Starting Triple Therapy for H. Pylori - Advice appreciated

To my surprise, the post-endoscopy biopsy determined that I had H. Pylori after all (which was previously ruled out due to a negative through a stool test).

So my doc is immediately starting me on the following regimen.

For 14 days, he wants me to take the following in the morning AND night.

20mg Aciphex (1 tablet)

500mg Clarithromycin (1 tablet)

500mg Amoxicillin (2 tablets)

He also recommeneded that I take 2 capsules of a probiotic daily to help maintain my digestive flora.

Has anyone gone through a similar treatment?

What should I expect during this period in terms of appetite and overall digestive health?

Does anyone have any tips on when to take the medication with respect to food consumption?

 

Hi, Chris, I've gone through a similar treatment two weeks ago (my treatment was 7 days). For me was very difficult to take all 4 tablets before meal - I felt full before I even started to eat. I didn't take probiotic during treatment. The only side effect I had - a very bad taste in the mouth during those 7 days and I rinsed my mouth with mouthwash 3-4 times a day.
And by the way, I don't know yet if my H. pylori is gone. My husband did a test and (miracle!) - he doesn't have it at all. Why? I don't know. My family doc also.

Hi Chris,

h.pylori, eh? Well, at least they found something that's curable!

IMO, your doctor is correct with the triple therapy approach. I would touch base with him regarding possible side effects and how he wants you to take the medicines, i.e. Antibiotics with food, PPI 1/2 hour before mealtime, etc.

Let us know how you do. Feel better.

GM

Gastricman, you don't know how relieved I was when my doctor told me that I had h.pylori after all.  Because there is an explanation now for the way I feel and the way my body has been.  Before knowing this, I was a mess trying to figure out what was actually wrong with me (as you know from my very first post).

The doctor mentioned in passing that he was puzzled as to why I tested false negative for h.pylori with the stool antigen test.  Well, I was too and decided to do some internet detective work and actually was led to the page of the laboratory that did the actual test.  It basically said that it has a successful detection rate of 96% but false negative can happen IF you are on a proton pump inhibitor medication (which I was on when I submitted the sample) and that the sample should be submitted at least 2 weeks AFTER not being on PPI.

Nickles, I am not even waiting to see if the antibiotics work or not.  I also came across various positive things said about manuka honey with respect to the treatment of h.pylori.  So I started taking manuka honey today as well.  If nothing else, it actually tastes decent on my toast.  So antibiotics AND manuka honey.  We'll see in two weeks.  God, I can't wait to get back to how things were. 

 

Not even sure if I even belong in the GERD-heartburn forum but that's what the doc originally dx'ed me with.  So I guess this is where I will hang out for now.

Tomorrow will be my last day of the 14 day triple therapy.  I am happy to report that my GI symptoms have improved.  My appetite is back to normal although I still can't eat as much as I used.  My stomach seems much more settled (was able to handle a whole Chipotle burrito one day and a tuna sandwich the other day).  Unfortunately, the lack of energy, muscle weakness (almost like a numbness) and insomnia still persist (these were all symptoms I had when my stomach went crazy on me in mid-February.)  Now that my stomach and esophagus feel better, shouldn't I be seeing some improvement with my energy as well?  I admit I still have some anxiety because I turned into a bit of a hypochondriac due to my GERD/Gastritis/H. Pylori Infection and there is a nagging voice in the back of my mind that keeps thinking that I have something much worse even though both my General Doctor and Gastroentrologist think that my problem has to do with H. Pylori and they just seem not concerned at all.

I read that gastritis can cause poor absorption of B12 vitamins, which can cause the very symptoms I listed above but when I met with my gastroentrologist today, he adamantly stated that there is no connection between h. pylori and my non-GI symptoms.  But on the internet, both from individual anecdotes and reputable sources such as Mayo Clinic, I am reading that h. pylori can cause gastritis, gastritis can cause B12 absorption issues and B12 deficiency can cause general fatigue and numbness.  I am confused and the confusion is only adding to my anxiety.  Do doctors these days even make connection between cause and effect?

I have read my fellow GERD/heartburn board member's stories and sometimes, it feels like I don't have it so bad since I never experienced pain of any kind, but I just want to feel normal again. 

I guess all I can do is finish my triple therapy and then see if my symptoms improve afterwards.  I guess the antibiotics themselves can be pretty taxing on the body.  Thanks for listening. 

 

EJ, thank you for your words. I too hope that what is happening to me now is due to the side effects of ppi (double dose during the triple therapy, no less) and the antibiotic.

I am done with the antibiotics tonight. As far as the ppi goes, my gastro doc still wants me on aciphex for a while. Sigh.

Can you remind me what your side effects were when you were on ppi?

Chris,

I had heart palpitation(i get 60-65 min normally but i was having over 90 when i stayed still for an hour before i measure), i do have 'normal' low blood pressure but it got down to 90 high,
I had anxiety, depression, feeling 'like' heart congestion. You know the feeling you need to take a deep breath but can't?
If you shall remember in other thread, i tried to explain it as my pre-menopause, but it was consistent and did not fit to my cycle. I was so miserable and unhappy. When i believed i was being healed why would i have made that up in my head?

I did not expect it to go away that quickly so it is not in my head(i keep saying that because that's what my big sis said) but it went away after three days after i stopped ppi.
Now when i measure my heartbeat 'for fun' i get only about 70 even when i was walking about. And i feel great. I felt great when i still had some heartburn right after i stopped ppi.

I may be simply lucky that i can control my symptom with zantac 'cause i know many here just can't. I was scared also about symptom coming back. But seeing that even those who were forced to take ppi for a long term have to go through this weaning off sooner or later in the end, well it was worth a try.
I checked myself in to my bedroom so to speak and bore with it whenever heartburn happened for first few days and now i lower the does and still ok. I feel it under control. I rode the rebound sucessfully i think.(almost 2 weeks since stopping ppi now)

So ask your doctor. They don't care about or believe necessarily your side effects or your mysterious symptoms. Ask him/her if you could go with h2 blocker instead. Sooner the better. My doc agreed when i told her about my heart palpitation and asked.
I didn't even mention about my depressed feeling because since she made such a big deal about my puny weight loss lest she might want me to come back and take anti depressant or something. I heard some doc did. What drug dispensers!

I read an academic article that In Europe they prescribe ppi only a few days at a time when symptom is especially worse but here in US they bombard it like that.

Gastroesophageal Refl ux Disease Kenneth R. DeVault Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL,USA

" Intermittent therapy with an H 2 RA or PPI is most likely to be successful in patients without esophagitis and with mild to moderate heartburn. There are very few data to support any one approach for “ on - demand ” therapy. H 2 RA taken on an as - needed basis provides acceptable control in patients with mild, intermittent symptoms. PPI do not seem to be a good choice for on - demand therapy since their onset of action does not maximize for a few days. That having been said, there are data and experience to suggest this approach may be benefi cial in some patients. A more reasonable use of PPI is on an intermittent basis, where, rather than taking one pill, the patient may take a few day courses when their symptoms are bothering them more. This approach has not been approved as an indication in the USA (with the exception of the label for OTC Prilosec), but is a more accepted approach in Europe."

Best luck!

Post Edited (Willovercome) : 3/22/2013 12:20:46 PM (GMT-6)

Aw shucks, chris, :) you are very welcome. I just hope everything works out for you.
Let me know if acupuncture works out for you.
Cheers!