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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Antral Gastritis H Pylori

Hi i m dev from India. 8-9 months ago, 1st endoscopy showed antral gastritis with h pylori..took antibiotic with ppi for 3 months..After 3 months, 2nd endoscopy was done which showed normal result. Doctor still asked to continue PPi for 2-3 more months and then tapper the dose slowly..So after tappering down and stopping PPI my health was OK for 3 months..Followed normal diet with no spice and junk food..But then last week i drank 30ml scotch whisky with water..From next day pain in stomach started, acidity, burning feeling in stomach..Please suggest suitable treatment..is it because of the small amount of alcohol?? Is there any ulcer formed?? Should i go for another endoscopy??
Mon, 22 Sep 2014
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Internal Medicine Specialist,  's  Response
Hi,

Thank you for your query. I can understand your concerns.
Failure of H. pylori eradication with triple therapy in a compliant patient is usually due to infection with a resistant organism.
Quadruple therapy where clarithromycin is substituted for metronidazole (or vice versa), should be the next step.
Quadruple Therapy for at least 14 days
Omeprazole 20 mg daily
Bismuth subsalicylate 2 tablets qid
Clarithromycin 500 mg bid
Tetracycline 500 mg qid
Dual therapy [PPI plus amoxicillin, PPI plus clarithromycin, ranitidine bismuth citrate (Tritec) plus clarithromycin] are not recommended in view of eradication rates of Alcohol intake can result in inflammation of the esophagus and stomach causing epigastric distress ;alcohol is one of the common causes of gastritis.
Abstinence i s advised in view of recurrence of dyspeptic symptoms.





Regards

Dr. T.K. Biswas M.D.
Mumbai
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Suggest Treatment For Antral Gastritis H Pylori

Hi, Thank you for your query. I can understand your concerns. Failure of H. pylori eradication with triple therapy in a compliant patient is usually due to infection with a resistant organism. Quadruple therapy where clarithromycin is substituted for metronidazole (or vice versa), should be the next step. Quadruple Therapy for at least 14 days Omeprazole 20 mg daily Bismuth subsalicylate 2 tablets qid Clarithromycin 500 mg bid Tetracycline 500 mg qid Dual therapy [PPI plus amoxicillin, PPI plus clarithromycin, ranitidine bismuth citrate (Tritec) plus clarithromycin] are not recommended in view of eradication rates of Alcohol intake can result in inflammation of the esophagus and stomach causing epigastric distress ;alcohol is one of the common causes of gastritis. Abstinence i s advised in view of recurrence of dyspeptic symptoms. Regards Dr. T.K. Biswas M.D. Mumbai