Advice for persistant H. pylori

[connaki]

I'm in Australia, 39, and was diagnosed with H.pylori for the past 6 months after developing bloating symptoms (I could be allergric to amoxacillin - had a small reaction when I was young - but I will now go and find out). The doctor initially put me on 20mg 2/day Esomeprazole, 400mg metronidazole 3/day and 400mg clarithromycin 2/day for 7 days. I did another breath test and it came back positive. Then 3 months ago the doctor put me on another treatment - this time 20mg 2/day Esomeprazole, 500mg cephalexin 2/day and 100mg doxycycline 2/day again for 7 days. I did another breath test 2 months ago and it was positive again. I only just finished taking another antibiotic course - this time 20mg 2/day Esomeprazole, 400mg clarithromycin 2/day and 400mg metronidazole 3/day - and am now waiting to be testing again.

The doctor who gave me the last regiment asked me if I REALLY wanted to get rid of it?? He said that there is so much antibiotic resistance (and that I could probably get it again) that its not worth it - especially because 20mg esomeprazole a day keeps me pretty well..

Don't you think that the doctor should be trying different antibiotics?? I tried telling him that but he didnt listen..

PS. I am definitely going to get tested for amoxicillin allergy, as I think I was probably misdiagnosed like a lot of others back in the 80s!

[Helico_expert]

agree that you should not be given clarithromycin and metronidazole again.

You can seek second opinion. see if anyone is willing to get you bismuth-based quadruple treatment.

[connaki]

Yes, I have also seen data that shows that metronidazole and clarithromycin have large resistance rates in Australia. I'm actually in the US (for work) and just bought a few bismuth tablets - do you recommend I tell my doctor to include these in my next attempt (given the latest attempt is likely to fail)?

[Helico_expert]

yes, you can certainly tell your doctor to include bismuth in your next trial.

the trick is to get very high dose PPI. you can also tell him that Prof. Marshall uses Rabeprazole 20mg 3x a day.

Nevertheless, it is better you get another breath test before treatment. Who knows you may be lucky and got rid of it.

[connaki]

Thanks for the advice - it is really appreciated!! I'll let you know if I got lucky - but I doubt it

As a biomedical researcher myself, I have been looking up this topic for the past 6 months - there's so much new research being conducted, and unfortunately I believe that the doctors dont usually have the most up-to-date research handy!

PS. And you are right about the high PPIs during treatment - all the latest literature points to better eradication with higher PPIs. I've also seen some promising recent research around Bismuth - hopefully the Australian guidelines change to make it more widely available!

[Helico_expert]

You are welcome. You know where (this forum) to find answer next time you have questions about H. pylori.

[connaki]

Yes - I really do appreciate your help with this - its good to know that we have access to a lab with the latest research on this.

I"ll let you know how I go in one months time!

Keep well