Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

The cure of Hp usually requires antibiotics. Other things have been tried and have a weaker effect.

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James88
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Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

Post by James88 » Wed Jun 14, 2017 1:28 am

Hi All,

I have been fighting Helicobacter for over 2.5+ years.

It was first picked up when I had bad stomach pain and they found I had stomach ulcers. After a breath test it confirmed Helico was to blame.

I have tried 4 different antibiotics treatments - Nexium HP7 (14 days), Rifibutin treatment, Bismuth Treatment and another treatment before the Rifibutin so I am on 4th line treatment moving onto 5th one now.

Now in February 2017 this year I had the news I was Helico free!!! Felt like I had just won $500k!!!. Now 5 months later I started getting stomach pain and gastic bleeding I had another breath test and they said I am positive once again for Helico I am not even sure how this is possible before my last test I had not been taking any Nexium or antibiotics for 2+ months!!! =(

I had a colonscopy yesterday and they found the following - Mild Gastritis in stomach, 3x large hemorrhoids, 3 x polyps and fungal infection in esophagus. Gastric bleeding would be from the Hemorrhoids which they injected, the fungal infection we can fix, the mild gastritis I will work on fixing what do people recommend here.

I am only 29 and I am worried about Gastric cancer as many family members have had it grandparents/ uncles ect =( My dad also suffers from many stomach issues and has been on Nexium for 15 years.

I am not over weight and I am healthly and do not drink much alcohol or smoke or eat spicy food, I run a business so I am a little stressed at times.

- My question is what is next treatment wise a new Gastro DR I had said we might need to do a combination treatment of EVERYTHING!!! it sounds quite full and from experience Rifibutin was the worst drug I had it cause gastric bleeding for 7 days after taking it.

A new Gastro Professor I am seeing I feel confident about which is positive I just need answers what to do long term.

Should I be getting endoscopy and colonscopy every 2-3 years??

Helico_expert
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Re: Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

Post by Helico_expert » Wed Jun 14, 2017 1:55 am

Since they found abnormalities in your stomach, you should have an endoscopy check up every year until everything is cleared up.

about your H. pylori treatment, how did you know your Rifabutin treatment worked? did you do a follow up breath test to show clearance of HP? I asked because it is actually quite hard for anyone to be reinfected with HP. More likely that you failed previous treatment. Nevertheless, if indeed you were reinfected, perhaps you should find out the source. Usually the very close one living under the same roof. Sharing food/drink, toilets, and domestic animals.

Everyone living under the same roof should be aware of personal hygiene. Brushing teeth, washing hands, and not sharing food will reduce the transmission by a lot.

So what did your specialist do this time? did he get some biopsies for culture and testing? if he didnt, what treatment is he prescribing you?

James88
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Re: Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

Post by James88 » Wed Jun 14, 2017 2:45 am

Specialist said that biopsies are hard to culture, last endoscopy I had in 2016 they could not culture the helico. I recently changed specialists as well as my last one made a few mistakes and I was not 100% happy with him. New one has many research papers on Helicobacter and I feel more confident with him he is a professor and his research interest is helico. The last guy seemed to be a more general specialist.

After the rifabutin treatment this was 1+ years ago I still came back positive for helico on follow up breath test.

Do you also think that the breath test in Feb could have been a faulse positive becuase the helico could have been hiding in stomach wall and not picked up is this possible or maybe it was 98% wiped out and the 2% was still around.

I am worried that my dad might be infected with helico and potentially cross contaminate me.

Also on a side note I had some VERY heavy antibiotics in 2006 when I had MRSA could this be correlated to the failure of antibiotics treatments? If I contracted helico as a child.

I wouldn't mind sharing my case files with Barry and the team in perth as well for a cross check on everything.

James88
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Re: Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

Post by James88 » Wed Jun 14, 2017 2:46 am

Also here is the only treatment that came back positive - viewtopic.php?t=206094

Helico_expert
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Re: Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

Post by Helico_expert » Fri Jun 16, 2017 9:52 am

Your doctor is right about culturing H. pylori. It can be tricky. However, it is the only way to culture H. pylori at current stage.

It is possible that you got a false negative breath test in October 2016. Nevertheless, you got it now and if possible, your doctor should try culture it. Anyone living with you should get tested too. Just in case.

Thanks for sharing the link to your previous post.

In your latest treatment, you had PPI, Bismuth, Amox and Doxycycline.

You can remind your doctor that Bismuth and Amox can be reused as H. pylori never get resistant to them. In addition, since Amox is a very safe drug, can consider increasing the dose to 1g, 3 times a day. Also, dont try Nexium anymore. Some people metabolise Nexium faster and less effective. Try Rabeprazole (20mg, 3 times a day).

So, if your doctor is not able to culture H. pylori, perhaps he can consider using furazolidone.

James88
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Re: Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

Post by James88 » Sun Jun 25, 2017 11:48 am

Thanks the last treatment I had I was doing 14 x days of Amoxycillin 500mg (two capsules twice a with food) so that was a decent amount.

The specialist I am seeing said my next treatment could be - Rifabutin/ Levofloxacin/ Amoxil/ PPI - I am just worried as I did a 14 days course of Rifabutin in the past and it didn't work and I had side effects.

What if my next treatment is - Bismuth/ 3 x Amoxil daily/ Rabeprazole it seems similar to my last treatment.

What about other antibitoics like - clarithromycin + amoxil + PPI found studies here - https://www.ncbi.nlm.nih.gov/pubmed/11367976


https://www.ncbi.nlm.nih.gov/pubmed/27060292

Helico_expert
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Re: Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

Post by Helico_expert » Sun Jun 25, 2017 2:48 pm

Clarithromycin is usually the first line treatment. When failed, it is assumed that it is resistant.
metronidazole is usually the second line. Again, when failed, it is also assumed resistant.
levofloxacin is usually the third line. I am not sure if you had it before. It is quiet easily became resistant if you had it before.
Rifabutin is less likely to become resistant to. However, we had seen a few cases.

other antibiotics your doctor can try is Tetracycline and Furazolidone.

you should ask your doctor to increase PPI dose, perhaps try 20mg Rabeprazole 3 times a day.

James88
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Re: Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

Post by James88 » Tue Jun 27, 2017 9:15 am

Isn't Tetracycline the same group as doxycycline. I have been tested on Doxy in the past with the bismuth.

I need to acquire a full list of prior treatments from my past gastro dr and line these up with the new dr.

Helico_expert
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Re: Negative after bismuth Treatment now Positive again for Helico (whats next?) =(

Post by Helico_expert » Wed Jun 28, 2017 12:03 am

yea... Tetracycline is the same family with Doxycyline. However, Tetracycline is not well absorbed by the body. We believe that it works better that way as it stays in the stomach longer. it is still on debate whether doxycline works better than tetracycline.

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