Re: ON 2ND TREATMENT FOR H.PYLORI !!!

Posted By HFHSM.D.-ym on August 06, 1998 at 14:38:01:

In Reply to: Re: ON 2ND TREATMENT FOR H.PYLORI !!! posted by DEB on August 05, 1998 at 21:30:21:






: : I HAD AN ENDOSCOPY W/BIOPSIES THAT CAME BACK POSITIVE FOR H.PLYORI,GASTRITIS,AND ESOPHAGITIS.  FIRST TWO WEEK TREATMENT CONSISTED OF AMOXICILLIN,FLAGYL, BISMUTH AND PREVACID.  IT HELPED ALOT BUT STILL IN PAIN.  NOW I'M SUPPOSED TO START A 2ND 2 WEEK TREATMENT OF TETRACYCLINE,AMOXICILLIN,BISMUTH AND PRILOCEC.  THE PHARMACIST SAID I SHOULDN'T TAKE TETRACYCLINE AND AMOXICILLIN TOGETHER, IT WOULD CAUSE A LOT OF SERIOUS SIDE EFFECTS BUT AFTER DISCUSSING IT WITH A DIFFERENT DOCTOR, SAID IT WAS OK.  I'M CONCERNED ABOUT MIXING THE TWO AND ALSO CONCERNED THAT THE DOCTOR DIDN'T FEEL THE FIRST TREATMENT DID THE TRICK.  ANY ADVICE YOU COULD GIVE WOULD BE GREATLY APPRECIATED !!
Dear Deb,
Prior to starting another course of treatment for the eradication of Helicobacter pylori infection I would want to know if the first regimen actually worked. If you took all of your medicines as prescribed for the two week period there is a good chance that you already got rid of the bacteria. There is a test called the carbon urea breath test that is now available at many institutions. This test is very accurate at detecting eradication failures. It is, however most accurate, if performed at least 6-8 weeks after treatment is completed. You also need to be off antibiotics, bismuth and lansoprazole (Prevacid) or omeperazole (Prilosec) prior to the test. Another more invasive way to check for Helicobacter pylori eradication would be to repeat the endoscopy with biopsy 6-8 weeks after treatment. You must also keep in mind that your pain may not totally go away with Helicobacter pylori eradication. You may require chronic maintenance therapy for esophagitis and gastroesophageal reflux disease. It is also important to adhere to anti-reflux measures. Your pain may not necessarily be related to the Helicobacter pylori infection. 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.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
: *Keywords: lansoprazole (Prevacid), Helicobacter pylori infection, ulcer, gastric cancer, lymphoma, nonulcer dyspepsia

THANKS SO MUCH FOR RESPONDING.  UNFORTUNATELY, I DIDN'T EXPECT A RESPONSE SO QUICKLY AND STARTED THE NEXT COURSE OF ANTIBIOTICS...IT WAS SUGGESTED TO HAVE ANOTHER ENDOSCOPY BUT I DIDN'T KNOW ABOUT THE WAITING TIME BETWEEN THE COMPLETION OF ANTIBIOTICS AND HAVING THE SCOPE.  DO YOU THINK I SHOULD FINISH THIS SECOND COURSE 0F MEDS?  I, SO FAR, HAVE GOTTEN MY TREATMENT AT A MILITARY BASE AND THE BREATH TEST ISN'T AN OPTION.   ALSO, I HAVE BEEN VERY CAREFUL TO ADHERE TO THE GERD PREVENTITIVES.  I THINK I MAY HAVE EXACERBATED THE GASTRIS (I DIDN'T KNOW I HAD IT AT THE TIME) BY TAKING MEGA DOSES OF ADVIL,MOTRIN AND ASPIRIN FOR MIGRAINES WHICH ALSO JUST STARTED A FEW MONTHS AGO.  I NOW HAVE IMITREX FOR THEM SO I WON'T BE TAKING ANYMORE OF THE ASPIRIN FAMILY MEDS.   THANKS AGAIN !
Dear Deb,
You certainly are correct about the aspirin and other nonsteroidal anti-inflammatory drugs. They are very irritating to the stomach lining and should be avoided especially while you are having symptoms. There are small risks taking antibiotic therapy including diarrhea, abdominal discomfort etc. but the most important risk is  the development of antibiotic resistance to bacterial organisms. Resistance of Helicobacter pylori infection to antibiotics such as metronidazole (Flagyl) and clarithromycin (Biaxin) has been reported. If you feel so much better with the treatment, I guess you can complete it, but if not you should probably stop. In either case speak to your doctor and keep him or her informed of what you plan on doing.
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.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: Helicobacter pylori, antibiotic treatment, bacterial resistance