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MALT Lymphoma

After many years of H.pylori infection a cancer can develop in the stomach. This is particularly common in Latin America and Asia (esp. Japan). It is believed that lifelong inflammation of the stomach lining causes low acidity which then allows carcinogens to be active in the stomach. These then cause stem cells (part of the healing process) to mutate and become cancer cells.

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ML-HELLico_Bacttle
Posts: 26
Joined: Wed Oct 24, 2018 7:32 am

Re: MALT Lymphoma

Post by ML-HELLico_Bacttle »

Dear Helico_expert:

You seem to be surprised Pylera didn't work. On top of this page, in my first message, is all I've taken & its results.

The appointment was today.
The panel decided that I'd try another course of antibiotics.

Susceptibility Test:
I had actually already talked to a gastroenterologist doctor before who said that they could do this but that it would take a long time & the in vitro results wouldn't necessarily guarantee success. I have the feeling it might be an expensive procedure or so otherwise they would have started by this, which seems pretty logical.

Rifabutin:
They have no access to it or experience with it.
It's not available in pharmacies either, only in Hospitals.
But I believe that they can get it if they want to…

So, the 3rd antibiotic therapy I was prescribed is the following:
Day 01 to 05: Amoxicilin 1000mg 1_Capsule Twice-A-Day + Rabeprazole 20mg 1_Capsule Twice-A-Day
Day 06 to 10: Levofloxacin 500mg 1_Capsule Once-A-Day + Tinidazole 500mg 1_Capsule Twice-A-Day + Rabeprazole 20mg 1_Capsule Twice-A-Day


01: Although I already had a couple of good references on Levofloxacin I don't fully trust this therapy...
Don't you think I should go back there & insist on the Rifabutin + Amoxicilin + Ciprofloxacin?

I'd rather try something that has more proven success right away than ruining my microbiome once more with a shot in the dark. Pylera was in May but only this month I had finally got it back to normal.

I've already taken Amoxicilin on the 1st one & it failed, tho it cleared up my ulcer... Shouldn't this be the 1st antibiotic H. Pylori resists to?
Interesting: I have avoided antibiotics all my adulthood so if my H. Pylori is resistant to Amoxicilin it can only be from when I was a kid & took a lot of drugs due to asthma attacks & fevers.


02: I have never understood this: if low stomach acid is precisely what favours H. Pylori why do antibiotic therapies always include a Proton Pump Inhibitor? Have you ever tried any therapy WITHOUT a PPI?

Helico_expert
Site Admin
Posts: 4489
Joined: Wed Mar 02, 2011 7:20 am

Re: MALT Lymphoma

Post by Helico_expert »

yea, PYLERA is a strong antibiotic that H. pylori is hard to gain resistant with.

Amoxicillin is a special antibiotic that H. pylori can never develop resistant to as well. So you can repetitively use it. If the patient is not allergic to Amoxicillin, we will give 3 gram dose of Amoxicillin per day (1g, 3x a day).

Ciprofloxacin and Levofloxacin is the same. You can use any one of them.

Metronidazole and tinidazole is the same. However, your doctor should know that it is present in PYLERA and your strain may have developed resistance to it. Nevertheless, there are studies that suggest that resistance to metronidazole can be overcome it is used with other antibiotics. your doctor should understand the efficacy of this treatment strategy better than me for your local strains.

PPI helps reduce the acid so the antibiotics work better. We find higher dose of PPI increase cure rate. We normally prescribe Rabeprazole, 20mg 3 times a day.

lastly, bismuth is another good drug to add to your treatment. H. pylori cannot become resistant to bismuth. And bismuth can prevent C. diff complication. You can discuss with your doctor about adding bismuth to your new treatment.

ML-HELLico_Bacttle
Posts: 26
Joined: Wed Oct 24, 2018 7:32 am

Re: MALT Lymphoma

Post by ML-HELLico_Bacttle »

Dear Helico_expert:

Thank you so much, once more.

Pylera:
How can it be possible that I have strains of H. Pylori resistant to Pylera if I've never taken its components before?…
It could be that I might have been reinfected/recontaminated after that but with a strain that would be on the stomach side of the mucosa, following that theory…
Somewhere in Pylera there is this passage:
"The increased gastric retention time is likely to be beneficial, as it likely prolongs the exposure of H. Pylori to bismuth, metronidazole and tetracycline hydrochloride."
If Pylera depends majorly on this exposure then the reason for its failure in my case must be precisely because H. Pylori is already shielded. I imagine H. Pylori on the other side of the mucosa watching the Pylera components & having a laugh…


Amoxicillin:
I had A LOT of penicillin when I was a kid...
If I take what their proposal do you think I could safely up the Amoxicillin + Rabenprazole dose to 3xDay?


