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hi my name is XXXXXXX and i am from oman

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Posted on Fri, 25 Jan 2019
Question: hi
my name is XXXXXXX and i am from oman

i have been dignosed with h.pilory imfection 2 momthns back and i got treatemt for that
but the issue is that i am getting this infection almost evey year ingot this in 2015, 2017 and 2018

i do suffer from stomach probelm since 2008 and i have been treated with following medicin like like PPi and fiybers

also i do have small hamangoma in my liver since 2013 and the size too small

my blood test are normal and good

but the only thing is i cant understand why i am getting h.pilory every time

i am attaching the last endoscopy report to you
doctor
Answered by Dr. Ramesh Kumar (39 minutes later)
Brief Answer:
Proper 3 months therapy required.

Detailed Answer:
Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice
Most likely cause in most cases is improper management of H.pylori.
H.pylori requires proper 3 months of management including two broad spectrum antibiotic with a strong proton pump inhibitor.

I would suggest you to start a fresh course of-
Tab Amoxicillin 1000 mg twice daily
Tab Clarithromicin 500mg twice daily
Tab Rabeprazole 20 mg once daily.
Initially follow this for 21 days.
After that doses would be tapered down.
Complete treatment would take a minimum of 3 month.
Missing doses or not following treatment properly may result in resistance in bacteria.
Once 3 month course is complete a breath test would be done to see if H.pylori is completely eradicated or not.
All these medicines are easily available in Oman.


Hope I was helpful
Feel free to follow up,
Thanks

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Ramesh Kumar (12 hours later)
Hi Doctor XXXXXXX
Thanks for ur reply
U have wrote to me there are two opetions for me for the h.pilory treatment one of them
Was doing the sensitivity test

The other option I could not read it because could not find it

Regards
doctor
Answered by Dr. Ramesh Kumar (15 hours later)
Brief Answer:
follow up.

Detailed Answer:
Hi,
Option 2-
Ask your doctor to move to second line drug therapy with Rifabutin plus metronidazole plus levofloxacin and Rabeprazole for a minimum of 21 days and then check breath test every week for 2 weeks to see if infection is there or not.
Thanks!
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar (24 minutes later)
what about bismuth regmen is it effective.
doctor
Answered by Dr. Ramesh Kumar (2 minutes later)
Brief Answer:
No

Detailed Answer:
Hello again,

No way old regimen.
Not effective now usually.
Old school medicine.
Thanks
Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2479 Questions

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hi my name is XXXXXXX and i am from oman

Brief Answer: Proper 3 months therapy required. Detailed Answer: Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice Most likely cause in most cases is improper management of H.pylori. H.pylori requires proper 3 months of management including two broad spectrum antibiotic with a strong proton pump inhibitor. I would suggest you to start a fresh course of- Tab Amoxicillin 1000 mg twice daily Tab Clarithromicin 500mg twice daily Tab Rabeprazole 20 mg once daily. Initially follow this for 21 days. After that doses would be tapered down. Complete treatment would take a minimum of 3 month. Missing doses or not following treatment properly may result in resistance in bacteria. Once 3 month course is complete a breath test would be done to see if H.pylori is completely eradicated or not. All these medicines are easily available in Oman. Hope I was helpful Feel free to follow up, Thanks