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Any studies on management of H pylori in rare situation no antibiotic works to eradicate it?

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downwithhp
Posts: 30
Joined: Sun Jan 12, 2020 2:46 am
Location: United States

Any studies on management of H pylori in rare situation no antibiotic works to eradicate it?

Post by downwithhp »

You all are probably sick of me, but I'm currently just managing my H pylori infection since no antibiotic has worked to kill it while I wait to find a new treatment from my doctors.

Are there any studies talking about how patients manage their H pylori infection in situations where no treatment has worked? I cannot find a single study or even those medical news sites. I also can't find a single study or research paper on patients who have an Hp infection resistant to almost every antibiotic at least in the United States.

Is this like a new thing to the science community? It's frustrating I can't find anything about my condition. It's like I'm that 1% who has this and therefore no need for anyone to study it. If you find anything about my issue (again, management of H pylori when antibiotics don't work, not about eradicating it), that would be wonderful. I am wondering if my omeprazole is not working too well because I'm having stomach pains and pains everywhere in my GI track and I also can't find any thing about that online. I wish there was something out there to provide new info to help me.

Plus, i've spoken to some of the top H pylori specialists and they can't figure it out.

Thanks in advance.

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barjammar
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Re: Any studies on management of H pylori in rare situation no antibiotic works to eradicate it?

Post by barjammar »

I have seen a few patients like you over the years.
I suggest try to suppress the Hp with something that it cannot become resistant to. I'm thinking of bismuth.

This could be pepto-bismol 2 tabs 3 times daily for 1-2 weeks. With or without food doesn't seem to matter. If kidneys are normal then 2 weeks treatment in each 2 months should be fine (continuous taking can lead to accumulation of bismuth in the body but I have never seen a case).

Some people taking high dose ppi's (nexium etc.) do have suppression of Helicobacter. So take a big dose for several weeks or longer (e.g. esomeprazole 40-80 mg daily or rabeprazole 20 mg 2-3 times daily).

Doxycycline rarely causes resistance to Hp, take 100 mg daily on top of the other suggestions. People take this for skin problems and it seems safe. It is not a proven great treatment for Hp but will suppress the bug in some people.

Finally, after a break from antibiotics for six months, have another biopsy and culture to see what the germ is still sensitive to. It might revert to a susceptible strain and then opportunities to treat might arise.

Keep an eye on the new drugs coming available. PCAB type of acid blockers in combination with amoxycillin seem useful.

8-)
Check the link below for information on hard-to-treat cases. Then search the forums for questions and answers similar to yours.
docs/200808%20stenstrom%20Hp%20Treatment.pdf

downwithhp
Posts: 30
Joined: Sun Jan 12, 2020 2:46 am
Location: United States

Re: Any studies on management of H pylori in rare situation no antibiotic works to eradicate it?

Post by downwithhp »

Thanks for your info. It really means a lot. I'm currently waiting to hear back on a special new H pylori resistance sequencing panel which another H pylori specialist recommended and also my current gastroenterologist, who has studied H pylori. If that doesn't work, my next steps will be your advice.

Thanks again.

minhle96
Posts: 10
Joined: Wed Sep 09, 2020 10:53 am

Re: Any studies on management of H pylori in rare situation no antibiotic works to eradicate it?

Post by minhle96 »

barjammar wrote:
Wed Oct 28, 2020 9:22 pm
Finally, after a break from antibiotics for six months, have another biopsy and culture to see what the germ is still sensitive to. It might revert to a susceptible strain and then opportunities to treat might arise.
8-)
Can you please explain more about this? Does this mean the antibiotic resistant strains can go away on their own and get replaced with a non-resistant strain? Can multiple different strains of Hpylori exist within the same stomach?

Helico_expert
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Re: Any studies on management of H pylori in rare situation no antibiotic works to eradicate it?

Post by Helico_expert »

This is based on a theory that resistant strain is normally less fit than common strain.
so, without the stress from antibiotics, the common strains will outgrow the resistant strains.

minhle96
Posts: 10
Joined: Wed Sep 09, 2020 10:53 am

Re: Any studies on management of H pylori in rare situation no antibiotic works to eradicate it?

Post by minhle96 »

Helico_expert wrote:
Fri Oct 30, 2020 12:29 pm
This is based on a theory that resistant strain is normally less fit than common strain.
so, without the stress from antibiotics, the common strains will outgrow the resistant strains.
Is there any stomach lining protector that can strengthen my stomach lining and prevent gastritis and ulcer while I wait during this 6 months period for the common Hpylori strains to grow back?

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

Re: Any studies on management of H pylori in rare situation no antibiotic works to eradicate it?

Post by Helico_expert »

It is usually the acid that causes ulcers and pain. When H. pylori is there, it attracts the inflammations.
The inflammation damages the stomach linings and leads to reduction of mucus secretion.
without the mucus, the acid can burn the stomach skin directly.. hence ulcer and pain.

So if you take PPI, it'll give time for the stomach lining to heal. When the inflammation is gone, the mucus will come back.


it's not easy for adults to catch H. pylori again. Unless you are living with someone carrying it and both of you are non hygienic. As long as everyone under the same roof keep good oral hygiene like brushing teeth and mouth wash, the chance of transmuting H. pylori is very low. We have married couples who never infect one another.

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