"your doctor should understand the efficacy of this treatment strategy better than me for your local strains."

That's what I'm so suspicious about… I don't feel they do because my oncologist is only a spokesperson for the gastroenterologists and for the reasons you pointed out. They are giving me the same with other names…

I have a really tough decision to make…
I don't want to upset them with doubting their professionalism/reputation but I'd like to have the best treatment.
Plus: I have the wisdom tooth cavity longing for antibiotics…
I guess I'll really get back there & try to make them get the Rifabutin or I'll have to find someone else that can.

Helico_expert
Site Admin
Posts: 4489
Joined: Wed Mar 02, 2011 7:20 am

Re: MALT Lymphoma

Post by Helico_expert »

Tetracycline, like Amoxicillin, is also a very difficult drug to gain resistant to. we have not seen a tetracycline resistant strain ourselves. But there are report elsewhere that such strain exist.

Amoxicillin is pretty safe. I think they use it in dental care, where amoxicillin can give up to 3g a day.

rabeprazole is also pretty safe. 20mg, 3x a day.

then again, you need to talk to your doctor about it. someone has to look after you if you are allergic or experience side effect to it.

i dont believe in the shielding theory. we have a cure rate of 95% when it is done the right way. I believe it is due to antibiotic resistance. perhaps you really have the tetracycline resistant strain. resistance can appear when the bacteria is under stress and spontaneously appear. when HP is under stress, the whole genome can go into massive mutation. that's how resistance strain developed.

it is a tough decision to challenge your doctor. perhaps you can seek second opinion?

ML-HELLico_Bacttle
Posts: 26
Joined: Wed Oct 24, 2018 7:32 am

Re: MALT Lymphoma

Post by ML-HELLico_Bacttle »

Dear Helico_expert:

Here are the latest:

I wrote an email to the institute/doctor explaining why I wanted to swap Tinidazole for Rifabutine or Tetracicline and perhaps adding Bismuth and alerting to the genetic dangers of my stomach going into radiotherapy if this fails.
And, as I was anxious about: I have been simply ignored.
I insisted several times but I had no concrete answer.

Yesterday I managed to get on the phone a doctor who belongs to the Group.
Please comment what you might find controversial:

She said that I should have started the therapy last 28th. Right...
I told her that Tinidazole is the same as Metronidazole to which H. Pylori is more likely to have gained resistance to than Tetracicline. She only replied that Tetracicline was in Pylera (2nd therapy) too.
I told her about the >95% success rate with added Rifabutin. She said that in a 4th line of treatment they might want to add Rifampicin, which is equivalent to Rifabutin.
Regarding the addition of Bismuth to this new 3rd therapy she said that Rabeprazole does almost the same as Bismuth & that in a 4th line of treatment Bismuth could then be added.
She said some MALT Lymphoma patients respond to 2nd line of treatment but that unfortunately there are more & more getting resistant.

Regarding my hypothesis of antibiotic-resistance due to antibiotic intake when I was a kid she answered that it could only be if I already had the bacteria back then which was unlikely.
Unlikely?! It's common knowledge that one acquires H. Pylori in childhood…
Then I told her that I only had gastritis symptoms back in the 90s and that maybe now the bacteria are protected by the mucosa.
I don't know why you wrote "i dont believe in the shielding theory"; I guess you were the one who suggested it in the 1st place and it makes perfect sense. That's what the Helico in the bacter is supposed to do: penetrate & seek shelter from stomach acid. To make myself clearer: what I meant before was that the bacteria are shielded from the FOOD SIDE of the stomach.
Back to the doctor: she said that a probable cause for antibiotic-resistant is via eating food that contains antibiotics.
She advised me to eat organic, as much as possible, and avoid smoked red meats which may contain H. Pylori. I don't eat them anyway. But I do eat a LOT of vegetables which might be in contact with faecal matter whether they are organic or not.
With that said she was the 1st doctor at the institute who ever mentioned anything regarding Nutrition.
I revealed that over the last years I did eat farmed Sea Bream & Salmon, practically daily. These are said to be loaded in antibiotics. It's still hard to believe it can have this sort of impact.

So, again, this is what I'm about to do in the 3rd antibiotic therapy/attempt:
Day 01 to 05: Amoxicilin 1000mg 1_Capsule Twice-A-Day + Rabeprazole 20mg 1_Capsule Twice-A-Day
Day 06 to 10: Levofloxacin 500mg 1_Capsule Once-A-Day + Tinidazole 500mg 1_Capsule Twice-A-Day + Rabeprazole 20mg 1_Capsule Twice-A-Day

I have no one to look after me most of the time.
No, in my first message of this thread there's the 1st therapy I made with Amoxicilin so I'm not allergic to it.
So if the Amoxicilin pack comes with more capsules than I'll need: how about upping the daily dose to 1g 3x day?

