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H PYLORI IN THE MOUTH!! What tests should I have please?

Breath tests are the most accurate way of detecting H.pylori without actually having an endoscopy (stomach examination). Breath tests are especially useful after treatment to make sure H.pylori is cured. Urea breath tests are known to be completely harmless. Either C14-urea or C13-urea tests are used. Read about them at the diagnosis section at http://www.helico.com/diag_breath.html where a diagram can be found. C14-urea breath tests use a radioactive tracer but such a tiny amount that it can be used safely at any age. It is a 15 minute test, convenient and inexpensive. The C13-urea test uses a stable isotope of carbon which is also harmless but requires two breath samples and takes about 30 minutes. Both tests have accuracy greater than 90%.

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b3rn41987
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Posts: 13
Joined: Mon Dec 30, 2013 8:49 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by b3rn41987 » Wed Jan 22, 2014 3:03 pm

Hi Helico_expert and Rifle-li,

Firstly, let me say Rifle-li that your re-infection is unfortunate but worth of further study because: I am not entirely convinced with helico-expert's response

Helico_expert, your statement : " In the end, we concluded that that's a false positive from mouth. Probably via contamination from an unknown source." seem to be flawed because you are deriving a conclusion ( "false positive, peobably viw contamination from unknown source" ) by a flawed reasoning ("because of the very low success rate").

Also you say: "But our finding (sample size = 1) suggested that it is also possible that contamination food or water or saliva from someone else could temporarily leave some H. pylori in the mouth for a short period of time (not measured). " Your conclusion seem to be erroneous because in one hand your study is "not measured" on the other hand you are concluded that "it could temporarily leave some H. pylori in the mouth ". How temporarily, where is the evidence that someone else's saliva would -possibly- leave H Pylori in someone else's mouth. If so, would it not be worth of investigating it bearing mind that sexual transmission (by kissing or oral sex) will also transmit the disease?

Also you say: "Is the mouth H. pylori always the same as the one in the stomach? " Is it? But how would you know if you did not study with a larger sample base?

Finally, you are concluding that : " Anyway, just want to stress that it's possible to culture H. pylori from mouth, but very difficult and inefficient." Yes it may be difficult but then your conclusion is clearly flawed because you seem to be saying that "well we find it difficult (meaning time consuming and costly) so we decided that it is at present not worth to make the effort for a further study".

I am getting an impression from your response that unless the issue effects the majority of public any minor issue will be ignored and will not be studied (due to financial constrains etc), so it will be concluded (regardless of how flawed the conclusion or the reasoning may be) that it is not worth studying.

I am not convinced with your reasoning and conclusions.
Thank you

b3rn41987
Genuine user
Posts: 13
Joined: Mon Dec 30, 2013 8:49 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by b3rn41987 » Wed Jan 22, 2014 3:03 pm

Hi Helico_expert and Rifle-li,

Firstly, let me say Rifle-li that your re-infection is unfortunate but worth of further study because: I am not entirely convinced with helico-expert's response

Helico_expert, your statement : " In the end, we concluded that that's a false positive from mouth. Probably via contamination from an unknown source." seem to be flawed because you are deriving a conclusion ( "false positive, peobably viw contamination from unknown source" ) by a flawed reasoning ("because of the very low success rate").

Also you say: "But our finding (sample size = 1) suggested that it is also possible that contamination food or water or saliva from someone else could temporarily leave some H. pylori in the mouth for a short period of time (not measured). " Your conclusion seem to be erroneous because in one hand your study is "not measured" on the other hand you are concluded that "it could temporarily leave some H. pylori in the mouth ". How temporarily, where is the evidence that someone else's saliva would -possibly- leave H Pylori in someone else's mouth. If so, would it not be worth of investigating it bearing mind that sexual transmission (by kissing or oral sex) will also transmit the disease?

Also you say: "Is the mouth H. pylori always the same as the one in the stomach? " Is it? But how would you know if you did not study with a larger sample base?

Finally, you are concluding that : " Anyway, just want to stress that it's possible to culture H. pylori from mouth, but very difficult and inefficient." Yes it may be difficult but then your conclusion is clearly flawed because you seem to be saying that "well we find it difficult (meaning time consuming and costly) so we decided that it is at present not worth to make the effort for a further study".

I am getting an impression from your response that unless the issue effects the majority of public any minor issue will be ignored and will not be studied (due to financial constrains etc), so it will be concluded (regardless of how flawed the conclusion or the reasoning may be) that it is not worth studying.

