post Pylera regimen

[FarmGirl]

Did the three Ps: Pylera - Prilosec - Probiotics; ultimately tested negative for H pylori. Everything seemed great for a few weeks but suddenly, the bloat and gas are back. Doc suggests continuing the probiotic, but it also creates gas/bloat so I don't take it regularly anymore. Doc also recommends enzymes to help digest food (esp lipase and amylase), but that's a maze of information.

I'm confused. I really don't know what to take and what not to take/when and when not/how much and what foods to continue to avoid (acidic, yes, but others??). I'm all for homeopathy if it works.

The biggest difference I see in taking the PPPs over the 10 days and then testing negative was the huge, amazing difference in BMs.

Perhaps I expect too much too soon? Does the stomach/duodenum linings have to heal, and if so, does this take weeks, months, years? I've read on other forums that some folks continue to have the bloat and gas whereas others do not. I know we are all different with our symptoms, but why would we still have symptoms if the AntiB worked?

I would appreciate anyone with experience to explain this to me as well as to talk about homeopathic remedies and diet (and enzymes).
I really want to stop worrying about this business. I'm willing to do what it takes.

Thank you.

[Helico_expert]

it does take time for your stomach to recover. I believe it is your stomach adjusting itself, trying to get use to an environment without helicobacter pylori.

nevertheless, i encourage you to do a followup breath test 4 weeks later. remember to stop any acid reducing drugs for at least 2-3 weeks before breath test.

[FarmGirl]

Thank you for your reply.

When I went back for the initial breath test, I was still taking the acid reducer, Prilosec. Would that have produced a false negative (?).

Also I am curious about the time line of the regimen:

Pylera ended on May 10. Returned about 21/2 wks later for the breath test (still on Prilosec and Probiotics). As long as I was taking the PPPs, I had no symptoms of bloat/gas -----until this week: now, it's almost back to square one. I figure I ate something to set it off??? That's my confusion.

Thus, you are saying to get another breath test in a month?

Any specific diet for post-H pylori?

I would like to read articles that talk about the healing process post AntiBiotic for the lining of the stomach/duodenum and overall digestion. Is there research on that?

[JN13]

I'd like to know this as well.

After feeling pretty good (digestively-speaking), now some of the irksome symptoms have returned. Maybe I'm rushing the food thing.

Advice for how to proceed to get this healing thing under control?

Doc said to keep taking the acid reducer for two more months.

[Helico_expert]

there is not a lot of study on diet after h. pylori treatment. some studies do suggest probiotics after antibiotics. I believe that will help too as probiotics may prevent the bad bacteria growing in the intestine.

in regards to PPI after h. pylori treatment, that is normally recommended for patients with stomach ulcers. I think your doctor just assumed that you have and ask you to kep taking PPI. after all, PPI has been used for many years and proven quite safe. and if you do have ulcers, it'll heal during this period. However, if your h. pylori is still around, then your ulcer will not heal. therefore, it is important to make sure your h. pylori is eradicated.

by the way, Prilosec will definitely affect your breath test and give negative result.

[JN13]

by the way, Prilosec will definitely affect your breath test and give negative result.
Helico_expert

This is disheartening. What this tells me is that even the doctors don't know (and I suspect a big pharma rep sold her on the idea of Pylera). She didn't even prescribe the Prilosec. In talking with the pharmacist, he is the one who said that normally, an acid reducer works along with the antibiotic. Then, of course, he and I read the directions for taking Pylera and sure enough -- not one, but two Prilosec/day during treatment.

We, as patients, can be informed but only so far. What in the world are we suppose to do? It's very expensive (the Pylera alone was $552 for 10 days' treatment), time consuming, disruption of life, emotional to deal with and the side effects -- AND we're still telling the doctors what regimen we need?

Thanks for this forum and for you, "expert". I would never have known that Prilosec affects the breath test and gives negative result.

[Helico_expert]

it takes about 1-2 days for Prilosec to completely turn your stomach neutral. when the stomach is neutral, H. pylori will turn off the enzyme that neutralize the acid. or else it'll be too acidic and they'll die (very smart).

so when did you do breath test ?

[JN13]

Ended Pylera on 5/10/13
Helico expert, you asked when did I take breath test.

Timeline:
Pylera ended on 5/10/13
Continued Prilosec (one after breakfast) and Probiotics, as prescribed, until Breath test: 5/21/13 -- negative

Doc said to stay on Prilosec for two more months "to help heal" stomach.

Yesterday, 6/8/13, I stopped Prilosec. How long must I wait before taking second breath test?

Also curious to know: how long does Pylera (or the antibiotic) stay in the stomach AFTER you stop taking it? I'm wondering if that is why my symptoms went away for a few weeks?

While I'm writing all this: is there a resource link that lists doctors of Internal Medicine in U.S. who have special knowledge of H pylori? I want to find a physician that I don't have to tell what to do to make me well.

You are right: the H pylori bacterium is fascinating from a research standpoint. I enjoy reading about how it evolves and sustains itself. Pretty clever, indeed.

[Helico_expert]

How long must I wait before taking second breath test?

you'll have to wait 2-3 weeks before doing breath test.

how long does Pylera (or the antibiotic) stay in the stomach AFTER you stop taking it?

everyone has different metabolic rate. So i think the drugs should only stay in your body for 1-4 days.

is there a resource link that lists doctors of Internal Medicine in U.S. who have special knowledge of H pylori?

Sorry, that I cannot help you. I am sure there is a lot of great doctors in US. perhaps you just need a second opinion or a specialist.

[JN13]

Thanks for the answers.

Turns out, I went online and found a couple of research scientists in the area studying H pylori, who are also associated with the university hospital. With any luck, may be able to find someone (MD) close by.