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H PYLORI IN THE MOUTH!! What tests should I have please?

Breath tests are the most accurate way of detecting H.pylori without actually having an endoscopy (stomach examination). Breath tests are especially useful after treatment to make sure H.pylori is cured. Urea breath tests are known to be completely harmless. Either C14-urea or C13-urea tests are used. Read about them at the diagnosis section at http://www.helico.com/diag_breath.html where a diagram can be found. C14-urea breath tests use a radioactive tracer but such a tiny amount that it can be used safely at any age. It is a 15 minute test, convenient and inexpensive. The C13-urea test uses a stable isotope of carbon which is also harmless but requires two breath samples and takes about 30 minutes. Both tests have accuracy greater than 90%.

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b3rn41987
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Joined: Tue Dec 31, 2013 4:49 am

H PYLORI IN THE MOUTH!! What tests should I have please?

Post by b3rn41987 » Wed Jan 08, 2014 9:42 pm

Dear Moderator,

I have not seen any test mentioned in your forum or on your website to see if H-Pylori is present in the mouth (that is saliva, dental plague and dental cavities). This issue I feel is extremely important because I have seen many studies which concluded that due to the acid regurgitation from stomach to the mouth, the oral cavity such as saliva, dental cavity and dental plague may also be infected with H-Pylori and the mouth may become a reservoir for H Pylori as well as a potentially a source of transmission or reinfection". In other words, even if you kill H-Pylori in your stomach, your stomach may be re-infected if you do not kill H Pylori in your mouth. Therefore the stomach and the mouth should both be tested and treated at the same time. However both may require a different set of treatment. For instance, killing H Pylori in the stomach may require double, triple or quadruple antibiotic therapy whereas killing it in the mouth may need removing your tooth fillings and injecting the area with an antibiotic. I have recently completed QUADRUPPLE therapy (for 14 days) due to the H Pylori in my stomach. The treatment was gruelling but on the 10th day I became feeling much better despite the side effects of the heavy antibiotics. All of the symptoms of my chronic Gastritis vanished at the end of the treatment. Seeing how the symptoms are vanished, I feel that my H Pylori has now been eradicated from my stomach but to make absolutely sure I will be having a Breath Urea test as well as a Stool Analysis within 5-6 weeks time. However one point remained, that is the treatment of my mouth because in the heat of my H-Pylori break out I began developing some dental issues. This was a surprise to me because I had never had a bad tooth in my life, I clean my teeth regularly and go to the dentist only for a quick polish. Despite this however, one of my tooth began decaying so I ended up getting it filled. The problem was that although the tooth was filled I was still having a toothache, the dentist checked it again and again but could not find anything. I then began investigating if this was somewhat related to my H-Pylori in the stomach. I am glad I did, because I came up with hundreds of studies which suggested that H Pylori must be eradicated from the mouth as well as from the stomach. After the quadruple therapy all my Gastritis and other gastro related symptoms have vanished except the problems in my mouth. I am now afraid that I killed H Pylori in my stomach but not in my mouth hence one day I may be re-infected again. I brought up this issue with my GP and asked for a test to see if I have H Pylori in the mouth. He had absolutely no clue! I was not surprised because he was the same person who said to me " Well your triple therapy is failed, so try to live with it!" Yes I did! but I ended up with chronic gastritis within 2 years! This total irresponsible attitude still exists in some of the medical community who call themselves "expert"! What a joke! I was disgusted with all this but this is another story! I then tried to find out a periodentist or doctor or even an hygienist to perform H-Pylori test in the mouth. I even called some of the UK labs to see if I can get a test kit from them to run the test myself. But, no luck! Despite there are many research on the subject, it seems impossible to find a test or someone to treat H Pylori in the mouth. I then came a cross with your website. Please could you tell me if Dr Marshall knows how I can get this test in the UK and who would treat to eradicate H Pylori in the mouth? Thank you.

rifle_li
Posts: 48
Joined: Sun Mar 27, 2011 10:30 pm

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by rifle_li » Wed Jan 08, 2014 10:35 pm

I have asked the same question as you. Helico_expert has answered it. Maybe it is helpful for you. Please see the link below:
viewtopic.php?f=18&t=202639

Helico_expert
Site Admin
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Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by Helico_expert » Thu Jan 09, 2014 8:58 am

Thanks rifle_li for the link.

