Helicobacter Forums

So upon a having an upper endoscopy, I was diagnosed with mild gastritis. The biopsy taken from the area tested positive for H.Pylori. My doctor has prescribed the Prevpak to treat the HP. I have taken a number of PPI/H2 blockers (zantac,pepcid,dexilant). They have all given me some pretty bad side effects such as sore muscles, headaches and indigestion.

I want to rid myself of HP, but I do not want to go through the side effects of Previcid. Would the antibiotics still work if I decided not to the take the previcid. I suspect the prevecid is in there to ease the discomfort of heartburn. Is there any added benefit to the combination of Previcid with the antibiotics? I don't want to sound like a pharmaceutical conspiracy theorist, but I feel like all H2 blocker/PPIs are dangerous. They initially relieved some discomfort from eating, but eventually my acid levels were so low that I couldn't digest anything efficiently and it was contributing to bloating, putrification and indigestion. I worry that this puts the drug taker in a bad cycle of going on and off these acid lowering drug. I understand that it is rare that people suffer from excessive acid production but the norm is that not enough acid is produced. If that is truly the case, why are we treating stomach problem by further inhibiting the ability to digest?

I also suspect I had a hiatal hernia. With some massage techniques and breathing techniques I have been able to get the hernia to drop. All my episodes of heartburn and panic attacks seem to occur when my insides were up in my ribs. I was able to address this a few weeks prior to my endoscopy and I was not diagnosed with a hiatal hernia. By being aware of my stomach position, I've been able to control my heartburn.

sorry about the long entry. but the main question is:

Would the prevpac therapy still work if I decide not to take the prevacid?

Hi,

The 2010 august issue of the GUT magazine ("Helicobacter Pylori Treatment in the era of increasing antibiotic resistence") has an interesting explanation for the use of PPIs during eradication treatment.

Basically, it says that Clarithromycin and Amoxicillin are antibotics that require microbial replication to kill organisms such as Helicobacter Pylori, which means these organisms need to be replicating for the antibiotics to be effective. But at any one time, a proportion of these organisms are not replicating, making it difficult for the antiotics to do their job. That's when the PPIs (Omeprazole, Lansoprazole...) come into play! PPIs reduce the amount of acid in the stomach to make the environment more adequate for replication. When the organisms start replicating, the Clarithromycin/Amoxicillin kick into action.

Also beware that most packs out there don't contain the correct dose of antiotics. For example, Prevpac is composed of:

lansoprazole 30-mg) Capsules
(amoxicillin 500-mg) Capsules
(clarithromycin 500-mg) Tablets

BUT the standard triple therapy is:

lansoprazole 30-mg OR Omeprazole 20mg Capsules - twice daily
amoxicillin 1000-mg Capsules twice daily
clarithromycin 500-mg Capsules twice daily

So note that Prevpac has half of the suggested dose for the standard triple therapy. You might be better off just buying each medication separately.

Hope you get well soon!
Luci.

Hi Luci:

I believe you are the moderator of this forum? My name is John, I´m 35. I live in South America. Oh boy, let´s see if I can explain you my situation a little bit.

I was diagnosed with H. Pilory several years ago, several years in a row. I never gave any importance to it, neither my GI doctors here, until I started to have real chronic symptoms all of the sudden.

Now I have chronic bloating and reflux, and even ocassional shortness of breath. I also have sleep apnea related/agravated by the reflux. Needless to say, I need to treat my H. Pilory. I just went on this trip to the USA where I took the breath urea test, which we don´t have here. I tested positive.

So now I wanna take the antibiotic treatment for H. Pylori, but i kind of wanna either self medicate upon the best advise from this forums of take that info to a doctor and have then prescribe me the medication. It´s funny doctors here don´t give much importance to H. Pylori. They say everyone has it, but it´s no big deal. Ironicly, Colombia, my country, is one of the worst ones on H. Pylori and stomach cancer.

So, by no means I´m saying I´m gonna do whatever I wanna do without taking a well informed decision, but I wanna take this matter into my own hands or at least try to help myself. Is there any way you can tell me what the best antibiotic therapy for H. Pylori is? Or perhaps where I can look for help on this. Also what´s the best way to take it (dosage, combination, interaction/time of the day to take each drug)?

