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some questions about h pylori

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sam-w
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some questions about h pylori

Post by sam-w » Fri Mar 25, 2016 9:20 pm

Hi,

I took a 14 day course of ABX + PPI for H Pylori (Omeprazole, Amoxicillin, and Clarithromycin) last year. I retested after 2 months via faecal antigen test, and the result was negative.

I changed out all the toothbrushes in my house, and I even made my husband take a blood test to make sure we weren't passing the infection back and forth between us. He was negative, which was a relief.

My story seems very similar on these boards - that gastritis post H Pylori treatment is very common (is it iatrogenic?). It seems crazy to me that we recommend treatment for H Pylori knowing that people may end up with a lifelong case of gastritis!

Anyway, here are my questions:

1) Are there any good papers about the safety or efficacy of PPIs or H2 inhibitors long-term?

2) Are there any good papers about post-H Pylori gastritis?

3) Even if I did have H Pylori again, and went through all the re-testing and painful treatment (and increased to 4 antibiotics this time, which sounds so painful, I wanted to die the first time around) rigamarole, am I right to say that there would still be no guarantee that the gastritis would be improved?

4) What is the standardized mortality ratio for h pylori? (Just FYI - A standardized mortality ratio for the population at large is 1.0. Anything higher than 1.0 suggests that more deaths occur than were expected and less than 1.0 suggests less than expected. This the way epidemiologists can identify whether certain diseases and chronic illnesses actually impact life expectancy or not.

As an example - Crohn's has an SMR of 1.39 [D. Duricova et al., 2010]. I do not have Crohn's, but I was just wondering if H Pylori meets the qualification as a chronic illness, and whether it actually impacts life expectancy...

Helico_expert
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Re: some questions about h pylori

Post by Helico_expert » Tue Mar 29, 2016 1:29 am

1) Are there any good papers about the safety or efficacy of PPIs or H2 inhibitors long-term?
http://link.springer.com/article/10.100 ... 015-0576-z
http://onlinelibrary.wiley.com/doi/10.1 ... 12697/full

In general, acid inhibition is known to associate with B12 deficiency and osteoporosis. H2 blocker is more onset and has less lasting effect. PPI is more thorough and longer inhibition of acid secretion, but it takes longer time to kick in.
2) Are there any good papers about post-H Pylori gastritis?
unfortunately very is known about this. Some people believes that that the stomach is trying to readjust itself back to normal.
3) Even if I did have H Pylori again, and went through all the re-testing and painful treatment (and increased to 4 antibiotics this time, which sounds so painful, I wanted to die the first time around) rigamarole, am I right to say that there would still be no guarantee that the gastritis would be improved?
This is a very subjective question. Some patients improved and some dont. But most people does feel better. So have you had yourself tested for H. pylori? Have you done an endoscopy examination before?
4) What is the standardized mortality ratio for h pylori? (Just FYI - A standardized mortality ratio for the population at large is 1.0. Anything higher than 1.0 suggests that more deaths occur than were expected and less than 1.0 suggests less than expected. This the way epidemiologists can identify whether certain diseases and chronic illnesses actually impact life expectancy or not.
H. pylori is a very chronic infection. More than half of the world population is infected with H. pylori. Usually people became a carrier when they are young children. Most people carry H. pylori without symptom for without knowing. However, about 50% of the carrier will experience some kind of symptoms when reach 30-50 yrs old. Many of these symptoms are negligible and so there is very little record in this area. about 10% of these infected person will develop peptic ulcer diseases and about 1% will progress into cancer. So overall, although not calculated, the mortality ratio is expect to be very very low. Of course, if you meant before the discovery of H. pylori where the prevalence was like 90%, lots of people are required to take long term PPI and die from bleeding ulcers.

sam-w
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Re: some questions about h pylori

Post by sam-w » Fri Apr 15, 2016 8:22 pm

hi, Thanks for the answers to my questions.

You asked me
So have you had yourself tested for H. pylori? Have you done an endoscopy examination before?

My H Pylori was actually diagnosed via a faecal antigen test. I had had an endoscopy, but it found nothing, thus the faecal test.

Feb 2015 - H Pylori treatment (omeprazole, amoxicillin + Clarithromycin)

May 2015 - re-test (and no PPIs were used from end of treatment to retesting) - no more H Pylori antigen

May 2015- now - vomiting and regurgitation

My doctor honestly seems out of his element - he didn't even tell me to retest post-treatment. He doesn't understand the post-treatment vomiting. I had to do research to try PPIs on my own, but I get a horrible headache from them and also horrid constipation. I feel very stuck because my quality of life has been severely impacted by the vomiting/regurgitation but I honestly don't know what else I can do as PPIs seem to be the only treatment for the vomiting.

Helico_expert
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Joined: Tue Mar 01, 2011 11:20 pm

Re: some questions about h pylori

Post by Helico_expert » Sat Apr 16, 2016 9:10 am

if you have tested yourself in May and got a negative result for H. pylori, the chance of getting H. pylori again since then is low. Assuming that the test is accurate of course.

H. pylori doesnt cause vomit and headache. So i am suspecting other type of food poisoning. Usually vomit is self limiting. food poisoning that involve vomiting usually comes with fever and gets better after 3-5 days. So how do you feel now?

if you have not feel better, and it has been a while, have your doctor checked for the possibility of food poisoning? such as giardia?

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