Helicobacter Forums

Both by vision during endoscopy and by histology (mild chronic gastritis)

Saw the gastro yesterday and he said that in the histology they have definitely seen the H Pylori organism and said this was the gold standard check looking for actual bacteria and not the signs of it as is the case with stool and breath test.

He has now asked to do another 14 days triple therapy course of Amoxicillin, Lerofluoxecin and and PPI. He has I could also take Cimetidine if needed.

Do you think my acidity symptoms which comes and goes are because of the gastritis caused by H Pylori or it could be just stress etc causing them.

your doctor is responsible for your overall well being. Perhaps the histology is true. perhaps you have been reinfected? have your family been tested?

now that you have been given triple therapy.. do you want to add bismuth to your treatment?

Could it be that the viral load is very small for its traces to be detected in stool or breath tests but was seen in the histology as was the gastritis?

The Gastroenterologist has now said to do a 14 day antibiotics + PPI treatment

Amoxcilline 1g TB
Levofloxacin 500mg TB
Dexilant 30mg TB

He said I can also take Cimetidine 400mg up to 4 x a day to keep the acidity in control

Do you think adding bismuth will help?

Have you seen people combining PPI with H2 blockers?

What is the best regime to follow for the next 14days in terms best times in the day to take antibiotics and ppi to maximise efficacy?

Is Levofloxacin better than Clarithomycine and Metronidazine?

Have you seen cases where 3 treatment fails and the person just have to live with h pylori?

Sorry the antibiotics and PPzi course is for twice a day for 14 days

Is there any rules to follow to maximise the efficacy of antibiotics? Can I have milk in the morning half an hour after having antibiotics? Should I take ppi before or together with the antibiotics?

hmmm.... the problem is that it is very difficult for serology to get false negative.

But histology is the gold standard. Assuming that pathologist is experienced (usually is).

Levofloxacin is not better than Clarithromycin and metronidazole. I would say they are about the same. Nevertheless, levofloxacin is normally reserved for worse disease. A combination with amoxicillin is ok. It will be better to boost it with bismuth. The reason is because H. pylori can develop resistance to levofloxacin quite easily. Probably not many doctors know about it.

Milk is mainly affecting the tetracycline. But if you are concerned, you can avoid it totally during the treatment.

PPI and cimetidine have the same purpose, that is to stop acid secretion. They can have synergistic effect. The antibiotics do work better in a more neutral environment. Therefore, the strategy is to keep the acid level low at all time. It is better to have multiple dose of PPI rather than single dose. for example 20 mg twice a day is better than 40mg once a day. three times a day would work even better. So take it consistently throughout the treatment to maintain the concentration in the body. It doesnt matter if it's with or without food/antibiotics; before or after meal/antibiotics.

cimetidine is a fast acting drug (but "short-lived"). So it is best to take it 30 min before meal or hunger.

Thanks. That is super helpful

So if required I could take Cimetidine or Famotidine together with Dexilant x 2 per day?

The lab found mild chronic gastritis associated with occasional helicobacter on the surface

Does that mean that the concentration of helicobacter is low but enough to cause chronic gastritis ? Assuming it is type B gastritis not type A

How would they know that it is a chronic gastritis and not acute?

How do you cure gastritis?

So if required I could take Cimetidine or Famotidine together with Dexilant x 2 per day?

I think it's ok. but you better consult your doctor

even if you have low H. pylori, there will still be gastritis. The pathologist will be able to tell if the inflammation is "active" or "non-active".
an active gastritis means the white blood cells are still hunting for pathogen.
a non-active gastritis means the white blood cells are just gathering.. probably in the process of retreating.

the "acute" or "chronic" gastritis you meant probably refer to the symptoms. in layman's term, acute gastritis means quick and intense pain.

The histology report said "mild chronic gastritis associated with occasional helicobacter organism on the surface"

Given my acidity symptoms and evidence of helicobacter on the surface I assume that it must be active

Another strange think in my case is that in the first endoscopy in October 2020 helicobacter was found but no gastritis. Now both have been found which probably explains to some extent the probable cause of my symptoms

I think it's probably worth while to go back to your doctor to ask for a second look at the histology. Find out if it's active or inactive gastritis. Also, was the bacteria on the surface determined by special specific immune stain. The immuno stain will be definite if there is H. pylori.

If it's inactive gastritis, the surface bacteria may not be H. pylori.

if it's inactive and there is H. pylori, then something is wrong.