I just want to reassure that it is possible to detect H. pylori in the mouth via DNA testing, but it is very difficult to culture viable (or living) H. pylori from mouth. The mouth is simply dominated by the mouth bacteria and there is no room for H. pylori to compete. H. pylori is a very slow growing organism and so it is easily out compete by other organism. Perhaps being the only bacteria in the stomach, without competition, has slow down it's growth rate.

in addition, the antibiotics you took will travel in your blood to your whole body. some people with skin disease was cured and they thought H. pylori is related to skin disease. in fact, it's because the antibiotics have travelled to the skin and kill whatever pathogen is causing the problem. When you go to the dentist and have your tooth extracted, you are usually prescribed ingestible antibiotics to prevent infection in your mouth. So, the quadruple therapy that you have taken, would have kill everything in the mouth too.

if i have not answered your question, please ask again.

b3rn41987
Posts: 13
Joined: Tue Dec 31, 2013 4:49 am

Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by b3rn41987 » Fri Jan 17, 2014 8:41 pm

Thank you rifle_li and Helico_Expert.

Helico_Expert, Can you please state your experience (experteese) on the subject as (sorry but) I am a bit weary of people calling themselves 'experts'. In particular, if you are the person (David Hompes) who wrote a book on the subject and calling himself a 'helico expert', I would say to you that yes I have read your book and I have found it too 'commercial' (especially the part your claim that you "cured" your HP with rather expensive matula tea (?!).

Also with regard to your comment about DNA test: this is not the test that I came a cross. The test that the researchers used to test the HP in the mouth is PCR ANALYSIS TEST.

Finally with regard to your comment: "but it is very difficult to culture viable (or living) H. pylori from mouth", I disagree with your comments and suggest that perhaps you should consider the following studies:

Thank you,

______________________________


Is chronic laryngitis associated with Helicobacter pylori? Results of a prospective study]. [Article in German] Jaspersen D, Weber R, Diehl KL, Kind M, Arps H, Draf W. “H. pylori is found in the stomach of patients with chronic gastritis. The infection is usually transmitted by the gastro-oral route and bacteria could be identified in saliva and dental plaque.”

Is the presence of Helicobacter pylori in the dental plaque of patients with chronic periodontitis a risk factor for gastric infection? Mohammed Al Asqah et all, : “A periodontal pocket in the teeth of individuals with chronic periodontitis may function as a reservoir for H pylori. This finding suggests that the oral cavity may be a reservoir for H pylori, and potentially a source of transmission or re-infection.”

Uma Sudhakar at all -Isolation of Helicobacter pylori from dental plaque: A microbiological study: “The aim of our study was to isolate H. pylori from dental plaque in gastric and duodenal ulcer patients and compare it with dental plaque of healthy subjects. Dental plaque has been implicated as a possible source and route of re-transmission of H. pylori.[10] Krajen et al,[11] first reported on the presence of H. pylori in dental plaque. Subsequently, various studies reported a wide range of isolation. Newman[2] suggested that bacteria fermenting carbohydrates in food produce a low pH in the dental plaque and this microaerophilic acidic environment with an average oral temperature of 35-37°C can be ideal for growth of H. pylori. It has been quite a shock to the medical system to discover that several of the gastroduodenal diseases that scientists thought that they understood fairly well are actually caused by H. pylori. “

Anand PS, Nandakumar K, Shenoy KT at all study: “H. pylori in dental plaque is seldom eliminated by H. pylori-eradication therapy, and this may act as a source for future reinfection. Hence, eradication of H. pylori from the dental plaque should be made an important part of comprehensive management of H. pylori-associated gastric diseases.”

