Post-Treatment Care for Helicobacter Pylori Infection: What to Expect

Follow-up treatment after the diagnosis of Helicobacter pylori infection?

In July, I experienced stomach pain and went to a clinic for an ultrasound, where they suggested it might be related to gallstones and prescribed medication for me to rest at home.
Later, I went to the hospital and found out that I was infected with Helicobacter pylori.
I finished a two-week course of medication on August 3rd.
Yesterday, after having a late lunch, I started experiencing stomach pain again.
Today, I visited Dr.
Tseng Chi-Long (the same doctor I saw last time, and I have an appointment with him on Saturday).
He mentioned that the location of my pain could be due to gallstones and that I need to do another stool test to confirm whether the Helicobacter pylori has been eradicated.
He also mentioned that it would be more accurate to check a month after finishing the medication.
However, I received the stool test kit today and submitted the sample directly to the laboratory.
Should I schedule another appointment at the hospital for a stool test after September 3rd? I originally planned to return on September 20th to review the test results.
Thank you! T^T

Zhang Ruixi, 30~39 year old female. Ask Date: 2018/08/16

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello Ms.
Chang,
Helicobacter pylori is associated with chronic gastritis, gastric ulcers, and gastric cancer.
The standard treatment regimen typically involves ulcer medications combined with 2 to 3 different antibiotics, administered either concurrently or sequentially for 10 to 14 days.
To accurately determine whether H.
pylori eradication was successful, testing should be conducted at least one month after completion of the treatment and after a minimum of two weeks without ulcer medications.

It is important to note that successful eradication of H.
pylori does not guarantee the absence of stomach pain; dietary habits must still be monitored, and treatment for ulcers and gastroesophageal reflux disease should be completed and followed up.
Abdominal pain requires differential diagnosis.
For individuals with gallstones, it is recommended to maintain a regular diet and avoid overeating or consuming excessively fatty foods.
Complications of gallstones may include mild abdominal pain, cholecystitis, and pancreatitis.
Wishing you safety and health,
Dr.
Ming-Hui Lin
Attending Physician, Gastroenterology
Taoyuan General Hospital, Ministry of Health and Welfare

Reply Date: 2018/08/16

More Info

Post-treatment care for Helicobacter pylori (H. pylori) infection is crucial for ensuring the effectiveness of the treatment and for monitoring any potential complications. After completing a standard treatment regimen, which typically includes a combination of antibiotics and proton pump inhibitors (PPIs) for about 10 to 14 days, patients often have questions about what to expect next.

First and foremost, it’s important to understand that while the treatment aims to eradicate the H. pylori bacteria, it does not guarantee that all symptoms will resolve immediately. Some patients may continue to experience gastrointestinal discomfort, which can be attributed to various factors, including the healing process of the stomach lining, dietary choices, or even the presence of other gastrointestinal issues such as gallstones, as you mentioned in your case.

In your situation, since you have already completed the two-week course of medication, the next step is to confirm whether the treatment was successful. The most reliable way to check for the eradication of H. pylori is through a follow-up test, which is typically performed at least one month after completing the antibiotic therapy. This is because testing too soon may yield false negatives due to the presence of bacterial remnants or dead bacteria, which can still be detected in the body.

Regarding your concern about the stool test you submitted, it is advisable to follow up with your healthcare provider. If your doctor recommended waiting until after a month for a more accurate assessment, it would be prudent to adhere to that timeline. If you have already submitted the stool sample, you should discuss the results with your doctor during your scheduled appointment on September 20. If the test indicates that H. pylori is still present, your doctor may suggest a second-line treatment, which often involves different antibiotics or a longer duration of therapy.

In terms of dietary considerations post-treatment, there are no strict food restrictions, but it is wise to avoid foods that may irritate your stomach, especially if you are experiencing ongoing symptoms. This includes spicy foods, acidic foods, and caffeine. Staying hydrated and consuming a balanced diet rich in fiber can help support your digestive health.

Additionally, it is essential to monitor your symptoms closely. If you experience severe abdominal pain, persistent nausea, vomiting, or any other concerning symptoms, you should seek medical attention promptly. These could be signs of complications such as ulcers or gallbladder issues, which may require further evaluation.

Lastly, regarding the concern about antibiotic resistance, it is valid to be cautious. If H. pylori is not eradicated after the first treatment, it is crucial to follow your doctor’s advice for subsequent treatments. The risk of developing antibiotic resistance increases with repeated exposure to the same antibiotics, which is why healthcare providers often switch to different medications for retreatment.

In summary, after completing treatment for H. pylori, it is essential to follow up with your healthcare provider for testing, monitor your symptoms, maintain a balanced diet, and be aware of any new or worsening symptoms. Your proactive approach to your health is commendable, and staying in close communication with your healthcare team will help ensure the best outcomes for your condition.

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