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h. pylori exterminated, but atrophic gastritis remains

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

Moderators: Toni, barjammar, luci2010, Ondek-Expert, kkimura

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malcolm
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h. pylori exterminated, but atrophic gastritis remains

Post by malcolm » Thu Sep 08, 2011 9:39 pm

Until recently I had a pylori infection, probably picked up within the past 10 years in a developing country, but 2 months ago, on my second try with antibiotic treatment, it appears that it has been eradicated. (My breath test was 0.1, below the threshold of 2.0 for positive.) The problem is that the atrophic gastritis that I have had for the past 3 years hasn't gone away, and actually may have gotten a little worse. (This year's barium x-ray test showed some inflammation in the lower esophagus, which wasn't present a year ago.)

My question is, do I have any hope that my atrophic gastritis may heal now that the bacteria is gone? Or is my stomach permanently damaged? It's only been 2 months since the antibiotic treatment, so I'm hoping that I just haven't waited long enough, but I'm worried because my condition was much more serious than just the ordinary chronic gastritis that many people with heliocobacter have, and it progressed relatively quickly.

Helico_expert
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Re: h. pylori exterminated, but atrophic gastritis remains

Post by Helico_expert » Sat Sep 10, 2011 12:48 am

so when did you finish your last antibiotic treatment and how long did you wait before you did your breath test?
can you list down the antibiotics you had taken too?

thanks

malcolm
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Re: h. pylori exterminated, but atrophic gastritis remains

Post by malcolm » Sat Sep 10, 2011 7:39 pm

Thank you for your response.

I finished my antibiotics in early July and had a breath test 6 weeks later, on 22 Aug. I just had a barium X-ray on 8 Sept, which was about 2 months after the antibiotics were finished. I have no idea which antibiotics I took (I live in Japan), but it was my second treatment, after the first one, with different antibiotics, having failed last year. What does this have to do with when and if my atrophic gastritis will go away, or do you suspect that the infection has not been eliminated?

There are 2 kinds of AG - I have the type that is caused by h. pylori, as is evidenced by the way it started from the lower part of my stomach and gradually spread upward. No one else in my family has ever had stomach problems, probably because none of them have ever had h. pylori.

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barjammar
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Re: h. pylori exterminated, but atrophic gastritis remains

Post by barjammar » Sun Sep 11, 2011 5:45 pm

Atrophic gastritis could be present as an appearance (through the endoscope or the barium meal) or on biopsy. Assuming the biopsy was used to make that diagnosis, then the following applies.
1. Atrophic gastritis does not resolve completely - it is mostly permanent.
2. If the AG is very severe (i.e. all the acid secreting mucosa is replaced by intestinal mucosa, or pyloric mucosa, and you cannot make acid any more) then you will have a small cancer risk of about 0.5% per year. I would recommend that you undergo surveillance at endoscopy each year.
3. If the AG is mild, then you do still make some acid. As such your cancer risk will probably decline over the next 5 years back to a low risk.
4. There is some work to suggest that vitamin C confers some protection from carcinogens. I recommend that you take a small daily dose of vitamin C, 250mg would be plenty. Or drink orange juice every day. Fresh vegetables and refrigeration in the USA caused stomach cancer to decline even at a time when most people were still infected with Hp (1930-1960).
5. Very salty diet increases cancer risk so avoid salty foods (anchovies, fish and chips with salt++).
That should do it!
8-)
Check the link below for information on hard-to-treat cases. Then search the forums for questions and answers similar to yours.
docs/200808%20stenstrom%20Hp%20Treatment.pdf

malcolm
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Re: h. pylori exterminated, but atrophic gastritis remains

Post by malcolm » Tue Sep 13, 2011 9:21 pm

Thank you very, very much, Dr. Marshall, for your response.

My atrophic gastritis was diagnosed by a barium X-ray (actually, its been there 4 years in a row), but I have yet to have a biopsy. This year I had a gastroscopy, but the doctor performing it said that she didn't see any evidence of a problem, so she didn't do a biopsy. (At the time I didn't know how serious a problem AG is. I wish someone had mentioned this to me a few years ago.) I will have another endoscopy and biopsy in a few weeks when I get the print out of my annual physical. I often burp a little after I eat and recently have had some acid reflex, so hopefully this indicates that I have stomach acid.

I hate salty food, but its hard to avoid it in Japan. At least now my wife might be persuaded to stop adding salt to our food, as I've been asking her to do for years. (I showed her what you wrote.)

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Re: h. pylori exterminated, but atrophic gastritis remains

Post by Helico_expert » Wed Sep 14, 2011 6:10 am

when is your last breath test? have you eradicated your H. pylori?

malcolm
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Re: h. pylori exterminated, but atrophic gastritis remains

Post by malcolm » Fri Mar 07, 2014 11:25 am

I just want to update this old thread to give hope to anyone undergoing treatment for h. pylori and AG:

After I posted about my eradication treatment and atrophic gastritis 2 1/2 years ago, I developed horrible acid reflux in the fall of 2011 (a few months after the treatment). Sometimes I would wake up nauseous in the middle of the night, and one time I tore my esophagus from vomiting so hard. A gastroscopy revealed some acid damage to the bottom of the esophagus and dark spots of AG were visible in my stomach.

I started on some medicine for the acid reflux, including a PPI, and they fixed the problem. 6 months later I stopped taking the PPI (I had stopped the other medicine earlier) and was fine after initially experiencing some return of the symptoms for a week. A little more than a year after the h. pylori antibiotic treatment, I had another gastroscopy and this time the black spots were no longer seen and I was told that my AG was almost completely gone (a 1 on a scale of 1 to 6). According to the doctor my risk for stomach cancer is no higher than if I had not had the infection.

It's been a couple of years and my stomach feels great, the best it's felt in years. I eat anything I want, and I love spicy food. I just want to say thank you to Dr. Marshall for his research and everyone here for their advice, and also I would encourage anyone who is infected to get it treated right away and to know that even though you may be experiencing horrible gastritis or acid reflux, with treatment there's a good chance that it will only be temporary.

Helico_expert
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Re: h. pylori exterminated, but atrophic gastritis remains

Post by Helico_expert » Fri Mar 07, 2014 11:38 am

That's a wonderful news. Your update is very important to the community.

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Nat
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Re: h. pylori exterminated, but atrophic gastritis remains

Post by Nat » Wed Jun 18, 2014 5:02 am

Thanks for the update Malcolm. Speaking from someone going through eradication ....its really uplifting hearing about your success.

Yankee
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Re: h. pylori exterminated, but atrophic gastritis remains

Post by Yankee » Thu Dec 17, 2015 2:38 pm

Dear Malcom,

Sorry to come back on this old post, and also sorry for my english, I'm french speaker living in canada. It gives me hope to know that you are now able to eat spicy food.

I have atrophic gastritis cause of H. pylori. The H. pylori is now eradicated since june 2015. 7 weeks after, the breath test become negative.

But I still have acid reflux as soon as I eat acid food: milk, spicy food...etc

Could you please tell me the medecines and ppi you've been taken that healed you? Did you take vitamin C as suggested by barjammar?

Orange juice was given me reflux a year ago when I had H. pylori. So, I've stopped everything acid including orange.

Now I'm taking zinc carnosine supplement and slippery elm. That help me, but I'm healed. anytime I eat "bad" food, the pain comes back. I also used to take omeprazole sometime in case of crisis.

Thank you very much.

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