post Pylera regimen

[JN13]

Helico expert, you wrote:

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).


If that's true, then why do we keep taking the Prilosec with the antibiotic -- it seems like it is a cat and mouse kind of game. We take the acid reducer to neutralize the acid, but H pylori figures out how to get around that. Is that why we have to take the AR daily? Would you go into more detail about the behavior of they do that?

Also, I thought H pylori LOVED an acid home?

[Helico_expert]

H. pylori survive in acidic environment. but it actually prefer to grow at neutral pH.

you take PPI for at least 2 reasons.
1. there is no acid to attack the ulcer. so ulcer get a chance to recover.
2. antibiotics work better in neutral pH. acid will destroy antibiotics.

perhaps you like to know why the stomach acid is not dissolving your stomach? it's so acidic that it can corrode almost anything.
it is because your stomach is constantly producing a thick mucous to separate the acid and the stomach wall. H. pylori "dig" itself into the mucous through tight junctions and pores in the mucous to the stomach wall and live there happily. so when H. pylori is "outside" the mucous, it turns on the urease enzyme and neutralize acids it encounters. when it is "inside" the mucous, the continuous activation of urease will create an environment too alkaline that will kill itself, so it turns off urease.

let me know if i have not explained enough.

[JN13]

Learning about their behavior is pretty fascinating and may help in understanding how the drugs work. So this "urease enzyme" -- is it the target of the antibiotic?

I asked my doctor why the hydrochloric acid didn't kill the bacterium and she said it had no effect. What I gather is that H pylori is in the mucous and is safe. Which means that the antibiotic has to penetrate the mucus lining to kill it and the PPI reduces the acid so that the antiB can work effectively.

Does that activity in turn increase the urease enzyme produced by H pylori? I would assume the bacterium has defense mechanisms that kick in?


I'm also curious about this: why would H pylori be living "outside" the mucous if it prefers to be inside?

[Helico_expert]

it is interesting how H. pylori survived in the harsh environment. It is also important to know so we know how to kill it.

it stays outside the mucous to it can "travel" to other parts of the body (upward or downward) to help it spread.

the urease enzyme is not the target of antibiotics. there is no specific drugs designed to inhibit the urease enzyme. I guess it's too expensive to develop such drug. nevertheless, i know there is some projects going on to develop vaccine to target some proteins related to urease.

[JN13]

Went back to physician today because symptoms have increased dramatically since I stopped PPI (stopped everything but an occasional Probiotic that also seems to cause bloat.

My physician did not know that I was suppose to stop Prilosec for 2-3 wks prior to breath test. So we did that again as well as more tests for liver function and pancreatic enzymes.

I am still confused: if I am negative for H pylori, then is it pure coincidence that all my symptoms went away during treatment and I was able to eat anything I wanted (after a long period of time). Subsequently, 2-3 wks later, symptoms returned slowly but surely. And then, once I stopped the Prilosec completely, even more symptoms emerged and with a vengence. Is that nothing but coincidence?

Is there other diseases or problems that would mimic H pylori and be treated (or masked) by the antibiotic, then raise its head again after treatment? I thought Pylera was an AntiB designed to specifically target H pylori. See why I'm confused?

I would really like to hear someone's knowledgeable response. I hope I have expressed myself clearly.

[Helico_expert]

I think most importantly is to wait for your breath test result.

Pylera was a combination of antibiotics that is marketed for H. pylori, not specific for H. pylori. Therefore, it sometimes unintentionally cured other underlining bacteria/parasite infections. For example, rosacea, a skin disease, was reported cured after H. pylori treatment.

Nevertheless, let's hope your result is positive. then we can formulate a second treatment plan. If your result is negative for H. pylori, that means your problem is not H. pylori related and need other specialist to investigate.