Is there any advice you can give me to potentiate the antibiotics effect?

There is no prescribed preference regarding taking them with food or without so:
If I feel well taking them on an empty stomach will they be more effective?
Or can they damage stomach lining?

During Pylera I made a low-iron & low-calcium food protocol.
Do you think I should do the same now?

I have the idea that you only believe in synthetic drugs but:
I'm entering the 2nd month of Mastic Gum + Monolaurin + Manuka Honey.
There is evidence that these do something and at this moment I need EVERYTHING.
Do you know if they can interfere with the antibiotics, though?

I'm also planning on loading myself with pre&probiotics.
On the Amoxicilin 1st therapy, and despite I did take probiotics, I had a major diarrhoea 3 weeks after I finished it.
In Pylera I didn't. I used a different probiotic.

No, my doctor knows very little about my local strains because no sensitivity test to H. Pylori was ever performed.
All he knows is the biopsies results.

If it's true that my H. Pylori, in a couple of days, could change its genome to gain resistance to something I had never taken as Tetracycline then it can do ANYTHING...

Second opinion: would you be able to treat me if this fails?

Helico_expert
Site Admin
Posts: 4489
Joined: Wed Mar 02, 2011 7:20 am

Re: MALT Lymphoma

Post by Helico_expert »

I told her that Tinidazole is the same as Metronidazole to which H. Pylori is more likely to have gained resistance to than Tetracicline. She only replied that Tetracicline was in Pylera (2nd therapy) too.
From the laboratory, we have seen that H. pylori gain resistant to metronidazole much easier than tetracycline. Nevertheless, there are studies that shows that Tetracycline can help overcome metronidazole resistance.
I told her about the >95% success rate with added Rifabutin. She said that in a 4th line of treatment they might want to add Rifampicin, which is equivalent to Rifabutin.
It is true that Rifampicin is the same as Rifabutin.
Regarding the addition of Bismuth to this new 3rd therapy she said that Rabeprazole does almost the same as Bismuth & that in a 4th line of treatment Bismuth could then be added.
It is not true that Rabeprazole does almost the same as Bismuth. Rabeprazole stops acid secretion. Bismuth is oxidised in acid and become bismuth oxide, which then form a coating in the stomach killing bacteria.

Bismuth can be used repetitively because H. pylori cannot become resistant to it. Therefore, bismuth can be added to 1st line, 2nd line, 3rd line treatment to boost the cure rate.
It's common knowledge that one acquires H. Pylori in childhood…
it is common knowledge among H. pylori research group, but not common among general public and doctors.
I don't know why you wrote "i dont believe in the shielding theory"; I guess you were the one who suggested it in the 1st place and it makes perfect sense.
it is because antibiotics are absorbed in your blood and wherever the blood flows, every single cells will have contact with the antibiotics. H. pylori extracting nutrient from the stomach cells, cannot hide away from antibiotics.
Back to the doctor: she said that a probable cause for antibiotic-resistant is via eating food that contains antibiotics.
She advised me to eat organic, as much as possible, and avoid smoked red meats which may contain H. Pylori. I don't eat them anyway. But I do eat a LOT of vegetables which might be in contact with faecal matter whether they are organic or not.
With that said she was the 1st doctor at the institute who ever mentioned anything regarding Nutrition.
I revealed that over the last years I did eat farmed Sea Bream & Salmon, practically daily. These are said to be loaded in antibiotics. It's still hard to believe it can have this sort of impact.
It is possible that antibiotics can be detected in many food. especially in developing countries where antibiotics are abused by the farmer. This is one of the hottest topic in recent years. developing countries are brewing super bugs that are resistant to all antibiotics.

i think the safest is to have your vegetable cooked. germs will be killed, antibiotics will be destroyed. organic or not, it doesnt matter, as long as it's washed thoroughly and cooked well.
So if the Amoxicilin pack comes with more capsules than I'll need: how about upping the daily dose to 1g 3x day?
Yes, you can do 1g 3x a day.
There is no prescribed preference regarding taking them with food or without so:
If I feel well taking them on an empty stomach will they be more effective?
Or can they damage stomach lining?
we find no difference to take it with or without. So it's up to you. Prof. Marshall prefer after food. He thinks that it's better to have the drugs stay in the stomach longer.
During Pylera I made a low-iron & low-calcium food protocol.
Do you think I should do the same now?
Sorry, I am not sure. But we didnt control our patients' diet and achieve 95% cure rate.
I have the idea that you only believe in synthetic drugs but:
I'm entering the 2nd month of Mastic Gum + Monolaurin + Manuka Honey.
There is evidence that these do something and at this moment I need EVERYTHING.
Do you know if they can interfere with the antibiotics, though?
as long as you take the antibiotics. the rest is optional. These natural products are not harmful. and may be helpful with reducing side effect. So you can take them if you feel that they are useful.
Second opinion: would you be able to treat me if this fails?
Since Prof. Marshall works in the public sector, i am afraid the waiting list can be quite long.

