How to treat erosive gastroduodenitis if the H. pylori test result is negative?

Question

Hi doctor,

I have been prescribed Doxycycline for 30 days for erosive gastro-duodenitis after the H.pylori test result was negative. My concern is do I need an antibiotic necessarily? As I have already taken Doxycycline for 28 days last year for syphilis treatment. Another concern is regarding an anal fissure exactly on the spot of the previous syphilis ulcer. The fissure has no pain. I have done three VDRL tests after the completion of treatment. All the results were negative. What could be the cause of this anal fissure? it has been a year and still, the fissure has not healed. Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed your attached files (attachment was removed to protect the patient's identity).

1) I have seen your endoscopy images and report (attachment removed to protect the patient's identity), there is gastritis with few erosions, but H.pylori (Helicobacter pylori) test is negative. I suggest you take acid suppression medicine like Pantoprazole 40 mg half an hour before breakfast for four to six weeks and add an antacid syrup like Gaviscon 10 ml after every meal as well. I do not think you need antibiotics for this. Especially Doxycycline, as it itself causes gastritis and gastric erosions. So, I would not suggest Doxycycline for this.

2) Regarding your anal fissure, it seems to be a chronic anal fissure, for all chronic anal fissures, you would need a good physical examination by a doctor, especially a surgeon. He can give you a good medical trial for six to eight weeks. If it does not resolve, chronic anal fissures need minor surgical procedures as a treatment. Meanwhile, avoid constipation and straining while passing stools.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I have reviewed your attached blood and stool reports (attachment removed to protect the patient's identity) and these are grossly unremarkable. Gastritis is simple inflammation of the internal stomach lining, which can be due to multiple reasons. H.pylori and medicine are two of them. Otherwise, in your case, it could be related to diet or eating junk food. Even stress or anxiety can increase acid production and causes gastritis and erosions.

Thank you.

Answer 3

Hello,

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