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H Pylori but no inflammation?

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Johno87
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H Pylori but no inflammation?

Post by Johno87 » Wed Sep 14, 2016 11:10 pm

Hi all, so I'm coming up to the 3 month mark of my h pylori treatment, and it seems as though my symptoms are getting worse. I now have a constant ache in my upper abdomen, and occasional stabbing pains under my right and left ribs.

I've had a battery of tests done, including blood tests, urine tests, stool sample, CT Scan, abdominal ultrasound, Chest xray, and an endoscopy. I also had a breath test done a month after treatment, which was negative. All other results so far have been negative, and my endoscopy showed no inflammation (both by eye and biopsy). I was on a PPI though during my endoscopy. My current tentative diagnosis is functional dyspesia, although I still need to do a colonoscopy if my symptoms don't resolve.

So my question is: is it possible to have H pylori but no inflammation? And is it possible for H pylori to cause constant abdominal pain with a negative endoscopy?


Thanks for your time.

Helico_expert
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Re: H Pylori but no inflammation?

Post by Helico_expert » Wed Sep 14, 2016 11:47 pm

If you have H. pylori, you'll have inflammation and histology will not miss.

the standard endoscopy examination cannot see H. pylori. only histology, CLOtest, and culture can determine the presence of HP.

Johno87
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Re: H Pylori but no inflammation?

Post by Johno87 » Wed Sep 14, 2016 11:53 pm

Thank you for your prompt reply. I was taking a PPI the night before I had my endoscopy the next day, would that have affected the biopsies? They took four (esophagus, two from stomach, and one from the duodenum). Each showed no signs of inflammation.

Do you have any idea for why I'm experiencing my current symptoms? Is it just a matter of waiting for my stomach to heal?

I've seen so many doctors and specialists, and none of them can tell me why I'm experiencing my current pain, other than diagnosing it as a functional disorder.

Johno87
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Re: H Pylori but no inflammation?

Post by Johno87 » Sat Sep 17, 2016 5:35 pm

Anyone with ideas?

Helico_expert
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Re: H Pylori but no inflammation?

Post by Helico_expert » Mon Sep 19, 2016 11:11 am

opps... missed your post.

PPI will reduce H. pylori load and may reduce inflammation.

i think you'll need to slowly reduce your PPI or switch to something milder, such as Ranitidine, and do a follow up breath test. Make sure your H. pylori is completely eradicated. Then only you can focus on the healing.

Johno87
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Re: H Pylori but no inflammation?

Post by Johno87 » Tue Sep 20, 2016 1:19 am

Thanks Helico Expert.

Would the PPI also cause them to miss inflammation in a biopsy? I had the same symptoms both on and off the PPI (a constant ache below my sternum).

Today is two weeks off of the PPI, and I can't tell if the pain I'm feeling is from the acid rebound effect or something else (an ache 24/7 with occasional burning, especially in the morning).

Helico_expert
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Re: H Pylori but no inflammation?

Post by Helico_expert » Tue Sep 20, 2016 4:49 am

it really depends on your immune response. But, the histology must be able to see inflammation, either the active chronic gastritis, which indicate something is still not right, or just chronic gastritis, which indicate that it's healing.

if you want, you can take ranitidine for a week to see if that helps. next week, you can go for a follow up breath test to find out if your treatment actually works.

Johno87
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Re: H Pylori but no inflammation?

Post by Johno87 » Wed Sep 21, 2016 12:16 am

Thanks, I have an appointment with my doctor on Thursday, and will hopefully do a breath test on Friday. Part of me hopes it's positive, and that another course of antibiotics will get rid of my pain, while the other half never wants to do those antibiotics again.

Is it possible that the H Pylori is still in my stomach causing pain, even if the endoscopy and biopsies didn't see anything?

If It's positive I have to make a hard choice over whether the antibiotics will fix my problem or make it worse.

Helico_expert
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Re: H Pylori but no inflammation?

Post by Helico_expert » Wed Sep 21, 2016 12:21 am

It is always better that your H. pylori is eradicated in your previous treatment. So you dont have to go go through the antibiotics again.

If you are indeed still positive of H. pylori, then I think it is better to have another treatment to have your H. pylori eradicated. It is always better not to have a pathogen in your stomach, knowing that it is associated with gastric cancer.

If you are negative of H. pylori, you just need to give time for your stomach to be healthy again. Everyone is different. Some people recover within a week, and some take months or years. Most importantly, only when there is no H. pylori, your stomach can slowly recover.

Johno87
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Re: H Pylori but no inflammation?

Post by Johno87 » Wed Sep 21, 2016 12:29 am

Thanks, I will update this post once I get my breath test results (test will be on Friday).

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