How is H. pylori infection treated effectively?

Question

Hello doctor,

I went to the general specialist last year because of severe heartburn. I have been experiencing severe acidity, I am often not able to sleep at night due to acidity. Antacids provide limited relief. There is also vomiting very often in the morning while I brush my teeth. There is also a lot of stomach gas and I experience diarrhea several times a month. I was advised to do a gastroscopy and biopsy which revealed chronic gastritis due to H. pylori infection. There are also polyps in the stomach because of that. I took the French triple treatment but there is no change in the symptoms. All these symptoms get particularly worse during stress. Pantoprazole has not been very effective, an ultrasound was also done, and the doctor said the ultrasound was normal. The blood report was also normal. Do you have any suggestions regarding the treatment?

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern. I have reviewed your case history in detail and attached laboratory investigations as well (the attachment was removed to protect the patient's identity).

1. H. pylori gastritis has been treated and usually dual antibiotics therapy is very effective so no need to repeat therapy from that point of view.

2. I have seen calprotectin levels as well, which means your loose stools are not infectious as well.

Coming back to your symptoms, I would like to recommend you continue PPI (proton pump inhibitors) like pantoprazole or newly available Dexlansoprazole (Hydroxypropyl cellulose, Titanium dioxide) 30 mg half an hour before breakfast, antacid syrup regularly two tablespoons full after every meal (like Gaviscon). As your stress-related symptoms are positive and otherwise your workup is unremarkable except for H. pylori which has been treated already, I would like to suggest anxiolytic medicine for a shorter duration, probably two to three months. Stress management and anxiolytic medicine will significantly improve your stomach symptoms, functional dyspepsia, and bloating are well-known problems in sensitive individuals. I hope I cleared all your doubts.

Thank you.