Concerns About H. pylori Infection and Treatment Options

Question #25112

45 days ago

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Concerns About H. pylori Infection and Treatment Options - #25112

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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 months

Have you noticed any specific foods or activities that trigger your symptoms?:

- Yes, certain foods

What is your current diet like?:

- Mostly healthy but with some irritants

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

45 days ago

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

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Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

44 days ago

Hello dear
See after clinical evaluation it seems incomplete eradication of infection
It will require proper evaluation and accordingly treatment
Please get below tests done for confirmation and share result with general physician medicine for better clarity
CBC
Esr
Serum ferritin
Blood antibody test
Hb concentration
Urea breath test
Endoscopy.
Please get comprehensive therapy on h.pylori and then proceed for further evaluation
Regards

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Dr. Alan Reji

I'm Dr. Alan Reji, a general dentist with a deep-rooted passion for helping people achieve lasting oral health while making dental visits feel less intimidating. I graduated from Pushpagiri College of Dental Sciences (batch of 2018), and ever since, I've been committed to offering high-quality care that balances both advanced clinical knowledge and genuine compassion for my patients. Starting Dent To Smile here in Palakkad wasn’t just about opening a clinic—it was really about creating a space where people feel relaxed the moment they walk in. Dental care can feel cold or overly clinical, and I’ve always wanted to change that. So I focused on making it warm, easygoing, and centered completely around you. I mix new-age tech with some good old-fashioned values—really listening, explaining stuff without jargon, and making sure you feel involved, not just treated. From regular cleanings to fillings or even cosmetic work, I try my best to keep things smooth and stress-free. No hidden steps. No last-minute surprises. I have a strong interest in patient education and preventive dentistry. I genuinely believe most dental issues can be caught early—or even avoided—when patients are given the right information at the right time. That’s why I take time to talk, not just treat. Helping people understand why something’s happening is as important to me as treating what’s happening. At my practice, I’ve made it a point to stay current with the latest innovations—digital diagnostics, minimally invasive techniques, and smart scheduling that respects people’s time. I also try to make my services accessible and affordable, because good dental care shouldn’t be out of reach for anyone.

39 days ago

Your symptoms are most consistent with ongoing H. pylori–related gastritis with strong stomach sensitivity, worsened by irritant foods and anxiety rather than a new infection.
• New infection vs herbs vs progression: Reinfection from your wife in one week is very unlikely; the relapse is more likely from untreated H. pylori plus irritation from strong herbs, spices, acidic oil, and supplements, which can inflame an already sensitive stomach lining.
• How to tolerate eradication therapy: H. pylori usually requires antibiotic treatment to cure gastritis and prevent weight loss or ulcers, and doctors can adjust therapy (start with stomach protection, probiotics, lower irritation diet, anti-nausea support, or different antibiotic combinations) to improve tolerance—discuss your fears openly with a gastroenterologist.
• Sequential vs quadruple therapy: Sequential therapy is sometimes used but success depends on local resistance patterns and your history, so your gastroenterologist should choose the most effective and tolerable regimen for you—consult them for personalized adjustment rather than delaying treatment.

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Dr. Prasannajeet Singh Shekhawat

I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.

44 days ago

Hello
It sounds like you’ve been through quite a challenging time with your gastric issues and the H. pylori infection. It’s understandable to feel anxious about starting treatment, especially with concerns about side effects.
Here are a few steps you might consider:
1. Consult Your Doctor Again:

Since you have a confirmed H. pylori infection and moderate chronic gastritis, it’s important to discuss your concerns about the quadruple therapy with your doctor. They can provide reassurance and possibly adjust the treatment plan to better suit your needs.
2. Addressing Anxiety:

If anxiety is affecting your decision to start treatment, consider discussing this with your doctor as well. They may suggest strategies or medications to help manage your anxiety during this time.
3. Dietary Adjustments:

While you’re managing your symptoms, focus on a bland diet that is easy on your stomach. Foods like khichdi, curd, and boiled vegetables can be gentle on your digestive system.
4. Follow-Up Testing:

After completing the treatment, follow up with your doctor for testing to confirm that the H. pylori infection has been eradicated.
5. Support from Your Wife:

Since your wife carries H. pylori without symptoms, it might be helpful to discuss with her the importance of both of you being treated to prevent reinfection.
Thank you

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Dr. Shayeque Reza

I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.

44 days ago

Your relapse is not likely a new infection
It is mainly untreated H. pylori + stomach irritation from herbs/spices
Natural remedies alone are unlikely to cure it
Proper eradication therapy is recommended and usually safe
With careful diet and probiotics, most patients tolerate treatment well
Overall: treating the H. pylori is the key step to long-term recovery.

