Helicobacter Forums

Dear Helico Expert,

I've been suffering terribly for the past 6 months and will be indebted if you can help with me with my questions below.
I honestly don't know what's wrong with my body and it's decimating my once peaceful life.

My history in brief:
-6 months ago I was completely normal (prior to which years of heavy alcohol use and unhealthy diet)

-Oct 2018: Developed gastritis like symptoms to which Omeprazole 10mg, Gaviscon didn't respond (General Physician)

-Nov 2018 - Jan 2019: Unbearable heartburn, chest pains, arm pains led me to several Gastroenterogists, Endoscopies
Endoscopy Diagnosis: Grade A/B Reflux Esophagitis, Antral Gastritis, No ulcers, no Hiatal Hernia
Treatment: Esomeprazole, Pantoprazole & Famotidine in various 20mg/40mg combinations along with Gaviscon

-Feb 2018: Decided to shift to Ayurvedic treatment for a month.
Results: Natural sleep, Bowel movements & Appetite improved but acid reflux, chest pain symptoms remained the same

-March 2019 - April 2019: Started getting severe anxiety triggering the vicious cycle of reflux-->heartburn-->anxiety-->worsened symptoms
Treatment: stopped all PPIs and survived with Alprazolam (anxiety pill)

*General blood-work during this period were normal or borderline (CBC, FBS, HBA1C, Lipid, Liver, Kidney, Pancreas, Thyroxin etc)
*Cardiologist attributed my symptoms to GERD/Anxiety after Standard ECG, Treadmill Stress Test & Echo Test
*My diet for last 6 months: White rice & vegetables, chicken, bananas, fish andrecently beef soup,
No wheat products, No dairy products, No Alcohol/Smoking, none oily/spicy, no chocolate or carbonated drinks

My present condition:
-May 2019: Prayers led me to a documentary on Dr. Barry Marshall and then you on this website
-I consulted another local gastroenterologist last week and he ran 2 tests (Vitamin D3 & Full Stool Occult Blood Report) to which I added H. Pylori
Stool Antigen & Stool Antibody seperately
Results: Vitamin D - Deficient, Full Stool Occult Blood - Normal
H. Pylori Stool Antigen - Positive, H. Pylori Blood Antibody - Negative

-He put me on my first ever Triple Therapy: Amoxicillin 1g, Clarithromycin 500mg, Rabeprazole 20mg, Mosid Citrate 5 mg = Twice a day
along with Vitamin D & Multivitamin supplement = Once a day

-First 8 days:
No side effects + about 10-20% improvement on my usual symptoms:
Heartburn, weird pressure/pain on my LES coming from within the stomach when I lie down (even after allowing 2-3 hrs for gastric emptying)
Chest/Arm/Back/Leg pains, Palpitations, tinnitus, anxiety attacks

-Day 9/10: Diarrhea Nausea, Feverish, Headache, Lightheadedness, Faintish, Body/muscle pains, Blood Pressure fluctuations, Palpitations

Questions/Worries:

1) My immediate worry is: will my heartburn-anxiety attack cycles cause arrhythmia, heart attack or stroke one of these days; some online research
revealed that H. Pylori can affect various systems inside the body apart from causing standard GI problems.
I'm currently managing with a tablet of Alprazolam if my chest pains, anxiety is severe

2) Can H. Pylori grow on esophageal lining damaging the LES causing it to malfunction or maintain proper pressure? I've been desperately trying to understand if it's my LES that's not closing properly or is it because of H. Pylori, Candida overgrowth, Flora imbalance, other Parasite or even a bile Reflux problem

3) Generally how long after infection does H. Pylori start causing problems? Mine started just 6 months ago and I've never had symptoms before, could I have contracted H.Pylori couple of years before?

4) My current doctor advised I should take a Prebiotic/Probiotic for 2-3 months after Day 14 of Triple Therapy; Symbiotic Plus from Sensilab:
Active ingredients: yeast Saccharomyces boulardii 2.5 x109 CFU, bacteria Lactobacillus rhamnosus GG 6.0 x 109 CFU, inulin 50 mg

5) How long should I continue Rabeprazole after finishing Triple Therapy

6) Where I'm from (Sri Lanka) doesn't offer the technology to grow H. Pylori culture to test which combination of Antibiotics works best on my case
I'm just concerned that my triple therapy may not work..could I ask your advise on that?