I realize this could be a big imposition. Please feel free to tell me if you can´t help me. Any help will be appreciated. Thanks,

John.

Hi John,

I'm not the moderator... The moderators of this forum have not responded since February, so I think it's safe to assume that this forum is no longer moderated. But I'm happy to share the little knowledge I have.

You should to try to identify any possible resistance to antibiotics. You should begin checking the regional antibiotic resistance surveillance statistics for both your home country and the country you have been living in. This information is usually available online, do a search on google or ask your doctor where you could obtain this information. I'm Brazilian and I found out that in Brazil there is over 50% resistance to Metronidazole (which is the most common antibiotic used for eradicating HP). The higher the resistance rate, the less effective will be the antibiotic. Also, try to remember the name of antibiotics you have been given in the past as you may have built up resistance to them.

Another way to check antibiotic resistance, is to go through an endoscopy with culture and antimicrobial test - where they take a biospy (a sample of the bacteria in the stomach) and send to the lab where it will be grown in vitro and tested with different antibiotics to see which ones are more effective. Killing HP in vitro (outside the human body) is said to be easier than in vivo (inside the human body), so the tests are not 100% conclusive. Please note that this is an intrusive and expensive procedure (if you don't have insurance), and may not be your first choice. This is usually done on people who had failed HP eradication treatments. But you might want to have an endoscopy anyway to check for ulcers as HP is known to be responsible for 90% of ulcers...

Please remember that compliance is very important, don't stop taking the medication until you complete the whole course. Unless of course, you have serious side effects and is instructed to do so by a doctor.

HP eradication therapy usually has bad side effects, including stomach pain, nausea, vomiting... I found that taking a good combination of probiotics help aliviate some of the nasty side effects during treatment. There are many studies about the use of probiotics in conjuction with HP eradication drugs, some of them say it helps the eradication rate, others say it help with the side effects. So all in all, it's worth a try.

After you complete the treatment, you need to wait 28 days (without taking any acid suppressing drugs) before taking another breath test to confirm the eradication.

Some people still have symptons after HP eradication for a long time after treatment. There are various theories about this, some say it takes type to heal the stomach, others say it's an effect of the eradication treatment, and of course there is also the possibility that the problem wasn't caused by HP to begin with.

Good luck on your quest! I hope you feel better soon! Do come back and let us know the outcome

Luci.

Lucy:

Hi. I know you´re not the moderator, but I have to ask. I have even more doubts than I had before i think.

So, antibiotic therapy for H. Pylori is not the best treatment for it cause of all the downsides you mention? Is a natural therapy better?

You defenitely can´t recommend me an individual therapy/combination of antibiotics that´s like the most killer on for this bug? Who can I contact for this? Dr. Marshall? Does he treat patients long distance?

Thanks,

John.

Maybe it's too late for you but have a look at this slide. It means that you MUST have a PPI to make the amoxycillin work. These days we use ESOmeprazole which is twice as strong as omeprazole but just as safe. Or you can try rabeprazole, in big doses (more is better) such as 20mg three times daily. Then you will have TOTALLY no acid. Then the other drugs will work really well.

Thanks for the great chart reference. I did end up taking the Prevacid with my antibiotics. My body tolerated it pretty well eventually but I felt lousy for the first few days of this therapy. I just finished up my 14 days of Prevpak. Man, I am glad to not have that battery taste in my mouth anymore. Now my doctor has got me taking 6 pills of peptobismol (2 pill 3x a day). Based on my limited online research I have not seen this too often but I guess I will go through with it. This is the second day of this therapy and it's quite uncomfortable.

Is this a common method of treating H. Pylori or is my doctor a quack?

Hi Sharked.

Peptobismol is sometimes used in conjuction with antibiotics to increase the chances of a sucessful HP eradication. It's also available as a generic drug called Bismuth subsalicylate. It's believed that Bismuth has antibacterial action. It creates a protective coat on your stomach to protect it from acid and help heal ulcers. The most common side effect is darkening of stools, this disappears once you stop taking the medication.

Let us know how you feel once you finish your treatment
Hope you get better soon!

Luci.