H. Pylori and Prevacid

  I have tested positive for the H. Pylori bacteria. I am also taking Prevacid(30 mg/day) for GERD and also post-bulbar stenosis. Have been taking Prevacid for approx. two months. Prior to that, I was taking Pepcid/Zantac. Query: If I do not eradicate the bacteria via antibiotics, am I at greater risk for developing gastric cancer than if I eradicate the bacteria? Regardless of the bacteria issue, are there any adverse effects associated with long-term Prevacid therapy?
  I am facing gall bladder surgery and other possible abdominal surgery and would not want to begin the antibiotic treatment until I recover from surgery. Thanks for any advice you can give me.
Dear Bill,
Epidemiological studies suggest a relationship between Helicobacter pylori infection and the development of gastric cancer and gastric lymphoma (especially a type called MALT-mucosa associated lymphoid tissue). Nevertheless, a cause and effect relationship has not yet been established. Many gastroenterologists will prescribe medications to eradicate Helicobacter pylori infection once it is identified. This is because treating Helicobacter pylori infection will heal gastritis (inflammation of the stomach) and decrease recurrence of duodenal and gastric ulcer as well as prevent possible further bleeding episodes in patients who have bled from ulcers. In a few patients with nonulcer dyspepsia,  treating Helicobacter pylori infection can improve their symptoms. However, the treatment of Helicobacter pylori positive patients with nonulcer dyspepsia remains controversial.
If you are not experiencing debilitating symptoms there is no rush to treat Helicobacter pylori infection. It remains unclear how long it takes for the effects of this infection to develop. It probably takes years.
Concerning your query about long-term lansoprazole (Prevacid) therapy, one can only extrapolate from the experience with omeperazole (Prilosec). Both medicines belong to the category of medications called proton pump inhibitors (PPIs). Omeperazole (Prilosec), when first introduced in this country, was only approved for short periods because of the possibility of developing rare stomach tumors called carcinoid tumors due to prolonged acid suppression. These tumors developed in rats given very high doses of omeperazole (Prilosec). However, omeperazole (Prilosec) has since been used in Europe in patients with ulcers and gastroesophageal reflux for several years at a time without adverse effects. Therefore, it is currently prescribed in the United States for prolonged periods. In my clinical practice, I try to use lowest dose of omeperazole (Prilosec) or lansoprazole (Prevacid) necessary to control symptoms and try to wean patients off of the drug whenever possible. On the other hand, I will prescribe these medications for longer periods as necessary if clinically warranted. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
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