ML-HELLico_Bacttle
Posts: 26
Joined: Wed Oct 24, 2018 7:32 am

Re: MALT Lymphoma

Post by ML-HELLico_Bacttle »

Dear Helico_expert:
From the laboratory, we have seen that H. pylori gain resistant to metronidazole much easier than tetracycline. Nevertheless, there are studies that shows that Tetracycline can help overcome metronidazole resistance.
On the other hand, following my great consumption of farmed fish over many years, today I found a study that shows that in a Aquaculture System and Aquatic Surroundings of my country they found Tetracycline and Fluoroquinolones!…
"Nice"…
I may have been poking my H. Pylori with a thin stream of Tetracycline and Fluoroquinolones for years…
I really HATE this profit-driven DUMB system in which our society is set!…
Now how do I get out of this trap?!…
I suppose the only chance would really be something they don't put in fish-feeding flower.
Instead the institute has put me breeding a more powerful superbug…

Rabeprazole stops acid secretion.
I've been trying to recover my stomach acid; now I charge it with a PPI…
Can at least Rabeprazole be a good door-opener for the probiotics to get to the intestines safe&sound?
I believe the diarrhoea I had 3 weeks after the 1st Amoxicilin+Clarithromycin therapy might have been C Diff.

Bismuth is oxidised in acid and become bismuth oxide, which then form a coating in the stomach killing bacteria.
At the Pharmacy I tried to buy/add Bismuth but the pharmaceutical didn't have it isolated. He said the molecule is usually composed with something else. So in which form can I buy Bismuth?

i think the safest is to have your vegetable cooked. germs will be killed
Cooking destroys part of the nutrition. A big part of what I eat is raw.
Is there ANY way to eliminate H. Pylori from raw vegetables?

antibiotics will be destroyed.
I didn't know antibiotics would get destroyed in cooking…
From that perspective the farmed fish I ate wouldn't have them afterwards…
I usually didn't overcook them tho.

Prof. Marshall prefer after food. He thinks that it's better to have the drugs stay in the stomach longer.
If acid interferes with the antibiotics absorption would it be better to avoid vinegar and lemon while taking them?
Last edited by ML-HELLico_Bacttle on Fri Dec 21, 2018 7:25 am, edited 1 time in total.

Helico_expert
Site Admin
Posts: 4489
Joined: Wed Mar 02, 2011 7:20 am

Re: MALT Lymphoma

Post by Helico_expert »

At the Pharmacy I tried to buy/add Bismuth but the pharmaceutical didn't have it isolated. He said the molecule is usually composed with something else. So in which form can I buy Bismuth?
Yea, there are many bismuth compound, which work similarly. We normally prescribe bismuth subcitrate.
Cooking destroys part of the nutrition. A big part of what I eat is raw.
Is there ANY way to eliminate H. Pylori from raw vegetables?
A good wash is good enough to remove most bacteria. However, i think H. pylori is the least you should worry about from eating raw. There are far more scarier pathogens and parasites in the soil.
If acid interferes with the antibiotics absorption would it be better to avoid vinegar and lemon while taking them?
interestingly, vinegar and lemon are weak acid. They are nothing compare to stomach acid.

****************************************

I think it is best you continue to look for a laboratory that can help you get antibiotic susceptibility test done. That will help you get H. pylori eradicated more efficiently.

ML-HELLico_Bacttle
Posts: 26
Joined: Wed Oct 24, 2018 7:32 am

Re: MALT Lymphoma

Post by ML-HELLico_Bacttle »

I think it is best you continue to look for a laboratory that can help you get antibiotic susceptibility test done. That will help you get H. pylori eradicated more efficiently.
Are you saying I should not even do this 3rd therapy 1st?
I haven't started but I'm about to.

Helico_expert
Site Admin
Posts: 4489
Joined: Wed Mar 02, 2011 7:20 am

Re: MALT Lymphoma

Post by Helico_expert »

how about do it concurrently? It's not easy to find a laboratory that is equip to do that kind of testing.

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