Questions: Almost finished Triple Therapy

[Tweenie]

I hope I can get a few questions answered on this forum. I apologize, in advance, for this long post!

I was diagnosed with HP back in 1997 via endoscopy. I started but did not finish the treatment at that time. I don't remember what they gave me but it made me feel sick and I quit.

In November, my doctor had me start Ferrous Sulfate iron tablets starting with 325 mg for one month and then 650 mg for another month. By Christmas, my stomach was hurting so bad, I was bloating and just feeling terrible. My doctor took me off of the iron and I asked her to re-test me for HP. Sure enough, I still had it. I have never had an ulcer but the ache felt like a kind of "stitch" under my left rib and I felt like I had the worst hunger pangs EVER. My doc said she would not send me for a scope because even if I did have an ulcer, the treatment for HP would be the same.

I am on day 5 of my triple therapy of Lansoprazole, Amoxicillin and Clarithromycin. I was pleasantly surprised to have very little reaction to the pills in terms of stomach upset, etc. I do try to keep my stomach filled with herbal tea or crackers all day.

Does anyone know if iron treatment can cause HP to come to the surface again and perhaps cause an ulcer? If I do have an ulcer, will the treatment for HP do the trick and fix it? Should I be re-tested after I am finished the treatment? I really do want to be sure that it is gone this time. I just wish I would have stuck with the treatment years ago. I don't think I knew back in 1997 what the risks were of having this awful bug in me so I have been quite concerned about getting rid of it.

Any light you can shed on this is appreciated.

[Helico_expert]

H. pylori soak up iron like a sponge. Therefore, getting of H. pylori may fix your iron problem.

H. pylori can stay in body for a lifetime unless antibiotics are taken. Since you had a treatment many years ago and did not finish the course, it is possible that it has gained antibiotic resistance. Nevertheless, through time, H. pylori may loss the antibiotic resistant gene as there is no selection pressure. Therefore, please remember to get a breath test done one month after you finish your current treatment.

Your doctor is right. Many doctors do not give endoscopy as the treatment is the same. However, if you fail your current treatment, I would recommend you to get an endoscopy and request an antibiotic sensitivity test. That will increase your success rate in your next treatment.

getting rid of the H. pylori will fix your ulcer (if you do have one). However, NSAIDs (such as aspirin, ibuprofen, and etc) can cause ulcers too.

[Tweenie]

Thank you so much for the reply.

I finished the 7-day triple therapy three days ago and my stomach felt better while I was taking the medication! For the last two days, my stomach feels quite unsettled - a little bit nauseous and I still feel that "stitch" on my left side - under my rib cage. Is this normal?

[Helico_expert]

I think it's the side effect kicking in. However, if the discomfort persist another few days, then you should see a doctor. Also, remember to do a followup breath test one month after the test.

[Tweenie]

Do you mean side effects from the triple therapy? But I was fine throughout the whole treatment and it was when I finished it that I started to feel this way. I'm bloated and full of gas again with some nausea. Will it help if I take probiotics ?

[Helico_expert]

i am not sure if probiotics will help. you may try and find out. afterall, your guts normal flora has been reset. lets just hope that its not because your triple therapy failed.

[Tweenie]

Thank you for your comments, Expert.

I'm wondering, just how common is stomach cancer when you have been infected with HP? It worries me.

[Helico_expert]

the cancer rate due to H. pylori is very very low. It's probably less than 1% among all the infected patients. Factors that increase stomach cancer include. 1. Genetic; 2. Diet; 3. H. pylori

1. if your relatives have stomach cancer, your risk is much higher with or without H. pylori
2. Regions with high stomach cancer rate are places where people who consume high amount of salt.
3. H. pylori is associated with many stomach diseases. Stomach cancer is only a tiny portion among all the stomach diseases.

[Tweenie]

Thank you again, Expert. I am really hoping that the bug has been eradicated. In the meantime, my stomach is not feeling great...still a feeling like a bubble under the left side of my rib cage. Also, some nausea and gas. I don't drink coffee anymore or eat spicy foods, etc. even though I love both. I will ask my doctor to re-test me in a few weeks. Any other suggestions? Do you know if others who go through treatment experience the same symptoms after treatment?

[Helico_expert]

I think the best is to talk to your specialist who can do a physical examination on you. Otherwise, you just need wait until you do the breath test. Since you were taking iron tablets, you may want to monitor your iron level as well?