Helicobacter Forums

Right but see that's what I'm trying to say.. I haven't had any problems with acid, acid reflux in a long time. I haven't had the need to take any antacids or PPIs in over a month now for some reason. In fact it's the opposite, I have low acid! I even bought some supplement called HCl Betaine and taken a few with meals.
I also did the sodium bicarbonate water test and I don't burp at all meaning I'm lacking acid. So why on earth would I need to take a PPI to suppress acid secretion if I'm already really low on it? It simply doesn't make any sense to me and personally seems a bit dangerous and could make things even worse imo. I would understand taking a PPI if I felt I had acid burning in my stomach and believe me I know that feeling. But I haven't felt that in a very long time.
Now I read that helico can also block acid secretion is this true (hypochlorhydria)? This is confusing to me cuz I thought helico thrived/caused more acid production not less?

Are u still advising I take a PPI even tho the helico is reducing my acid output? Logically it makes no sense but hey I'm not an expert..

hmmm.. H. pylori causes inflammation. I believe it's the inflammation that affect the acid secretion.

I believe because everyone has different immune response, hence difference inflammation pattern, which lead to different disease outcome.

majority people (say about 80%) have no change in stomach acid secretion. Hence no symptoms.
a small group of people (about 20%) have more acid secretion. Hence stomach ulcers.
a even smaller group (less than 1%) have low acid secretion. Also no symptoms. But higher risk of gastric cancer.

Nevertheless, since your endoscopy report did not show anything abnormal, you'll be in the low risk group. I am not sure how true it is that you have low acid. You may feel that you have low acid due to very good bile secretion that neutralise the acid quickly.

Hi, sorry for the late reply, I've been deciding whether to do the treatment or not, delaying it everyday but I decided finally since I cant stand vomiting everyday and the brain fogs fatigue etc. I'm on my 5th day so far. To restate this is my therapy twice a day for 2 weeks:

-first a PPI (20mg Pantoprazole)
-then 30min later: bismuth subcitrate 240mg
-then 30min later: eat a meal
-then take the 2 antibiotics: amoxicillin 1g and clarithromycin 500mg
-and finally a probiotic (w/ L.boulardii) 2hrs afterwards

Is this treatment fine and in the right order?

The treatment so far hasn't been pleasant at all: gross bitter taste in tongue all the time, stomach pains (this is the worst), general unwell feeling.

Just a few questions I have if you don't mind:

1) I don't tolerate PPIs well as I mentioned before, but I realize through much research on the internet that without taking them I cant effectively eradicate the bug apparently. Is my 20mg Pantoprazole twice a day sufficient? Yesterday I decided to not take it in the morning but took it in the evening.. I wanted to see if I would feel better and I kinda did. I hate being forced to take a drug that I cant tolerate well, but ill try to hang in for the remaining 10 days I have some how. What if I took a 20mg rabeprazole 1x say in the evening? Could this effectively replace my current 2x20mg pantoprazole?

2) Also, how important is it that I take the bismuth subcitrate? Remember I have non-ulcer helico. I dunno if you saw my youtube video of my gastroscopy but it looked pretty clean, the doctor even said, just some mild gastritis. Is bismuth used only for people with ulcers?

3) And I saw some researches of 7-day therapy, 10 and 14. So how long should I go for considering I don't have the worst case of helico and my stomach generally appears fine (no ulcers)?

Lastly I just want to mention that today I measured an all time low my weight is now 67.5kg and I'm a 36 yr old male at 180cm, its very underweight.. I was 81kg last year and 75kg before all my troubles began in May of this year. I really hope this is all due to my helico and that I eradicate it successfully so I can regain my weight! 75 is optimal for me..

Thanks again for your feedback!

hmmm... vomit is not a common symptoms of H. pylori. But nevertheless, it's good to have H. pylori eradicated anyway. In addition, the strong antibiotics may knock out whatever pathogen is giving you the vomit symptoms too.

The bitter taste is most probably from clarithromycin. It is absorbed in your blood and distribute throughout your body, including your saliva. So you can constantly taste it. It also indicates that the H. pylori that may be hiding in your mouth will get kill too.

1. Rabeprazole is the same as pantoprazole, but due to the slight different structure, some people may metabolise it differently. I wouldnt recommend substituting pantoprazole 20mg two times a day with rabeprazole once a day. However, if you find rabeprazole better, you can try rabeprazole 20mg twice a day. It doesnt really matter when you take it. most importantly is to have the pills taken evenly spread out. for example, twice a day means you will take it every 12 hours. three times a day mean you will take it every 8 hours. The idea is to maintain the high concentration of drugs in your blood. So there is no chance for H. pylori to become resistant to it.

2. bismuth subcitrate has two functions. one is to kill off H. pylori. and the other is to prevent C. diff complication. It doesnt have much side effects. So i would recommend you to continue taking it.

3. 7 days, 10 days, or 14 days? In general, the longer you take, the better the cure rate. but also the worse of side effect. we normally prescribe 10 days and have a cure rate of over 90%.