I am not convinced with your reasoning and conclusions.
Thank you

b3rn41987
Genuine user
Posts: 13
Joined: Mon Dec 30, 2013 8:49 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by b3rn41987 » Wed Jan 22, 2014 3:03 pm

Hi Helico_expert and Rifle-li,

Firstly, let me say Rifle-li that your re-infection is unfortunate but worth of further study because: I am not entirely convinced with helico-expert's response

Helico_expert, your statement : " In the end, we concluded that that's a false positive from mouth. Probably via contamination from an unknown source." seem to be flawed because you are deriving a conclusion ( "false positive, peobably viw contamination from unknown source" ) by a flawed reasoning ("because of the very low success rate").

Also you say: "But our finding (sample size = 1) suggested that it is also possible that contamination food or water or saliva from someone else could temporarily leave some H. pylori in the mouth for a short period of time (not measured). " Your conclusion seem to be erroneous because in one hand your study is "not measured" on the other hand you are concluded that "it could temporarily leave some H. pylori in the mouth ". How temporarily, where is the evidence that someone else's saliva would -possibly- leave H Pylori in someone else's mouth. If so, would it not be worth of investigating it bearing mind that sexual transmission (by kissing or oral sex) will also transmit the disease?

Also you say: "Is the mouth H. pylori always the same as the one in the stomach? " Is it? But how would you know if you did not study with a larger sample base?

Finally, you are concluding that : " Anyway, just want to stress that it's possible to culture H. pylori from mouth, but very difficult and inefficient." Yes it may be difficult but then your conclusion is clearly flawed because you seem to be saying that "well we find it difficult (meaning time consuming and costly) so we decided that it is at present not worth to make the effort for a further study".

I am getting an impression from your response that unless the issue effects the majority of public any minor issue will be ignored and will not be studied (due to financial constrains etc), so it will be concluded (regardless of how flawed the conclusion or the reasoning may be) that it is not worth studying.

I am not convinced with your reasoning and conclusions.
Thank you

b3rn41987
Genuine user
Posts: 13
Joined: Mon Dec 30, 2013 8:49 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by b3rn41987 » Wed Jan 22, 2014 3:07 pm

Hi Helico_expert and Rifle-li,

Firstly, let me say Rifle-li that your re-infection is unfortunate but worth of further study because: I am not entirely convinced with helico-expert's response

Helico_expert, your statement : " In the end, we concluded that that's a false positive from mouth. Probably via contamination from an unknown source." seem to be flawed because you are deriving a conclusion ( "false positive, peobably viw contamination from unknown source" ) by a flawed reasoning ("because of the very low success rate").

Also you say: "But our finding (sample size = 1) suggested that it is also possible that contamination food or water or saliva from someone else could temporarily leave some H. pylori in the mouth for a short period of time (not measured). " Your conclusion seem to be erroneous because in one hand your study is "not measured" on the other hand you are concluded that "it could temporarily leave some H. pylori in the mouth ". How temporarily, where is the evidence that someone else's saliva would -possibly- leave H Pylori in someone else's mouth. If so, would it not be worth of investigating it bearing mind that sexual transmission (by kissing or oral sex) will also transmit the disease?

Also you say: "Is the mouth H. pylori always the same as the one in the stomach? " Is it? But how would you know if you did not study with a larger sample base?

Finally, you are concluding that : " Anyway, just want to stress that it's possible to culture H. pylori from mouth, but very difficult and inefficient." Yes it may be difficult but then your conclusion is clearly flawed because you seem to be saying that "well we find it difficult (meaning time consuming and costly) so we decided that it is at present not worth to make the effort for a further study".

I am getting an impression from your response that unless the issue effects the majority of public any minor issue will be ignored and will not be studied (due to financial constrains etc), so it will be concluded (regardless of how flawed the conclusion or the reasoning may be) that it is not worth studying.

I am not convinced with your reasoning and conclusions.
Thank you

rifle_li
Genuine user
Posts: 48
Joined: Sun Mar 27, 2011 2:30 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by rifle_li » Thu Jan 23, 2014 2:14 am

Thank you, b3rn41987.
Firstly let me state that I am a patient, not a doctor. So my opinion is only of myself. I have read a lot of articles of H.pylori after sick. Most doctors think reinfection is rare after eradicate. One three years study included 500 peoples in China showed reinfection rate is less than 5%. And these patients were not asked to take some special hygiene methods in everyday life. Most Chinese family share food in one plate, that is bad habit, but it seems not the crucial path to transmit H.pylori.
It is difficult to distinguish reinfection and recrudescence of H.pylori in clinic. Only DNA test can prove that. But it is hard to operate in clinic. So many doctors think that the infection 1 year after eradicate is reinfection. And infection within 6 months or 1 year is recrudescence. This theory make me believe what happened to me is reinfection. I do not ensure that is true or not. Maybe some people like me is susceptible to H.pylori. Anyway, the real path of H.pylori transmit is still unknown. I am glad to discuss with you.