(Suk FM, Chen SH, Ho YS, Pan S, Lou HY, Chang CC, Hsieh CR, Cheng YS, Lien GS at all study): “Dental plaque has been suggested as a permanent reservoir of Helicobacter pylori (H. pylori) and a potential source of reinfection.”

Desai HG, Gill HH, Shankaran K, Mehta PR, Prabhu SR. at all study: “Triple drug therapy (bismuth, tinidazole, and amoxycillin or doxycycline) was administered for 15 days to 24 patients. By the CLO test, H. pylori was eliminated from the gastric mucosa in all 24 patients but persisted in dental plaque in all of them. Our observations indicate that dental plaque is unaffected by triple drug therapy and is perhaps a permanent reservoir of H. pylori if local therapy also fails to eradicate the organism.”

A M Nguyen, L Engstrand, R M Genta, D Y Graham, and F A el-Zaatari at all study: “The detection of H. pylori in dental plaque suggests that this H. pylori colonization is not restricted to the gastric mucosa and that this ecological niche may serve as a possible sanctuary which may be responsible for reinoculation of the stomach after topical anti-H. pylori therapies such as bismuth.”

Rachael Z Stolzenberg-Solomon, Kevin W Dodd, at all study: “Poor dental health has been associated with increased risks of oral, esophageal, and gastric cancer and may also be associated with pancreatic cancer. “

Helicobacter pylori; oral hygiene© J Can Dent Assoc 2002; 68(8):489-93 : “It has been suggested that attempting to improve oral hygiene through standard periodontal procedures would be prudent as an ancillary measure to conventional ulcer therapy, especially in patients whose gastric infections have proven recalcitrant. H. pylori may also be a cofactor in the recurrence of aphthous ulceration, especially in patients sensitized through gastric colonization and mucosal attachment.”

(Song Q, Lange T, Spahr A, Adler G, Bode G. at all study): “H. pylori was present in the oral cavity of 97% of tested patients.”

Miyabayashi and others reported on a Japanese study of 47 patients with H. pylori gastritis: “ The therapeutic regimen consisted of 30 mg/day lansoprazole, 750 mg/day metronidazole, and 400 mg/day clarithromycin administered for 2 weeks. . pylori in the oral cavity affected the outcome of eradication therapy and was associated with a recurrence of gastric infection. We recommend that oral H. pylori should be examined by nested PCR and, if positive, should be considered a causal factor in refractory or recurrent cases. We analysed the correlation between the success of gastric eradication and the prevalence of H. pylori in the oral cavity, as determined by nested polymerase chain reaction (PCR) before and after eradication therapy (nested PCR improves the specificity of the PCR amplification process). Of the 24 patients who tested negative for oral H. pylori before eradication therapy, H. pylori was completely eradicated from the stomach in 22 (92%). None of these 22 patients experienced recurrence during the mean follow-up period of 19.7 months (range 1–48 months). In contrast, 4 weeks after initial therapy, complete eradication of gastric H. pylori was achieved for only 12 (52%) of the 23 patients who tested positive for oral H. pylori. Of these 12 cases, 7 remained oral positive and 5 became oral negative and 2 of the oral positive cases relapsed within 2 years of initial therapy. Among the 23 patients, oral H. pylori was eradicated by the therapy in only 8 cases (35%) and one of these relapsed within 2 years of initial therapy. The authors concluded that the presence of oral H. pylori was an important marker of potentially refractory or recurrent gastric H. pylori infection.”

Helico_expert
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Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by Helico_expert » Sat Jan 18, 2014 8:50 am

I have a PhD in microbiology and I have been working on H. pylori for 8 years. My expertise is actually more on the evolution side of this organism. Using H. pylori as a marker to trace human migration and how different human population interact. However, 3 years ago I was recruited by Prof. Barry Marshall and since then, I am involved in "clinical" research. I highlight clinical because we only focus on patients with multi-drug resistant H. pylori. Our patients have to fail more than 2 times on standard triple therapy before they can be referred to see Prof. Marshall.

