Concerns About H. pylori Infection and Treatment Options - #25112
Dear Doctor, I am a 35-year-old male, 180 cm tall. My weight was 61 kg and I was living normally when I suddenly developed dizziness and an unusual sensation of hunger. A general practitioner prescribed medication for acidity, dizziness, and Neofertan, but my stomach did not tolerate them. He later added Gaviscon and an antiemetic, without improvement. The nausea worsened and I stopped eating for one week. I then consulted a gastroenterologist who diagnosed gastric neurosis and increased the proton pump inhibitor to 40 mg, adding another medication and Librax. I improved slightly. After consuming ground dried figs, I had a relapse. Nausea and pain improved afterward, but I developed indigestion, loose stools, and lost 7 kg. The doctor again attributed it to gastric nerves. One month later I felt somewhat better, but dizziness and unusual hunger returned one week after stopping the 40 mg PPI. I underwent liver tests, anemia tests, and H. pylori testing. Results were normal except for confirmed H. pylori infection. The doctor said I might not tolerate eradication therapy at that time, which increased my anxiety. Four months later I had a gastroscopy (fibroscopy), which showed moderate chronic gastritis with H. pylori infection, and Entamoeba cysts in stool analysis. I was prescribed quadruple therapy without bismuth but did not start it due to fear of side effects. Instead, I used propolis, mastic gum, Manuka honey, and some herbs. I regained 1 kg, but loose stools and intermittent dizziness persist. I traveled to visit my wife (she carries H. pylori without symptoms) for one week. After returning, I regularly consumed cinnamon and strong herbs (cinnamon, clove, moringa, licorice, anise, star anise, cumin, black seed, fenugreek) and acidic extra virgin olive oil. I then developed stomach pain, burning, and a relapse. I took Aulcer 20 mg, which caused severe pain, nausea, and a strong urge to vomit. My questions: • Is this a new infection from my wife, irritation from herbs and oil, or progression of H. pylori? • Given my sensitive stomach and chronic inflammation, how can I tolerate eradication therapy? • Can sequential therapy be considered instead of quadruple therapy, and what are its chances of success in my case?
How long have you been experiencing these gastrointestinal symptoms?:
- More than 3 monthsHave you noticed any specific foods or activities that trigger your symptoms?:
- Yes, certain foodsWhat is your current diet like?:
- Mostly healthy but with some irritants100% Anonymously
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Doctors' responses
Hello
Cause of relapse:
Most consistent with irritation of pre-existing H. pylori gastritis from strong herbs/spices and acidic oil.
Reinfection from your wife after a brief visit is unlikely.
Symptoms after stopping PPI also support ongoing untreated infection.
How to tolerate eradication therapy:
1–2 weeks of PPI first to reduce inflammation → start therapy with meals → add a probiotic (e.g., Saccharomyces boulardii) → avoid gastric irritants during treatment → discuss a regimen adjustment if side effects occur. Many sensitive patients complete therapy successfully with this approach.
Sequential vs quadruple therapy:
Sequential therapy is an option, but quadruple therapy generally has higher eradication rates, especially with chronic infection.
Choice should be individualized based on tolerance and local resistance patterns.
Symptoms reflect persistent H. pylori gastritis with mucosal sensitivity; eradication therapy is the key step toward recovery.
I trust this helps Thank you Take care
100% Anonymously
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