5

How do you think about this second treatment?

The cure of Hp usually requires antibiotics. Other things have been tried and have a weaker effect.

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

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Posts: 4
Joined: Sat Sep 01, 2018 8:42 am

How do you think about this second treatment?

Post by fjo »

First of all, thank you for your comment in advance. I’m glad that I found a place where I can get opinions from several experts.

I’m just about to begin my second treatment for Helicobacter Pylori. I already have prescribed drugs in my hand, but I’d like to check if this prescription seems appropriate. Of course, the drugs were prescribed by a gastroenterologist. However, I’m curious how the members in this professional forum think about.

Some Background: I’m from South Korea where Helicobacter Pylori is very prevalent. (It’s so prevalent such that Prof. Marshall starred in a probiotics yogurt advertisement.) Here is a record of my stomach examinations.

2012: Had EGD for the first time with Doctor A. Diagnosed with chronic superficial gastritis. Biopsy was done and diagnosed with h. pylori. Since chronic superficial gastritis and h. pylori are common in S. Korea, the doctor didn’t consider them to be problematic. She said she had chronic superficial gastritis too.

2013: Had EGD with Doctor B. Asked the doctor not to do a biopsy as I already knew I had h. pylori. Diagnosed with chronic superficial gastritis as expected.

2014: Had EGD with Doctor C. I told him that I have h. pylori and he told me that it should be treated as it does no good to my health at all. He did a biopsy to verify that I have h. pylori and prescribed the following drugs for the first treatment.

Rabeprazole Sodium 20 mg - 2 times per day for 10 days
Clarithromycin 500 mg - 2 times per day for 10 days
Amoxicillin 1000 mg - 2 times per day for 10 days

2015: Had EGD with Doctor D. Asked him to do a biopsy to see if h. pylori had been eradicated. H. pylori was still there, but this doctor advised me to save the second treatment for serious stomach condition such as ulcer. He was concerned that if the second treatment fails and h. pylori develops resistance against antibiotics, I would have difficulty in case I get a stomach ulcer or something else.

As a side note, National Health Insurance Service of S. Korea does not recommend nor reimburse treatment for h. pylori unless the patient has certain stomach conditions. For this reason, Korean doctors are divided between whether h. pylori has to be always treated or not.

2016: Had EGD with Doctor E. No biopsy done. Diagnosed superficial gastritis as usual.

2017: Had EGD with Doctor F. No biopsy done. Diagnosed with atrophic gastritis and acid reflux. Given that I’m in early 30s, having atrophic gastritis certainly sounds bad. Nevertheless, the doctor just told me to get EGD annually.

2018: Had EGD with Doctor C again. He told me that I had severe inflammations in the stomach. (I had heartburn and back pain, so it was not surprising.) He said my stomach was in transition from superficial gastritis to atrophic gastritis. Biopsy was done to verify that I had h. pylori and he prescribed the following drugs for the second treatment.

Rabeprazole Sodium 20 mg - 2 times per day for 10 days
Tripotassium Bismuth Dicitrate 300 mg - 4 times per day for 10 days
Tetracycline HCl 500 mg - 4 times per day for 10 days
Metronidazole 500 mg - 3 times per day for 10 days

My dad was with me when Doctor C was telling me about the second treatment and he asked the doctor if 10 days was good enough. (He asked because his second h. pylori treatment was successful with 14 days of prescription.) The doctor answered that there is a negligible difference of cure rate between 10-day prescription and 14-day prescription and the doc just gave me a 10-day prescription.

My primary question is does this prescription look appropriate for a standard second treatment? I didn’t have antibiotic sensitivity testing, so I’m just asking in general. I don’t want to take insufficient drugs that may develop antibiotic resistance of h. pylori eventually.

I asked Doctor C if there is backup therapy in case this second treatment fails, and he answered there is. But I guess there is only a limited number of backup therapies remaining as h. pylori will become more resistant against antibiotics. If it were not for the risk of developing antibiotic resistance of h. pylori, I would have started the second treatment a long time ago. Frequent heartburn and occasional back pain are quite irritating.

If that second prescription does not seem adequate, I’ll see another doctor to get a different prescription based on what experts comment here.
Last edited by fjo on Mon Sep 03, 2018 3:40 am, edited 1 time in total.

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Re: How do you think about this second treatment?

Post by Helico_expert »

Thanks for the detail story. the second treatment you are having is a PBMT treatment or PYLERA. It's pretty good. look forward to hearing your updates.

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Joined: Sat Sep 01, 2018 8:42 am

Re: How do you think about this second treatment?

Post by fjo »

Helico_expert wrote:
Sun Sep 02, 2018 2:47 pm
Thanks for the detail story. the second treatment you are having is a PBMT treatment or PYLERA. It's pretty good. look forward to hearing your updates.
Thank you for the reply. I'll post an update after I get a breath test several months later. Hopefully, it'll be cured this time.

Posts: 6
Joined: Wed Sep 12, 2018 1:38 am

H Pylori vs Blood Pressure

Post by helico_highBP »

Hi All ,

Please advice

First of all this forum is really good where I am reading most of the information about people who are going through same pain.

About me : Age 28 , 6 feet , 200 lbs and used to go gym , running always.

In My case Even after going through triple therapy of Amox , Clarithromycin and Omeprazole I am still having bloating , Increased blood pressure ( ~140 / 85 )

Emergency Instances : -

For me this nightmare started with a Panic Attack ? ( thats what doctor said) where I landed up in ER via 911 help . Had increased heartbeats , sweating , chest fluttering kind of symptoms. As soon as paramedic came and took EKG it was all normal ( everything happened within 5 minutes )
I have gone through TROPONIN Tests , EKG each more than 3 times when these sessions of high blood pressure were going on.
Finally I have done Stress Test for Heart and couple of X Ray imaging but everything came normal.

H Pylori Detected :
After 6 visits with Doctor I got chance to do breath test and got detected positive for H Pylori - which I was happy because I though at least they found something wrong and something they can work on.

H Pylori Treatment :
Now my treatment is complete where I got 3000 mg of Amox + Clarithromycin + Omeprazole(20mg*2) for 14 days .

4 days after I started getting nightmares , lack of sleep and scary dreams which got relieved after 8th day but I still didnt step back from those antibiotics.

Post H Pylori Treatment :
Feeling much better compare to past month , started driving , playing tennis a little bit but since yesterday I started getting more stomach acidity , bloating and cold sweat sometimes.. I also started experiencing Heartbits / fluttering kind of sensations but Apple watch still shows heart rate between 75 - 97 bpm.

Doctor's always said Blood Pressure rise may be due to Anxiety or I am thinking too much but I still suspect if this bacteria has any relation with blood pressure ?

I usually get Numbing of Left hand , little bit of Pain , bloating most of the times and these sessions can last hours but eventually I feel better and again it continues.

Please please help as I am all stuck with these things and I just want to live my life again how it used to be prior to this bacteria

Thank You

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