Q: I am 26 years old, suffering from acidity, gastric trouble and constipation from the last 4 years. I don't drink, smoke or take any tea, coffee or cold-drinks. There is no problem of weight loss. Six months back I went through endoscopy where I was found to be H. pylori positive along with pan-gastritis, and chronic duodenal ulcer. I was given the H. pylori antibiotics(urclar-250 mg, satrogyl-300 mg, vizylac caps and novamox 500 mg twice daily for 2 weeks). Later I was asked to consume pantocid, domel and bifilac tablets for 3 months. All my symptoms disappeared except for less frequent constipation problems. Though the doctor said that I was fine but for the last few weeks again I am having acidity. In the morning there is a feeling of fullness in my stomach. Am I completely cured of H. pylori or ulcer problems? Can it come back again even after above medications?

A:You have been treated with eradication treatment for H. pylori. You remained well for 3 months but are getting symptoms of ulcers again. If the eradication treatment is successful you should not have H. pylori infection again, although it can still sometimes occur. It is also possible that the eradication treatment given was not successful and you still have H. pylori infection. In order to find out whether you still have H. pylori infection, I suggest you should have a breath test instead of another endoscopy. If breath test is not available then endoscopy and biopsy could provide the answer. If the H. pylori test is positive you should have another course of eradication treatment with a change of antibiotics or add another agent such as Tripotassium Ticitratobismuthate. This is a bismuth preparation which is quite effective in Helicobacter infection. This has to be given with 2 antibiotics and one proton pump inhibitor. These should be taken for 3 weeks. That is if you still have H. pylori infection present. If it is negative, you should continue with proton pump inhibitor only to control the symptoms. For constipation you should take Ispaghula husk.