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欧洲幽门螺杆菌治疗共识 5
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H.pylori is a real BEAST

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

Moderator: barjammar

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H.P porteur
Posts: 32
Joined: Fri Nov 05, 2010 6:46 am

H.pylori is a real BEAST

Post by H.P porteur »

I was reading an interesting paper of a case study in one patient where they have tried 7 different types of antibiotics in cocktails to eradicate H.pylori with PPI but they all failed. The beast always grew back and caused the symptoms. The urease test was always positive.

What was interesting. The patient was put on monotherapy with Bismuth but for a long period ( over 6 months). Slowly, it started to improve in her symptoms on this suppressive therapy but the dragon was only sleeping, it was not slain.

I think Vonoprazan ( Potassium Proton inhibitor), Amoxicillin and Bismuth can slay the dragon if taken for a longtime. like 2 or 3 months instead for few days.

What you think?

Is there new game changer or new arsenal that can be added to achieve a much better eradication rate?

I read a study where injection IL2 ( interleukin 2) cured H.pylori and achieve 100% eradication rate. What you think of that?

I think we are close to 100% eradication rate of H.pylori if we keep playing with Bismuth, Potassium proton pump inhibitors like vonoprazan and Amoxocillin and liposomal formulations of other drugs plus some selective probiotics that are proved to reduce or suppress H.pylori load.

I think also that persister cells of H.pylori are to blame. Persisters were not known. They are almost immune to antibiotics. They wait until antibiotics are eliminated then they regrow the bacteria back. They are famous with TB, Lyme, chlamydia and other bacteria. I think H.pylori being a successful parasite can use persisters to survive. So Persister busters can get rid of it.

Also if we disable its acid protection, this can also lead to game over. This bacteria survives only because she knows how to desarm our HCL in the stomach. So research that can find a way to disable its protection mechanism toward HCL will lead to its eradication.

What you think?

Helico_expert
Site Admin
Posts: 4466
Joined: Wed Mar 02, 2011 7:20 am

Re: H.pylori is a real BEAST

Post by Helico_expert »

you are very up to date!

yes, vonoprazan is a game changer. We noticed that acid suppression is very important during antibiotic treatment. Vonoprazan is more superior than the convention PPI. Therefore, amoxicillin + vonoprazan is enough to achieve over 90% cure rate. It would probably be even stronger with addition of bismuth compound.

IL2 is an inflammation "inducer". Some studies have shown that acute inflammation can sometimes eradicate H. pylori. However, I dont think that's a good idea inducing inflammation in the gastric. You may end up having stomach ulcer or other problems in other organs.

H.P porteur
Posts: 32
Joined: Fri Nov 05, 2010 6:46 am

Re: H.pylori is a real BEAST

Post by H.P porteur »

Hi Helico-expert,

Yes I think in few years H.pylori will be easily treatable. With AI and other technologies like CRISPR, Potassium pump inhibitors like Vanoprazan.

I am confused with Amoxicillin is effective despite H.pylori is a gram negative. And why it cannot gain resistance to it?

This is an interesting booklet about a method achieving 100% eradication rate. It talks about biofilm, bismuth and other things.

https://www.amazon.com/100-eradication- ... 387&sr=8-3

H.P porteur
Posts: 32
Joined: Fri Nov 05, 2010 6:46 am

Re: H.pylori is a real BEAST

Post by H.P porteur »

Another question

Is it possible for H.pylori to cause chronic sinus infections or jaw infection or it is a rare phenomenon?

Some studies speak of a link between Sinus infections , gum infections, jaw infections and H.pylori. Maybe there are other reservoirs than the stomach?

Colorado5280
Posts: 2
Joined: Sat Aug 06, 2022 3:56 am

Re: H.pylori is a real BEAST

Post by Colorado5280 »

Helico_expert wrote:
Fri May 27, 2022 9:05 pm
you are very up to date!

yes, vonoprazan is a game changer. We noticed that acid suppression is very important during antibiotic treatment. Vonoprazan is more superior than the convention PPI. Therefore, amoxicillin + vonoprazan is enough to achieve over 90% cure rate. It would probably be even stronger with addition of bismuth compound.

IL2 is an inflammation "inducer". Some studies have shown that acute inflammation can sometimes eradicate H. pylori. However, I dont think that's a good idea inducing inflammation in the gastric. You may end up having stomach ulcer or other problems in other organs.
Hello Helico_expert:

US member here. I'm happy to have found this forum!

I have just joined this forum after fighting a very stubborn H. pylori infection for 19 years now (post lap-chole aka gall bladder removal surgery in 2003). I have gone through an upper endoscopy and 2 horrible antibiotic regimens so far. The H. Pylori and bile gastritis (from the GB surgery) were diagnosed by endoscopy.

The first HP treatment was around 2004 and was the standard triple therapy at that time in the US. Breath test afterwards was negative but then symptoms have happened again off and on over the years.

The last treatment after stool test confirmed HP in Feb. 2021 was the 14-day quadruple therapy (family practice doctor):

CLARITHROMICIN
METRONIDAZOLE
AMOXICILLIN
OMEPRAZOLE

I have started to have the same symptoms again last week (bad nausea, poor appetite, lethargy, fullness after eating, etc.) so believe I will have to go back to the doctor to do a stool/breath test unfortunately. Because of COVID I haven't done the follow-up test yet but need to.

I just read about Vonoprazan and am very interested if/when it will be available in the US. My interest is because I have had 2 horrible reactions to high dose PPI's in the last 19 years (omeprazole and PPI's mixed with H-2 blockers) due to hypo-magnesium (before the FDA put a black box warning on PPI's and my doctors not warning me about this possible reaction) and had to go the ER twice for side effects. Does anyone know if there are hypo-magnesium issues with Vonoprazan since it is a different type of acid blocker? May not be a consideration if this is not available in the US yet or I don't know if it would be available at an academic medical center at all.

Also, I don't know if there is a recommendation for how much magnesium (or type) to supplement if I do have to use more PPI's for my current symptoms and/or "round 3" of H. Pylori eradication treatment (to avoid having hypo-magnesium issues again)? The doctors and pharmacists I've spoken to don't seem to be very knowledgeable about this issue.

Is it possible to substitute an H-2 blocker (in combination with Pepto Bismol possibly (bismuth)) instead of a PPI (e.g. omeprazole) with an eradication treatment? I've read there is a lower chance for hypo-magnesium issues with H-2 blockers.

In addition, I have heard there is a lot of CLARITHROMICIN resistance within the US. Because of this, one GI doctor I heard on a podcast recently recommended a third possible regimen:

LEVOFLOXIN, PPI AND AMOXICILLIN.

Does this sound like "best practice" in the US for a third round of H. Pylori treatment given my 2 past failures (if HP is indeed confirmed) or is there a better third round treatment recommended given current research globally? I know there are often different opinions among clinicians so I wanted to post my question here to see what the global H. Pylori experts suggest.

After the 2 prior, horrible antibiotic treatments, I would like to make sure I use the best third H. Pylori eradication treatment possible if I have to suffer again for 1-2 weeks with the antibiotics. Because of the intense symptoms, I certainly want to do everything I can to improve how I feel so I can return to a more normal life.

Thanks in advance! :)

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