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Hi, I have suffered from Crohn's disease for 8 years now and I was found to have the H Pylori disease during an endoscopy 4 years ago. I was given a course of triple antibiotics (which was awful!) and then retested 3 months later but the H Pylori was still present, along with my symptoms. So the doctor prescribed me yet another triple course of slightly different antibiotics and when I was retested 3 months later, the H Pylori was still there along with my symptoms.

As the two courses of antibiotics hadn't eradicated the H Pylori, my doctor just basically told me that we should just leave it and treat the symptoms instead so I am on Lansoprazole long term and I also take Gavesgon and Zantac when the symptoms are really bad.

About three months ago, when the symptoms were really bad and I felt the medication wasn't helping, I made an appointment to see the doctor but saw a locum doctor instead, as my doctor was away. The locum wanted to retest me for the H Pylori and so he did and I was found to still have it. When he called me with the results, he prescribed me with another triple course of antibiotics, saying we should really try to get rid of it as hving it long term could put me at risk of developing cancer! Anyway, to cut a long story short, I took the antibiotics and was retested this week and the H Pylori is still there and my usual doctor has told me that it is nothing to worry about and I should just continue with the Lansoprazole and Gavesgon and Zantac.

So my question to you is - why do two doctors have different opinions regarding H Pylori - one says just leave it and treat the symptoms and the other says that attempts to eradicate it should be made as it could cause cancer? I am confused!

Hi Tracy,

The situation with H Pylori and cancer is complex. It is true that H pylori is implicated in causing certain cancers, particularly stomach cancer. However, there is evidence that it might protect against developing oesophageal (gullet) cancer.

What is important to emphasise is that having H Pylori infection does not mean that someone will definitely develop cancer. We therefore don't test everyone for H Pylori infection. We think most H Pylori is picked up in childhood, although some infections will occur in adult life.

Currently advice is to test people based on their symptoms, or if certain findings (like a stomach ulcer, or an inflammed stomach lining) are seen at endoscopy. The advice is then to try to eradicate the infection with triple therapy (a combination of 2 antibiotics and a PPI (like omeprazole or lansoprazole)) exactly as was tried with you.

If the first line therapy doesn't work, then second line treatment with a different combination should be tried as your GP did.

If that doesn't work then guidelines advise GP referral to a specialist (gastroenterologist). If H pylori is difficult to eradicate then sometimes a repeat endoscopy and sampling is undertaken. The sample is sent off to the lab to test which antibiotics are most likely to kill the H Pylori so treatment can be tailored. A specialist would also be able to discuss the role of H Pylori in cancer in more detail if you wished.

The last thing to say is that even if the H Pylori is successfully eradicated, unfortunately this doesn't necessarily mean that your symptoms will go away. Quite a number of people experience indigestion and reflux symptoms even when all tests, including those for H Pylori, are normal.

I hope this information is helpful.

Kind regards,