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Do multiple failed Hp treatments make my Hp more and more resistant?

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downwithhp
Posts: 24
Joined: Sun Jan 12, 2020 2:46 am
Location: United States

Do multiple failed Hp treatments make my Hp more and more resistant?

Post by downwithhp »

So I've been through so many Hp treatments, all of which did not work. After having done a susceptibility test two years ago, my Hp is resistant to clarithromycin only. But obviously the other treatments did not work. What causes the antibiotics like tetracycline to not work even though the Hp not resistant to it?
Does this mean, my Hp infection has become that much more resistant to tetracycline? Or amox? What happens if I keep taking more and more treatments that still don't work? I don't want to be on omeprazole the rest of my life, but it's look more like my only option to at least maintain my infection. I've asked two doctors about susceptibility testing and it seems that it's not needed because I've already done the testing, just as a side note. Also, I am waiting to hear back from two gastro doctors, so I hope something new DOES work.

Helico_expert
Site Admin
Posts: 3868
Joined: Wed Mar 02, 2011 7:20 am

Re: Do multiple failed Hp treatments make my Hp more and more resistant?

Post by Helico_expert »

We dont exactly know why the antibiotics cant kill HP even though they are sensitive to.
Tetracycline and amoxicillin are both very good antibiotics for H. pylori, but they wont work independently. (maybe not a good combination also).

The theory is that the stomach acid is too strong, perhaps the PPI is not working well (maybe due to fast metabolism), so the antibiotics were inhibited by the acid.

downwithhp
Posts: 24
Joined: Sun Jan 12, 2020 2:46 am
Location: United States

Re: Do multiple failed Hp treatments make my Hp more and more resistant?

Post by downwithhp »

That's interesting to know. I'm noting that to tell my doctor. The tetra with amox was recommended by David Graham in Texas, US and approved my my GI. I have a feeling it's one of the few treatments I havn't taken, but I'm not a doctor. The PPI I took was 80mg of omeprazole daily with the other antibiotics. I am active in exercise daily and have been through my treatment, wonder if that contributes to my fast metabolism. I mean, I wouldn't doubt I have a fast metabolism. If my stomach acid is too strong, should I ask my doctor for an even stronger PPI, like esomeprazole? Thank you for your response.

Helico_expert
Site Admin
Posts: 3868
Joined: Wed Mar 02, 2011 7:20 am

Re: Do multiple failed Hp treatments make my Hp more and more resistant?

Post by Helico_expert »

yea.. the metabolic rate is related to a particular gene, CYP2C19. This gene is associated with the metabolism of many PPI including omeprazole, esomeprazole, pantoprazole, etc.

We like to use rabeprazole as it is not affected by that gene.
Also, it is better to have multiple dose than a single dose.
For example, it is better to have Rabeprazole 20mg three times a day, than 60mg once a day.

downwithhp
Posts: 24
Joined: Sun Jan 12, 2020 2:46 am
Location: United States

Re: Do multiple failed Hp treatments make my Hp more and more resistant?

Post by downwithhp »

Not sure if rabeprazole is available in the United States.
And when I took omeprazole it was 40mg twice daily, so not just a single dose. Had very high doses of tetracycline and Amox. So it baffles me and my doctor. But I’ll pass along this info to him.
Also, Is there a way I can can tell my doctor who I am speaking with? For this thread’s info, do just credit the H pylori team? I want to be sure so he knows since this is critical for my next steps. Thanks

downwithhp
Posts: 24
Joined: Sun Jan 12, 2020 2:46 am
Location: United States

Re: Do multiple failed Hp treatments make my Hp more and more resistant?

Post by downwithhp »

Just heard back from doctors, they're having new testing done, which "tests all major genes in the H. pylori genome for variants that are associated with antibiotics resistance." So, that's something about genes, kind of what you were talking about. It's a more comprehensive test than my previous susceptibility test. Let's hope i'm not resistant to them all.

http://amlaboratories.com/testing-servi ... ing-panel/
That's the test.

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

Re: Do multiple failed Hp treatments make my Hp more and more resistant?

Post by Helico_expert »

I look forward to hearing the result.

Just let you know, gene testing is probably 80% accurate. There is simply too many mutation to target and not all mutations are directly associated to resistance.

The traditional Bacterial culture is still the best. But it is difficult to grow and takes a long time. Not many laboratories like to do it.

downwithhp
Posts: 24
Joined: Sun Jan 12, 2020 2:46 am
Location: United States

Re: Do multiple failed Hp treatments make my Hp more and more resistant?

Post by downwithhp »

I’ll keep you posted. And to be clear, a bacterial culture is a biopsy done from an endoscopy right? I already had one of those and was told this would be more comprehensive. At this point, this really seems best. After so many treatments, I’ll take this testing and have been looking for answers for years

Helico_expert
Site Admin
Posts: 3868
Joined: Wed Mar 02, 2011 7:20 am

Re: Do multiple failed Hp treatments make my Hp more and more resistant?

Post by Helico_expert »

yup. Bacterial culture can only be done via endoscopy. It is the best.

The gene testing, I would say the technology is still not proven yet.

anyway, let's see what the test results say. If the test is able to detect resistance to Amoxicillin and Tetracycline, I will raise my eye brow a little.

Cipriabbath
Posts: 2
Joined: Thu Sep 24, 2020 3:30 am

Re: Do multiple failed Hp treatments make my Hp more and more resistant?

Post by Cipriabbath »

Hey guys.I'm almost in the same situation,with multiple failed eradications.What are the costs for this gene molecular test?

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