We published a paper together on Prof. Marshall's treatment.

http://onlinelibrary.wiley.com/doi/10.1 ... 3EA.f02t01

We are planning to publish another paper this year to follow up the study.

My other publication are more related genomes and very basic pure science of H. pylori or other Helicobacter species.

PCR is DNA testing. It is too sensitive and has a very high false positive rate. That's why it has not been approved as a diagnostic test.

It is truly difficult to culture viable H. pylori from mouth. Many people tried and failed. if you read those papers that you showed. many of them actually detected H. pylori via PCR (or DNA testing) and very little actually culture H. pylori. Some does but most dont. We tried for several months and because of the very low success rate, we dont think it's worth further investigation. In one case, we cultured a H. pylori from a patient's mouth without H. pylori in the stomach. The patient is actually negative for H. pylori. We spent lots of time re testing her biopsies, sequenced the genome of the bacteria, get her back for further test, and get her husband back for further test. In the end, we concluded that that's a false positive from mouth. Probably via contamination from an unknown source. This lead to a very important question. Is the mouth H. pylori always the same as the one in the stomach? The general understanding is that the stomach is the source of H. pylori to the mouth. But our finding (sample size = 1) suggested that it is also possible that contamination food or water or saliva from someone else could temporarily leave some H. pylori in the mouth for a short period of time (not measured).

Anyway, just want to stress that it's possible to culture H. pylori from mouth, but very difficult and inefficient.

rifle_li
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Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by rifle_li » Mon Jan 20, 2014 10:36 pm

Helico_expert's answer is very useful. Since it is difficult to culture viable H. pylori from mouth, I think share food in same plate, which is the traditional life style of China, unlikely transmits h.pylori from one people to another. Many doctors have the same idea. Research in China showed reinfection rate is less than 5% after eradicate. Even patients do not use any protection methods in everyday life.
So I am more confused about myself. My negative held for at least one year after eradicate. But now it is positive again. I am very careful in life. I can not doubt any risk factor except sharing food. I have stayed at one room for a short time with a vomited man but I did not touch any thing. Could that be a risk? It is unintelligible for me. About my situation, please see viewtopic.php?f=8&t=204565.

Jenny Wren
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Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by Jenny Wren » Mon Jan 20, 2014 11:08 pm

I pray that my 14 day triple therapy works. I don't think I could handle doing all these pills again. I'm starting day 10 today. 4 more to go. What is the success rate with the biaxin, amoxicillin, and prilosec? Dear God please eradicate this bacteria from my body.......please! I don't ever want to be that sick again.

Helico_expert
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Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by Helico_expert » Tue Jan 21, 2014 8:57 am

biaxin, amoxicillin, and prilosec regimen is the standard triple therapy. In countries where antibiotics are restricted, meaning not abused, it has a cure rate of 80%. in countries where antibiotics are abused, eg. china and many european counries, the success rate is less than 70%.

Nevertheless, if you rarely expose to antibiotics, it should work on you. Just remember to finish the full course of antibiotics to prevent antibiotic resistance. only 4 more days to go. keep up the good work. Remember to do a breath test a month later.

Jenny Wren
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Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by Jenny Wren » Tue Jan 21, 2014 9:27 am

Thank you helico! :)

Jenny Wren
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Re: H PYLORI IN THE MOUTH!! What tests should I have please?

Post by Jenny Wren » Tue Jan 21, 2014 10:41 am

I think I may have developed thrush. My tongue is so dry and sore. White stuff coating it. I have been taking a probiotic too. I'm so tired of this. I don't know how they treat thrush but I'm about broke paying for the two antibiotics. Don't have much money left for another prescription. :(

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