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Question for Helico expert

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charlie_tummypain
Posts: 11
Joined: Fri Oct 18, 2019 10:39 am

Re: Question for Helico expert

Post by charlie_tummypain » Thu Nov 21, 2019 10:19 am

I got my endoscopy colonoscopy postponed to mid-Dec so that I can get it done with a doctor at a larger hospital who is able to do the antibiotic susceptibility test. With this particular test, I read on Quest Diagnostics website that the gastric sample has to be transported under cold ice otherwise the sample could get compromised and H Pylori may not grow in the culture. Should I remind my doctor of all these things he has to be careful of? See the test below, I am not sure if he is going to be using LabCorp or Quest Diagnostics, but there seems to be a lot of things that need to followed exactly to get the desired results out of this testing.

https://testdirectory.questdiagnostics. ... 45/?cc=AMD

Helico_expert
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Re: Question for Helico expert

Post by Helico_expert » Fri Nov 22, 2019 12:01 pm

yup. it's important that the specimen is store at cold during transport. The shorter the delivery time, the higher the chance of culturing it. Your doctor should know it. The laboratory should remind him.

charlie_tummypain
Posts: 11
Joined: Fri Oct 18, 2019 10:39 am

Re: Question for Helico expert

Post by charlie_tummypain » Mon Nov 25, 2019 2:43 am

UBT came out to be negative on Friday, I went in for the test without eating, drinking anything and did not brush my teeth in the morning. UBT was done 5.5 weeks after I took last antibiotic. Stool test was done a few weeks ago. It was negative as well and it was done 2 weeks and 3 days after finishing antibiotics.

My throat symptoms are still there, now I have a little polyp/outgrowth on my left tonsil. I showed it to my Primary care physician, he asked me to see a Ear Nose Throat specialist.

Endoscopy Colonoscopy is scheduled for mid-Dec, should I ask them to take biopsy from the throat/tonsil area as well as from the stomach and then culture both of them to see what grows.

Could this be some form of viral? like EBV ? If it is viral, why am I having GI symptoms in addition to throat symptoms?

Helico_expert
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Re: Question for Helico expert

Post by Helico_expert » Mon Nov 25, 2019 11:41 am

good to know that you are HP negative now. but what is the cut off value for your breath test? i want to know how negative is your negative result.

i dont think culture is useful if there is no HP.

a histology is good to see the progress of your recovery

sibanathkanu
Posts: 3
Joined: Tue Nov 19, 2019 12:19 pm

Re: Question for Helico expert

Post by sibanathkanu » Wed Nov 27, 2019 6:35 pm

After triple therapy treatment , is there any chance of getting reinfected with h.pyloiri? And what are the foods that I must not consume so as to avoid getting reinfection?

Helico_expert
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Re: Question for Helico expert

Post by Helico_expert » Thu Nov 28, 2019 1:06 pm

Reinfection is possible, but rare.

The condition for the spread to happen is
1. Living together. Constant exposure to each other’s saliva.
2. The carrier has poor hygiene. Not brushing teeth and not washing hands after toilet.
3. The carrier is vomiting (eg. Alcohol drinking). Then there is high concentration of HP in the vomit. The cleaning person may catch it.

I believe that Food is not source of H. pylori infection. You can H. pylori from constant kissing and sharing utensils with your partner or relatives.

charlie_tummypain
Posts: 11
Joined: Fri Oct 18, 2019 10:39 am

Re: Question for Helico expert

Post by charlie_tummypain » Mon Dec 02, 2019 6:12 am

It is possible I could be getting false negatives on the stool test and UBT. I am not sure of the cut off value on the UBT, I tried looking up Quest Diagnostics website but could not find. The test result just said "Negative" , there was no mention of cut off values.

Helico_expert
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Re: Question for Helico expert

Post by Helico_expert » Mon Dec 02, 2019 9:30 am

the stool test is relying on the actual bacterial load. The more bacteria, the higher the accuracy.
the UBT is relying on both bacterial load and acid level. The more bacteria and acid, the higher the accuracy.

PPI can lower the acid and sometimes lower the bacterial load.
antibiotics can lower the bacterial load.
Some herbs may have similar effect to either PPI or antibiotics.

so you will need to stop both PPI and antibiotics (and possible herbs) for at least 2 weeks before doing stool or UBT testing.
The longer you wait, the more HP in your stomach, the higher the accuracy.

However, some people (usually the elderly) with atrophic gastritis, they dont produce enough acid, stool test or UBT may fail.

ankiwo72
Posts: 57
Joined: Fri May 17, 2019 2:45 am

Re: Question for Helico expert

Post by ankiwo72 » Mon Dec 02, 2019 11:40 am

Helico_expert wrote:
Mon Dec 02, 2019 9:30 am
the UBT is relying on both bacterial load and acid level. The more bacteria and acid, the higher the accuracy.
Oh wow, I didn’t know breath test was sensitive to stomach acid!

What if you didn’t eat for 3-4 hours prior to the test and were very hungry, producing lots of stomach acid thinking of food... could that by itself render a false positive result?

Helico_expert
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Re: Question for Helico expert

Post by Helico_expert » Mon Dec 02, 2019 12:12 pm

prior UBT, you will be asked for overnight fasting.

or at least 2-4 hrs after food for urgent cases.

the higher the acid, the higher the accuracy of UBT.

If you have HP, it produces urease enzyme to breakdown urea into CO2 and NH3. The NH3 is then used to neutralize the acid for its survival in the acidic environment.

if you dont have acid, HP is very smart in turning off the urease enzyme. so no excessive NH3 is produced. otherwise the environment will be too alkaline for its survival.

UBT = urea breath test. Prof Marshall discover this secret of HP and invented the urea breath test. He labeled the Urea with a Carbon isotope that can be tracked.

So if you dont have HP, no matter how acidic your stomach is, there will be no urease to break down the urea, you will not get false positive.

if you dont have acid, some other bacteria will start growing in the stomach, then the Urea will be broken down by some, but not as efficient as HP, you might get a low positive. Hence it is important to know the value of the UBT.

many doctors and nurses dont understand the principle and ignore the raw data. They just want simple positive or negative result. while it's accurate most of the time. but occasionally a false positive or negative results can happen if they are not careful.

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