Helicobacter Forums

Al Here wrote: Sat Apr 25, 2020 11:35 pm When supplementing with bismuth, does it make a difference if it’s bismuth subcitrate or bismuth subsalicylate? Also, is it better to take the liquid or pill form or does it not make a difference?

When searching for an answer to the same question I stumbled upon a research paper on the internet claiming a little higher efficacy for bismuth subcitrate..

Probably.
if you can get hold of it, go for it. otherwise, I think any other bismuth compound would work too.

How come you guys do 10-day first line treatment over the 14-day? Is there much of a difference? I really want to do mine for only 10 days to reduce damage to the microbiome.

10 days is like 90%
14 days is like 95%

so we think 90% is high enough. in return, our patients get less adverse side effect.

but for our very antibiotic resistant patients, we would also do 14 days.

So the chances of eradication are still in my favor if I do my treatment for 10 days? I haven’t missed a dose and I’ve been supplementing the treatment with bismuth 250mg 3-4 times a day and I started doing that about 2-3 days into my treatment. I’ve never taken any of the antibiotics I’m taking for this treatment so I’m hoping the h. Pylori i have doesn’t have much resistance to them but I am from Romania. Any idea what clarithromicyn resistance rate is in Romania/Eastern Europe? Although, I have lived in the United States most of my life (since the age of 6, I’m 22 now) so I definitely could’ve got H. Pylori here. Around how much of the good bacteria in the gut is wiped out by this treatment or how much is the micobiome effected? Also, if eradication isn’t successful, would I have to start another course of antibiotics right away or could I wait until this pandemic passes over and just use natural remedies to keep the h. Pylori at bay for the time being? I am not comfortable at all taking this many antibiotics during this time. I have a study I came across which concerned me about taking antibiotics during this time. This is the study I am referring to: https://www.crick.ac.uk/news/2019-07-02 ... n-the-lung

In this study, they gave the mice ampicillin, vancomycin, metronidazole, and gentamicin for 3-4 weeks. Mice that didn’t take the antibiotics course and mice that did take it were then all injected with the flu. 80% of the mice that didn’t take the antibiotics survived it, while only 1/3 of the mice that did take the antibiotics survived. This was because the antibiotics messed with the gut microbiome signaling to the lungs and delayed/disrupted the lungs first line of defense so the virus was able to multiply much more quickly. Do you think this is potentially applicable in humans and more specifically with the medications I am taking and for the period of time I am taking them?

If you dont normally take antibiotics, the of having a resistance strain will be low. But nothing is 100%. sporadic mutation can still happen from bad luck. Anyway, staying positive is important.

in regards to antibiotics may weaken lung immunity, it may be true. some of our patients did talk about flu-like symptoms during the treatment. However, you are on high dose of antibiotics, most of the bacteria will be suppressed. and almost all our patients successfully have their H. pylori eradicated.

microbiome is a very hot topic now. but colleagues have shown that in most people, microbiome can recover very quickly within 1-2 weeks. Probably due to the diet habit. whatever you eat, is going to shape the living condition in the guts and only suitable for a particular microbiota profile. So for the first two weeks, your guts microbiota will be disturbed. but gradually they will adjust themselves and go back to your normal condition. So dont worry too much.

So in your opinion, would you recommend I stick the treatment out for the full 14 days or would I be okay with just doing the 10 days? I know there’s probably no right answer but what would you recommend to your patients in this situation? Maybe I could do 12 days just Incase? I believe I’ve taken Flagyl before and amoxicillin but never clarithromicyn if I remember correctly. Also, I currently have yogurt, kefir, and kombucha. Would you recommend taking these during/after treatment too?

Your doctor is responsible for your overall well being. He would understand better which of the 10 days or a 14 days is better in your region.

If you have no adverse side effect, you should try your best to complete the treatment as prescribe.

Since you have not had clarithromycin before for other diseases, it's ok to have it this time for HP.

yogurt, kefir, and kombucha are fine during the treatment.

There was a study done on the effects of taking probiotics during/after antibiotics treatment. This study showed that taking probiotics during/after treatment actually delayed the return of a pre-antibiotic/regular microbiome drastically. One group was given a 11 strain probiotic supplement while the other was given placebo. The group that took the probiotics didn’t return to a fully restored microbiome even at the 6-month point while the group that didn’t take the probiotics only took 3 weeks to return to a normal microbiome. Do you think this is applicable to things like kombucha, kefir etc. or just to the probiotic supplement? Also, my doctor said I could take the treatment for 10 days if I wish but that we “may see that the infection doesn’t clear with this shorter course”. They also said that bismuth won’t do much to boost treatment or anything but I can still take it if I wish. I am still taking it to boost the cure rate and hopefully avoid C. Diff complication.

This is an article that cites the study I am referring to: https://www.healthline.com/health-news/ ... antibiotic

I dont have information about probiotic. but I think people who takes probiotics during the treatment is to prevent bad bacteria overgrow and reduce the side effect.

people who takes probiotics after antibiotics are like normal people taking probiotics. The probiotics will impact on your "normal" microbiome. At least that is the purpose of probiotics. In my opinion, probiotics is meant for people who's "normal" microbiome is bad. So they hope to introduce some good bacteria to disturb the "imbalance" and hopefully have better and healthier digestive system.

I think the real question is, will this change of microbiome because of probiotic good?
if it prevents bad bacteria growing, i think that's ok.
if the change of microbiota is not causing trouble, i think that's ok.

I also think that there are many types of probiotics out there. You may have to find the one that most suit you.