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Gastroenterology (Expert Forum)
How many treatments can I endure? Read this one
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
How many treatments can I endure? Read this one
by chrisallio, Sep 15, 2005 12:00AM
I was diagnosed with H-pylori in July of 2003. I was given triple therapy for 10 days, bismuth, tetracycline, and metronizidole. I found out about a week before I was flying off to start work overseas. I did most of the initially therapy, probably 8-81/2 days but jet lag, time change therapy got off.
Started having same symptoms as before, burning sensation, waking up in the morning with upset stomach. A hospital here did a stool sample and h-pylori again. The gave me treatment for 10 days with clarithromycin, aciphex and metronozidale. Side effects were better and finished treatment.
However, symptoms returned. In the summer of 2004, I visited my GI Doc in the states. They did endoscopy showing gastritis and did a biopsy which confirmed h-pylori. They gave the triple therapy of bismuth, tetracycline, and metronizidole again but for 14 days. Didn’t start the meds until I returned to the Middle East. I started the meds, but the side effects were intolerable. Suffered through seven days and had to stop.
In the spring of 2005, suffering from the same symptoms I underwent an endoscopy and biopsy which showed the same result, gastritis and h-pylori. This time I was given Tetracycline, Clarithromycin, and Aciphex for ten days. The side effects were much better and I had a feeling that the meds were working. I woke up with no pain or burning.
A couple of weeks after finishing the meds, the same symptoms appeared. While at home this summer(2005), I saw my GP in the US. Without a test to find confirm h-pylori was prescribed a 3-week course of Tetracycline, Clarithromycin, and Aciphex with the addition of Sucralfate. Brought the meds back to the Middle East. Did some research on the internet and found that sucralfate may interfere with Tetrcycline. I started the meds week ago without the sucrafate but I am not noticing the same response, i.e. reduction in symptoms. I wonder if after many treatments I have resistant h-pylori?
I haven’t seen a study combining Tetracycline, Clarithromycin, and Aciphex and sucraflate. They studies suggest at this point perhaps I should be doing the salvage therapy which consists of Tetraclyine, Bismuth, Aciphex and the addition of Furazolidone. I can buy all of these meds over the counter here. I am just wondering if it would make sense to stop what I am doing now and reevaluate, or go ahead and possible add Furazolidone to my current treatment. Or just go with my GP original instinct and add the Sucraflate?? Another concern is that all these meds are causing a lot of stress on my liver. I just recovered from HCV 2 ½ years ago. My liver enzymes were normal when I last check, but seem to have a lot of upper right quadrant pain when I take these meds.
Would greatly appreciate any advice you might have.
Started having same symptoms as before, burning sensation, waking up in the morning with upset stomach. A hospital here did a stool sample and h-pylori again. The gave me treatment for 10 days with clarithromycin, aciphex and metronozidale. Side effects were better and finished treatment.
However, symptoms returned. In the summer of 2004, I visited my GI Doc in the states. They did endoscopy showing gastritis and did a biopsy which confirmed h-pylori. They gave the triple therapy of bismuth, tetracycline, and metronizidole again but for 14 days. Didn’t start the meds until I returned to the Middle East. I started the meds, but the side effects were intolerable. Suffered through seven days and had to stop.
In the spring of 2005, suffering from the same symptoms I underwent an endoscopy and biopsy which showed the same result, gastritis and h-pylori. This time I was given Tetracycline, Clarithromycin, and Aciphex for ten days. The side effects were much better and I had a feeling that the meds were working. I woke up with no pain or burning.
A couple of weeks after finishing the meds, the same symptoms appeared. While at home this summer(2005), I saw my GP in the US. Without a test to find confirm h-pylori was prescribed a 3-week course of Tetracycline, Clarithromycin, and Aciphex with the addition of Sucralfate. Brought the meds back to the Middle East. Did some research on the internet and found that sucralfate may interfere with Tetrcycline. I started the meds week ago without the sucrafate but I am not noticing the same response, i.e. reduction in symptoms. I wonder if after many treatments I have resistant h-pylori?
I haven’t seen a study combining Tetracycline, Clarithromycin, and Aciphex and sucraflate. They studies suggest at this point perhaps I should be doing the salvage therapy which consists of Tetraclyine, Bismuth, Aciphex and the addition of Furazolidone. I can buy all of these meds over the counter here. I am just wondering if it would make sense to stop what I am doing now and reevaluate, or go ahead and possible add Furazolidone to my current treatment. Or just go with my GP original instinct and add the Sucraflate?? Another concern is that all these meds are causing a lot of stress on my liver. I just recovered from HCV 2 ½ years ago. My liver enzymes were normal when I last check, but seem to have a lot of upper right quadrant pain when I take these meds.
Would greatly appreciate any advice you might have.
Doctor's Answer
by Kevin Pho, MD, Sep 15, 2005 12:00AM
, Sep 15, 2005 12:00AM
Furazolidone is not available in the US, so I am not familiar with that medication.
As you know, there are several treatment regimens for H Pylori. I am also not aware of sucralfate being part of the standard regimen, although some experimental studies have suggested that it increases the eradication rate.
One treatment regimen that has not been mentioned is amoxicillin, clarithromycin and a PPI. This is normally the first-line treatment. This treatment regimen can be discussed with your personal physician if the H Pylori is refractory.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
As you know, there are several treatment regimens for H Pylori. I am also not aware of sucralfate being part of the standard regimen, although some experimental studies have suggested that it increases the eradication rate.
One treatment regimen that has not been mentioned is amoxicillin, clarithromycin and a PPI. This is normally the first-line treatment. This treatment regimen can be discussed with your personal physician if the H Pylori is refractory.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
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Licorice Root DGL chewable tablets 2-3xs day 20 min. before meals ( you can find these products and info. at most health food stores and on-line). You have already gone through so much and you will need to give your body time to heal. Hope you are feeling better soon.