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

43 days ago

The symptoms you’re experiencing, such as abdominal pain, nausea, and weight loss, are likely related to the progression of your chronic gastritis with H. pylori infection, rather than a new infection from your wife or the use of herbs and oils. H. pylori can contribute to ongoing gastric inflammation, and irregular use of potent natural remedies might exacerbate irritation, compounding the problem. When it comes to H. pylori eradication in a sensitive stomach, balancing successful treatment with tolerance to medication is key. Quadruple therapy, commonly includes a proton pump inhibitor, two antibiotics, and sometimes bismuth, which can occasionally cause gastrointestinal upset, but is generally well-tolerated by most individuals. However, given your history of sensitivity, it’s understandable why you’d be cautious. It’s worth discussing with your gastroenterologist about tailoring the eradication regimen, perhaps starting with smaller doses or substituting with less harsh antibiotics if adverse effects are a concern. Sequential therapy is an alternative where different sets of antibiotics are taken in sequence rather than together. Although it has shown reasonable success rates, results can vary based on local antibiotic resistance patterns and individual factors. Your doctor can provide guidance based on research and clinical experience, especially if some antibiotics are known to be more bearable. It’s critical to reconsider relying solely on natural remedies, as these can neither eradicate the infection nor address associated complications fully. Persistent symptoms like continued dizziness, significant weight loss, or ongoing abdominal pain warrant careful monitoring, and adjusting your therapy in response to these issues is quite important. Ultimately, comprehensive management might also involve diet adjustments to minimize irritants and help manage symptoms alongside any pharmacological regimen. If nausea and loose stools persist after attempting modified regimens, further evaluation may be needed to exclude other causes. Remember, successful H. pylori eradication can significantly reduce your symptoms and improve quality of life, so working closely with your healthcare provider is advisable to identify a strategy you can confidently tolerate.

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Dr. Nirav Jain

I am a qualified medical doctor with MBBS and DNB Diploma in Family Medicine from NBEMS, and my work has always been centered on treating patients in a complete, not just symptom based way. During my DNB training I rotated through almost every core department—Internal medicine, Pediatrics, Obstetrics & Gynecology, Surgery, Orthopedics, ENT, Dermatology, Psychiatry, Emergency medicine. That mix gave me the skill to manage acute illness, long term disease and preventive care together, something I find very important in family practice. In psychiatry I worked closely with patients who struggled with depression, anxiety, stress related problems, insomnia or substance use. I learned not just about medication but also about simple psychotherapy tools, psycho education and how to talk openly without judgement. I still use that exp in family medicine, specially when chronic disease patients also face mental health issues. My time in General surgery included assisting in minor and major procedures, managing wounds, abscess, sutures and emergencies. While I am not a surgeon, this gave me confidence to recognize surgical cases early, provide first line care and refer fast when needed, which makes a big difference in online or OPD settings. Now I work as a consultant in General medicine and Family practice, with focus on both in-person and online consultation. I treat conditions like fever, infections, gastrointestinal complaints, respiratory illness, and also manage diabetes, hypertension, thyroid disorders, and lifestyle related chronic diseases. I see women for PCOS, contraception counseling, menstrual health, and children for common pediatric issues. I also dedicate time to preventive health, lifestyle counseling and diet-sleep-exercise advice, since these small changes affect long term wellness more than we often realize. My key skills include holistic diagnosis, evidence based treatment, chronic disease management, mental health support, preventive medicine and telemedicine communiation. At the center of all this is one thing—patients should feel heard, safe, and guided with care that is both professional and personal.

42 days ago

Hello, thank you for sharing your concern. Most likely this is not a new infection from your wife. Reinfection in adults is uncommon, especially over just one week. H. pylori is usually acquired earlier in life. If you were already positive before travel, this is almost certainly the same ongoing infection, not a new one.
Your recent worsening is much more likely due to: Gastric irritation from strong herbs and spices / Acidic olive oil on an inflamed stomach / Underlying chronic gastritis with active H. pylori, etc.
Fluctuating symptoms because you have: Chronic H. pylori gastritis, Likely visceral hypersensitivity / functional dyspepsia, Weight loss from reduced intake. Stopping PPI may temporarily increase acid rebound, explaining symptom return after discontinuation.
The dizziness + “unusual hunger” feeling may be: Acid-related, Reactive hypoglycemia from irregular eating, Anxiety-driven autonomic symptoms.
Your H. Pylori should be treated. Eradication is medically recommended. Delaying treatment prolongs inflammation.
To tolerate eradication therapy with a sensitive stomach-
1. Stabilize stomach first (1–2 weeks):
- Tab. Pantoprazole 40mg before breakfast daily.
- Tab. Sporlac Plus twice a day.
Bland diet. Stop all strong herbs/spices. Small frequent meals
2. Then start eradication therapy as per your doctor’s advice. Most side effects are manageable and temporary.
Sequential therapy vs quadruple therapy? This depends on: Local antibiotic resistance, Previous antibiotic exposure, Regional guidelines.
If you are anxious about tolerance, discuss these with your doctor: Non-bismuth concomitant therapy, Adjusted regimen based on local resistance, Testing for antibiotic sensitivity.
Your condition is treatable. This does NOT look like cancer. It does NOT look like dangerous progression.
Feel free to reach out again.
Regards,
Dr. Nirav Jain
MBBS, D.Fam.Medicine

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Concerns About H. pylori Infection and Treatment Options - #25112

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