Testing and treatment for spouse and children?

[mmdl]

Hi everyone,

Very happy to have found this forum. I find it a bit comforting to know that I'm not the only one going through this horrid ordeal with HP.

First a bit about me. I live in Hong Kong and was diagnosed with severe gastritis and HP in November 2013 via gastroscopy with biopsy. Was given first line treatment of triple therapy (PPI, amoxicillin, and clarityomicin - if I recall correctly). After the treatment was tested in January 2014 via UBT and results came back negative.

Nearly 18 months have passed and I still had recurring abdominal pain and diarrhea. Went back to the gastroenterologist for check up and we did another gastroscopy in early July. Results came back with the CLO test negative but histology reports confirm moderate HP infection with severe mixed inflammatory infiltrate including plasma cells and neutrophils; along with moderate intestinal metaplasia (IM).

I was devastated with the results - especially the diagnosis of IM. The doctor said it was likely the first round treatment failed and the UBT came back with a false negative. This time around he prescribed quadruple therapy (bismuth citrate, rabeprazole, tetracyline and metronidazole) 14 days. Am about to finish the treatment tomorrow and will schedule a follow up UBT in about 4 four weeks.

My question shouldn't have the doctor also considered my family (wife and son - 2 year old) situation and assessed whether they should also be tested and treated? Since he didn't, should I have my wife and son tested and treated if necessary? I am terrified of getting reinfected with HP especially now that I have also been diagnosed with IM.

What is the likelihood of reinfection?

Comments and insight appreciated. Thank you.

[Helico_expert]

That's a fantastic question. Real reinfection is rare, but not impossible. That's why your doctor thinks that it is likely you failed your previous treatment. many doctors would think the same. However, you are right that even though the chance of catching H. pylori from your wife (via kissing) is low, given 18 months of trying, you only need one successful transmission via saliva to be reinfected. Therefore, if you are really worried of reinfection, perhaps it is a good idea that you get your wife to go check up too.

It is less likely for adults to catch H. pylori from children. I am assuming that we adults do not share food and drinks with children. If they are below 12 yrs old and have no symptoms, perhaps it is not necessary to test and treatment until they are older.