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Reinfection? - Pls advise Helico Expert

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Phoebe
Posts: 2
Joined: Thu Oct 03, 2019 5:58 pm

Reinfection? - Pls advise Helico Expert

Post by Phoebe » Thu Oct 03, 2019 7:45 pm

Hello,

I was diagnosed with h pylori about a year and a half ago - had triple therapy - retest came back negative but still continued on with symptoms for another year. Finaly had another retest which came back positive. Had same triple therapy from the GP but gastroenterologist said this was unlikely to work as it was much more likely it hadn't really gone away before. She prescribed triple therapy with different antibiotics and PPI with ranitadine as I didn't like too high a dose of PPI due to palpitations. This seemed to work and I was improving also had negative stool test.

Then a few months ago gastritis came back really bad - I went for stool test but was negative again. Prescribed ranitadine and PPI and have now added in amitryptaline as was getting nowhere. Slight improvement but still epigastric pain and acid symptoms. I stopped ranidatide for a day and pain came back very strong so started again.

My worry is I actually do have h pylori again but can't do another retest because I have been on the PPI. If I come off the PPI to do a retest I will set back my recovery if it is stress related gastritis as they suggest. I would just try to have faith in the two negative tests since treatment but as I have been in this position before - negative test but still infected - It's hard.

Could it just be damage from the previous infection made worse by stress even if I was initially improving?

What would you suggest @Helico_expert?

Thanks so much - any suggestions or insight would be amazing.

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

Re: Reinfection? - Pls advise Helico Expert

Post by Helico_expert » Fri Oct 04, 2019 9:29 am

is ranitidine alone enough? if so, you can stop ranitidine the night before breath test. Ranitidine has very short life-span in your body, will not affect the breath test.

if you have to take both ranitidine and PPI, then you will have to wait till you are better, then stop PPI, then do breath test.

another way is to do serology.
if it is negative, then you are definitely free of HP.
most likely it will be positive, because your immune system has memory of HP. However, you can ask for a HP specific IgG concentration. You will need to do this every three months. if the IgG concentration is gradually decreasing, then it is a sign of HP free. if the IgG concentration remain constantly high or higher, then very likely your HP is still around.

another way is to do endoscopy and histology.
You should get endoscopy examination if
1. you are over 40 yrs old
2. you have lots of symptoms for a very long time
3. you have family history of ulcer or cancer
4. your previous endoscopy showed abnormality, eg. ulcer, intestinal metaplasia, atrophic gastritis, polyps, cancer, etc

Most people recover after eradication of H. pylori. Some people needs longer time because of the damage done. If PPI helps, do continue. There are many other brands of PPI, should try a few of them to find the one that most suit you. Here, we like to use rabeprazole, because is generally more acceptable by many.

Phoebe
Posts: 2
Joined: Thu Oct 03, 2019 5:58 pm

Re: Reinfection? - Pls advise Helico Expert

Post by Phoebe » Fri Oct 04, 2019 7:06 pm

Hello - thank you so much for your reply!

That is very useful to know about serology - I wasn't aware of that.

Re the breath test - my consultant doesn't use the breath test only the stool test - I asked and she said the hospital doesn't do it any more. Will the stool test be as accurate? Also can I continue ranitadine up until the day before? Is two weeks off PPI enough?

I will definitely ask to see if they will do the serology testing. NHS in england is reluctant to do any tests really so I will continue through the private consultant.

I had an endoscopy last year which showed nothing much other than the appearance of possible celiac disease - another test came back negative. I wondered if this was damage from the HP. And the biopsy was HP negative but this was right after the first round of treatment so i guess that is why. I am 39 so just under 40.

thank you so much for your advice x

Helico_expert
Site Admin
Posts: 3526
Joined: Wed Mar 02, 2011 7:20 am

Re: Reinfection? - Pls advise Helico Expert

Post by Helico_expert » Sat Oct 05, 2019 4:45 pm

stool test is as accurate. But all test is relying on good technician who knows what they are doing.

two weeks without PPI is enough for the stool test.

Maria.b
Posts: 42
Joined: Wed Apr 25, 2018 2:50 pm

Re: Reinfection? - Pls advise Helico Expert

Post by Maria.b » Sat Oct 05, 2019 5:44 pm

Hi helico expert
Can u explain the reasons why stool tests can give false negative i know because of ppls and obivously the lab doing the tests but can low count of bacteria cause wrong results? Also why has a vaccine never become available my kids have had all there vaccines even for chicken pox but ive never been offered this and yet so many people are suffering. But thank god for this forum xx

Helico_expert
Site Admin
Posts: 3526
Joined: Wed Mar 02, 2011 7:20 am

Re: Reinfection? - Pls advise Helico Expert

Post by Helico_expert » Sun Oct 06, 2019 4:17 pm

Yes, stool test, like breath test, is relying on the bacterial load. The more the bacteria, the more the antigen, and the higher chance for stool test to work.

PPI, even though not an antibiotic, can reduce bacterial load and hence can lead to false negative.

It cannot be vaccinated because you even when your HP is eradicated, you can still get reinfected with your own strain (we already did that experiment multiple times).

Maria.b
Posts: 42
Joined: Wed Apr 25, 2018 2:50 pm

Re: Reinfection? - Pls advise Helico Expert

Post by Maria.b » Mon Oct 07, 2019 1:25 am

Thanks for yr reply so for example if a blood test shows positive but stool is negative which would you believe with no ppls or antibiotics taken also how is it possible to become re infected with your own strain? Yr opinion means alot and thanku

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

Re: Reinfection? - Pls advise Helico Expert

Post by Helico_expert » Mon Oct 07, 2019 9:13 am

The blood test tells you the history of infection. Stool test will tell you your current infection status. So I would believe the stool test result.

Maria.b
Posts: 42
Joined: Wed Apr 25, 2018 2:50 pm

Re: Reinfection? - Pls advise Helico Expert

Post by Maria.b » Fri Oct 11, 2019 3:54 pm

So i took my biopsy results back yesterday this was my repeat endoscope after 15 months it writes chronic mild gastritis dont unerstand how mild and chronic go together but more important intestinal metaplasia not found and no ppl needed.

Helico_expert
Site Admin
Posts: 3526
Joined: Wed Mar 02, 2011 7:20 am

Re: Reinfection? - Pls advise Helico Expert

Post by Helico_expert » Sat Oct 12, 2019 5:06 pm

sounds great. it sounds like you are healing well. No intestinal metaplasia is great. So was intestinal metaplasia previously detected?

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