Helicobacter Forums

I have started the antibiotics course and just wanted to get a few tips to make it most effective

My breakfast is usually banana, Dates and oats milkshake and I also have yogurt with dinner.i understand that diary products can affect antibiotics

I can stop yogurt for 14 data but stopping my morning milkshake will be very difficult

Can I have dexilant at 8am and milkshake at 8:30am

Antibiotics at 10:30am

Lunch at 1pm with probiotics

2nd dexilant at 6:30pm and dinner around 7pm

2nd Antibiotics at 10:30pm

Would having little milk in my afternoon tea affect

PPI is to get absorbed into the bloodstream to be activated. So it doesnt matter with or without food.

if you are asked to take 2 times a day, you take it every 12 hours.
if 3 times a day, you take it every 8 hours.

spread out the medication evenly will help maintain the effective drug concentration in your blood.

I have been taking Amoxicillin and Levofloxacin together. Should I take them separately? Eg

5am- Amoxicillin 1g
7am - Dexilant 30mg
11am - Levofloxacin 500mg
3pm - Famotidine 40mg (if needed)
5pm - Amoxicillin 1g
7pm Dexilant 30mg
10pm Levofloxacin 500mg

Would this regime work better for next 14days?

This would be my third H Pylori treatment but not once has any doctor prescribed me bismuth. Is it not typical for them to prescribe this?

Sorry couple more questions

Can I take antacids during the 14 day antibiotics course as I have definitely found an increase in acidity 2 days into the course?

Have you seen 7 day triple therapy succeed in comparison to the 14 day treatment?

You can take Amoxicillin together with levofloxacin.

Some doctors are reluctant to prescribe bismuth because it's not easy to buy them. The side effect of bismuth is dark stool and that confused some doctors for internal bleeding. Because of that, bismuth was banned for many years. Only until recently, bismuth was used again because of massive antibiotic resistance.

In general, 14 days have better cure rate than 7 days.

I have now completed the 14 days course of Amoxcilline 1g x2, Levofloxacin 500mg x2 and Dexilant 30mg x2.

Since doctor did not prescribed bismuth I did not take this.

If I can find Bismuth can I take it own its own for say a week or it's not worth it?

Have you come across cases where stool and breath test have come back negative (no ppi for 14 days) but biopsy/histology was positive ?

Can people be free from chronic gastritis symptoms after eradication or would it take years ?

bismuth on it's on has maybe 20-30% chance of getting rid of HP. The side effect is very little. it works better with combination with other antibiotics. So it's up to you to try.

It's rare for breath and stool test to come back negative, but histology positive. This can probably happen when your stomach acid is low.

Majority of our patients return to normal after HP eradication. Some still experience milder symptoms after HP eradication.

Hi HelicoExpert

What do you mean that with low stomach this could happen?

Do you need to have a particular bacterial load in the stomach to have a positive breath or stool test? I mean could it be that my bacterial load is so small that both stool and breath tests were negative but histology saw the actual bacteria (Assuming that the pathologist knew what it was)

Despite the negative blood test, Stool test and breath test but given my on and off gastric symptoms plus evidence of mild chronic gastritis that too in the antral area and visibility of occasional helicobacter in the tissue sample suggests that it is still in my system. I hope the latest therapy has killed all of the bacteria but I guess I will not know until I do another endoscopy as I can't rely on stool or breath test anymore

H. pylori has a special ability to produce ammonia to neutralize the acid in stomach environment.

Also, in order not to produce too much ammonia which can make the territory too alkaline, it can regulate the amount of ammonia secretion according to the acid level.

the breath test is targeting the enzyme that breaks down urea into CO2 and ammonia. Therefore, when there is no acid, the enzyme is turned off, and so the breath test would fail.

when there is no acid in the stomach, all other bacteria can start growing. H. pylori will be out compete by other bacteria. But H. pylori cannot be eradicated. Hence, when acid level is low, the number of HP can also reduce, leading to false negative stool test.

Thanks. That's quite fascinating to hear how H pylori works

What I have still not fully understood is why do some people like myself with h pylori have acid reflux symptoms? Does the presence of h pylori cause our natural defence system to produce more acid but h pylori is to escape it.

If h pylori produces ammonia to neutralize the acid then this seems contrary to symptoms which are acid reflux related and is relived to some extent by antacids and ppi.

Have you seen people with 3 or more triple therapy treatment failures. Can this be removed by surgery?