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test's and small history, opinion welcome

There are several types of tests for H.pylori. The major ones have a their own forum.

Moderators: barjammar, Toni

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SteveH
Posts: 8
Joined: Tue Nov 25, 2014 6:49 pm

test's and small history, opinion welcome

Post by SteveH »

Hi, I have had health problems which started with GI problems since about 7 years. 6 years ago I was tested for h pylori via endoscopy (I don't not know how it was tested, urea or culture ect?) The gastro said my stomach lining was inflamed? It came back negative and I was refused the antibody blood test because of the negative endoscopy. Only recently did I realise this is the way my drs went about it, I thought they tested everything and all came back negative.....

So over the last 6 years my health has gotten worse and worse, with my GI symptoms having a knock on affect to my adrenals/thyroid due to inflammation ect ect. Also my stomach acid has dwindled down, my stools are very large. I had a pill cam (capsule endoscopy) which has picked up some ulcers (I only know they were in the small bowel, I do not know how close to the stomach or duodenum, I have asked for a copy of my results to check were the ulcers are located)

Now I have taken some antibiotics doxy and rifaximin for 3 weeks as I also have SIBO, then 2 weeks later after speaking with my GP he has put me in for a stool antigen h pylori test....Is it possible that the antibiotics could interfere with my stool results as there was only 2 weeks between them? If the results come back negative (I'm due them within the next week) Should I be asked to get tested again because of the antibiotics, I was told they don't offer blood testing anymore, should I ask for another stool test from my GP, or speak with my gastro about biopsy, breath test?

Thanks

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: test's and small history, opinion welcome

Post by Helico_expert »

I think 2 weeks is good enough. But since you have ulcer detected, probably you want to do the colonoscopy again a few weeks later to make sure it is healed? then maybe in the same time do an endoscopy to get some biopsy for testing.
:p

SteveH
Posts: 8
Joined: Tue Nov 25, 2014 6:49 pm

Re: test's and small history, opinion welcome

Post by SteveH »

Hi again,

That's what makes it a bit complicated as the endoscopy/colonscopy did not pick up the ulcer, only the capsule pill cam picked up the ulcers and im not sure if im having that test again (but I have asked to see the result, so I can try and find out how close to the stomach the ulcer is)

I have a colonoscopy in 1 weeks time (Can this pick anything up relating to h pylori?)

I'm not sure when my next endoscopy is, but I should ask for a h pylori biopsy testing when I get the appointment? and im due my stool test results later this.

The reason I mentioned the breath test, was I read on this forum a gentleman had negative blood and stool test but a positive breath test and then responded to treatment?

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: test's and small history, opinion welcome

Post by Helico_expert »

i dont think colonoscopy can detect H. pylori, but if you are going to do an upper gastric endoscopy, then you may as well ask for the biopsy testing. Otherwise, just wait another few weeks and get a breath/stool test again (which may probably save you some money)

SteveH
Posts: 8
Joined: Tue Nov 25, 2014 6:49 pm

Re: test's and small history, opinion welcome

Post by SteveH »

Thanks for your input it's much welcome.

I will see my stool test results and take things from there. Whether its treatment or re-testing.

SteveH
Posts: 8
Joined: Tue Nov 25, 2014 6:49 pm

Re: test's and small history, opinion welcome

Post by SteveH »

I have just received the stool antigen test which says "faecal antigen NOT detected" and that's all it says regarding the result, and then it has a message saying "testing should be avoided if the patient has had PPI's and/or antibiotics" it doesn't give within a timescale though. As I mentioned earlier I had doxycycline 2 weeks before the test. How do antibiotics actually affect the test results?

How is it possible that there was a gentleman on this forum with a negative blood and stool test, but then a positive breath test? Shouldn't that be impossible?

Thanks

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: test's and small history, opinion welcome

Post by Helico_expert »

the stool antigen test rely on the amount of bacteria in your guts. If you are taking antibiotics, then the bacteria load may be reduced to minimum. So, detection of small quantity may give false negative result.

similarly, the urea breath test rely on both the bacteria load and acid environment. If the bacteria load is low, then there will not be enough enzyme to break down the radioactive carbon to give meaningful breath test result. In addition, if there is no acid, then the bacteria will turn off the alkaline producing gene (urease) and so there will be no breakdown of radioactive urea to give radioactive carbon dioxide. In both cases, a false negative result will be generated.

in regards to the negative blood and stool test, I know exactly which post you are talking about. in the blood, when you are infected with any pathogen, your immune system produce antibody against it and will remember it. So the next time you are infected with the same pathogen, these memory B cells will quickly gather and produce strong immune response against the pathogen to defend your body. So, because of that, whoever that is infected with H. pylori, their blood will remain positive for H. pylori from weeks to months and even years. Therefore, it is never a good method to confirm the eradication using serology test (blood test).

SteveH
Posts: 8
Joined: Tue Nov 25, 2014 6:49 pm

Re: test's and small history, opinion welcome

Post by SteveH »

Thank you very much for the reply in helping me understand.

I go for my colonoscopy today so I should be able to speak wit my gastro about getting a breath test and/or biopsy from endoscopy. Regarding the breath test and not enough acid, would this only happen from PPI's? if one has reduced acid from h pylori should there still be enough acid to give a valid result?

Regarding the blood and stool antigen/antibody is it at all possible that someone's body would not produce antibodies, if they had a weakened immune system or h pylori for 5+ years ect?

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: test's and small history, opinion welcome

Post by Helico_expert »

Theoretically it is possible to get a false negative result from immuno compromised patient. However, I am not experienced enough to encounter such case. On the other hand, children between 0-2 years old has very naive immune system. It is hardly any positive serology tests from children that young. So, it is either that their immune system is not mature enough to give positive testing or children below 2 years old never get H. pylori infection.

Why children below 2 yr old never get H. pylori could be many factors:
1. the stomach is not developed or acidic enough for H. pylori to colonise
2. the main diet is milk with little chance of H. pylori contamination

Regarding the breath test and not enough acid, would this only happen from PPI's?
Some elderly naturally produce less acid. So it is not only from PPI.

if one has reduced acid from h pylori should there still be enough acid to give a valid result?
it will be rare to have not enough acid in healthy person. However, there are studies where they give patient a small cup of citric acid before the breath test.

SteveH
Posts: 8
Joined: Tue Nov 25, 2014 6:49 pm

Re: test's and small history, opinion welcome

Post by SteveH »

My colonoscopy has pretty much given the diagnosis of chrons disease, multiple ulcers were found in the ileum. I have also sent off my 2nd stool antigen test, this time 4 weeks off antibiotics.

I have greatly reduced stomach acid at present, and I'm not sure of the cause. I can take 20+ HCL capsules with no burning affect. My bowel movements are very large due to poor digestion. I have been on steroids for 5 years and also have systematic yeast, so i'm not sure what state my immune system is in. I would hate to miss h pylori due to my immune system not fighting it. But if everything comes back negative I will have to accept the decision and move on I guess.

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