I know I'm asking for a lot but you are my only hope right now.

Thank you so much,
Shane Christopher
Sri Lanka (Age 35)

First of all, please remember that this website can only provide source of information. I cannot provide any diagnosis or any recommendation. Your gastroenterologist is the one that can physically examine you, prescribing you antibiotics and responsible for your overall well-being.

1. This website focus on the eradication of H. pylori. Although H. pylori may lead to other problems, it is best you seek examination from your gastroenterologist for your GI problem or cardiologist for your chest pain problem.

2. H. pylori can cause damage to LES. perhaps due to inflammation and reflux symptoms. Let's assume that it's due to H. pylori. Focus on getting rid of it first.

3. H. pylori infection is a very very very chronic infection. Usually people catch H. pylori during childhood. It can stay in human body without causing any symptoms for decades. However, for those who get symptoms, the peak is usually at around 25-35 yrs old. Once you get symptoms, the condition only get worse as time goes by.

4. probiotics are harmless. Some people find it useful and some dont. So take it if it makes you feel better.

5. Once finish the treatment, you should continue rabeprazole according to your condition. Some people take it for months or years. rabeprazole is pretty safe to take long term.

6. be optimistic. finish this course of treatment first. usually you have to stop PPI and antibiotics for 2 weeks before follow up and see if you still have H. pylori. if you have to take PPI due to the symptoms, you can switch rabeprazole to ranitidine for 2 weeks. ranitidine will not affect the stool/breath test result.


Discussion:
it's very weird to see stool test positive and blood test negative. Usually blood test is rarely wrong with negative results. Blood test is usually wrong with positive results.

You can boost triple therapy cure rate by adding bismuth and doubling PPI dose. We prescribe 20mg rabeprazole, 3 times a day.

Thank you very much Helico Expert for your response and valuable input.
I shall discuss with my gastroenterologist and continue the battle.

Could you kindly share if unintentional weight loss (10kg in 3 months) and tinnitus are known symptoms of H. Pylori?

Appreciate it,
Shane

Is stool test a better alternative for h pylori ..if you cannot manage to have brearh test

tinnitus is not a typical symptom of H. pylori infection.

stool test is as good as breath test.

weight lost of 10kg can be a worry. but as long as you are still within the healthy BMI, then it's ok.

Thanks Helico Expert, that helps..

Could I take an anti anxiety med like Alprazolam while on Amoxicillin/Clarithromycin therapy..any known drug Interactions? My anxiety is causing palpitations and chest pains which is really distressing..I’ve been taking Alprazolam but stopped it before I started triple therapy.

Thanks a lot,
Shane

Alprazolam should be fine. But you should always check with your family doctor. He is after all responsible for your well being, not me, not the website.

Thanks. Absolutely..just drawing some input from your experience in studying various cases over the years..sometimes getting through a strong course of antibiotics can be stressful causing anxiety which is also associated with GI Issues and Vagus nerve irritation. Wanted to know if you came across any anxiety drug interaction with H. Pylori treatment.

Amoxicillin and Clarithromycin are pretty safe and low side effect. You'll probably get some taste disturbance from Clarithromycin, where you'll constantly taste "metal". So just ignore it. It kinds of reminding you that you are on antibiotics and assure you that all your oral H. pylori is getting it as well.

all the best to your treatment.

Wow..didn’t know H. Pylori lives in the mouth as well.
I’m on my 11th day..feeling really weak and malnutritioned although I eat 3-4 times a day. Perhaps the intestines are not able to absorb the nutrition from food due to good bacteria being wiped out from therapy?

Somehow mustering the courage to get to Day 14..

Do you think it makes any sense if I started introducing the Probiotic/Prebiotic capsules before Day 14..will it hinder the antibiotics from doing the primary job of eradicating H. Pylori?

On a further note..could you kindly share an effective Prebiotic that you usually prescribe and the ideal dosage and typical duration?

Let me also take a moment to thank you for all the help and support so far and tell you how much I appreciate the work that you, the website and the management are doing to help us all over the world who are suffering and grappling with this awful condition.

Cheers,
Shane