Brief Answer: Gastric ulcer could cause persistence Detailed Answer: Hello XXXXXXX Thanks for posting on your query, I am so sorry for your health problem and I understand that it must be so difficult for you dealing with such a situation. It is possible that the helicobacter has lead to a gastric ulcer diseases which could be responsible for the chronic intermittent epigastric pain but it will be wise that your doctor rule out a gallbladder diseases such as cholecystitis or gallstones (which could cause similar symptoms). Your pancreas will also need to be evaluated through laboratory tests and an abdominal scan. If indeed, your problem is a peptic ulcer diseases, then a variety of treatment options will have to be considered and exploited to make you feel better. A gastroenterologist's opinion will need to be sorted in due time (if at all it has not yet been done). Eradicating H. pylori requires a tri- or quadri-therapy with antibiotics plus protein pump inhibitors (PPI) and treatment should go for about 7-10 days. Dietary and lifestyle changes need to be considered seriously, as recurrence is usually associated with poor diet and daily life activity. Starvation or staying for too long without eating can also lead to this. Diet changes include avoiding too spicy meals, fats and oil, alcohol, starvation (make sure you keep your stomach content with food most of the time-do not allow yourself to feel too hungry) etc. As last resort, a surgical intervention might be required (only if all medical approach fails). Hope this helps and please do feel free to write back if you have any other follow-up queries. Dr. Nsah

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