Helico_expert
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Posts: 2461
Joined: Tue Mar 01, 2011 11:20 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by Helico_expert » Thu Jan 23, 2014 2:45 am

so, back to the original question. What test should you have to test H. pylori in the mouth?

I think you need an expert growing H. pylori from mouth, maybe from one of those people who published those papers, or one of those who is willing to try their methods.

or you can do DNA test (or PCR) and perhaps, by sequencing the gene, will increase the value of the data. and if you do use more than one gene, say 5 genes or more, the data will be more trustworthy.

or, if you are lucky, maybe you can find someone who is willing to do metagenomic sequencing from your mouth to find out all the organisms living in your mouth.

indeed, every experiment has flaw and I am glad you can spot some of them. However, sometimes it is the limitation of what we can do. There is still a lot to be learnt from H. pylori. But since it can now be treated in the majority, it is true that it is getting neglected. The majority has other problems to worry about and unfortunately that's where the funding goes.

This is a good discussion. But I wish we have more funding and man power to help us investigate more on the H. pylori in the mouth issue.

b3rn41987
Genuine user
Posts: 13
Joined: Mon Dec 30, 2013 8:49 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by b3rn41987 » Fri Jan 31, 2014 12:51 pm

Thank you Rifle-li and Helico_expert,

Helico_expert, I had posted two more posts but I cannot see them on the thread now. My questions were:

1. In your previous response you had mentioned that the patients: "can be referred to Dr Marshall after a failure of two therapies", if so what kind of treatment will be available to such patients? For instance; I had a triple therapy (failed) and a quadruple therapy. I will be having a stool test soon to see if the quadruple therapy was successful but if I assume that both my therapies are failed, what other therapy (apart from trying a different group of antibiotics, perhaps?) would be available to me?

2. Is there any study to show what exactly happens in the stomach after H-Pylori eradication? Let assume that the patient had chronic gastritis with H Pylori but after the antibiotic treatment he/she manage to eradicate H Pylori yet he/she is still having the symptoms of gastritis. In other words, is it possible to have the chronic gastritis symptoms after H-Pylori eradication? If so why and how long will it take the body to heal? Or, will the patient be left with a chronic gastritis without H-Pylori?

Thank you

Helico_expert
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Posts: 2461
Joined: Tue Mar 01, 2011 11:20 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by Helico_expert » Sat Feb 01, 2014 4:34 pm

1. according to the guideline, in your case (failing a triple and quadruple therapy), you should ask your specialist to do an antibiotic sensitivity test to find out the next best antibiotic cocktail. Nevertheless, antibiotic sensitivity testing is not easily available. In situation where you cannot do antibiotic sensitivity test, you can discuss with your doctor about the treatment we published (check the following link).

original article
http://onlinelibrary.wiley.com/doi/10.1 ... E9B.f04t03

supportive document
http://onlinelibrary.wiley.com/store/10 ... 4ca1d1eb37


2. after eradication of H. pylori, the stomach will gradually return to normal (no gastritis). the healing can take from weeks to months, different from every individual. Symptom wise, a small percentage of patients develop reflux even without gastritis. It is still something we dont understand at the moment.

b3rn41987
Genuine user
Posts: 13
Joined: Mon Dec 30, 2013 8:49 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by b3rn41987 » Thu Feb 06, 2014 6:47 pm

Helico_Expert,

I have read both studies that you kindly submitted their links and I have found them very useful to say the least (Thank you).

1) With regard to the antibiotic sensitivity test I have now mentioned it to my GP who looked at me blankly and said he would not mind ordering it but he was not sure where (which lab) to get such test. Is there any lab that he or I can order this myself?

2) Also with regard to the acid reflux :

Am I right to assume that H. pylori suppresses stomach acid secretion instead of increasing stomach acidity?

• If the former is correct then the stomach acid should began increasing with the eradication of H Pylori, then it should turn to normal hence there should be no reflux.
• On the other hand, If the former is correct (stomach acid is low during H Pylori) then there should be no reflux either. (because after all where is the acid coming from to create reflux?)

But in both cases (during H Pylori infection and after the eradication of H Pylori) there is acid reflux. Why? What conditions (Is it the low or high level of acid) do create reflux?

Can acid reflux after the eradication be the result of a cell damage during the infection? If so, can this explain why some patients are still getting acid reflux even after eradication?

Thank you

Helico_expert
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Posts: 2461
Joined: Tue Mar 01, 2011 11:20 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by Helico_expert » Fri Feb 07, 2014 1:08 am

Some people can develop thrush during and after antibiotic treatment. You'll need another antibiotic for thrush. Or, you can try honey. I heard it's effective against yeast infection. Nevertheless, I am not expert to thrush .

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