Interesting GP reaction (Australia)

[aus212]

So I've been having some symptoms that led me to consider HP being the source. I asked my GP about it and he said "it isn't an issue as there are millions of people who have it and are asymptomatic, so what about them?"

He said, "what happens if you kiss your wife and get it again?"

And

"It's only newly discovered, what about before then?"

The general gist was that it's unimportant and shouldn't be bothered with.

Quite disappointing for an Australian GP,considering it was discovered in Australia and an award was won for it.

Luckily, I finally got a GP who considers it to be an issue but after I had been put on Nexium from the last GP. I've gone for the stool antigen test, I'm guessing Nexium could give a false-negative?

Generally how long should I be off Nexium for the breath test?

[Helico_expert]

interesting response from doctor. anyway, it is true that 50% of the world population is infected with H. pylori and majority of them has no symptoms. However, in most cases, the symptom usually develops after 20 yrs old and more severe in older age.

In many developing countries, after a few failure with the triple therapy, the doctor would normally ask the patient to ignore it and take PPI for life.

It is possible that H. pylori can be transmitted via kissing. However, the chance is going to be very very rare. H. pylori dont normally present in the mouth unless the person has constant reflux.

for Nexium, normally we would ask patient to stop for 7 days before the stool or breath test. see the following document for more info

http://www.helico.com/PYtest_guide_2013.pdf

[aus212]

Thanks for the prompt response. Yeah, the impression I got from him was that it's unimportant and not to bother with H Pylori.

I was told by the Pathology that Nexium wouldn't manipulate the stool result, I guess I will just stop nexium for 7 days and use the breath test to be sure.

Thanks again

[Helico_expert]

in regards to Nexium and stool test, the doctor probably listened to the stool test supplier. Which I frequently heard the same. Here are some reference about Nexium (esomeprazole) affecting stool and breath test.

http://www.ncbi.nlm.nih.gov/pubmed/15128344

False negative breath and stool tests are equally common in patients taking proton pump inhibitors.

http://www.emedicinehealth.com/script/m ... key=128446

Do not take proton pump inhibitors (such as Prilosec or Nexium) for 2 weeks before the test

[aus212]

Negative result for stool test. I told the GP that it could be because I was on Nexium up until the test and he said that Nexium would just reduce the active numbers of the bacteria but it would still show up in the stool test 100%.

He said the blood test is useless because it just means you may have had an infection in the past but it isn't active anymore. I tried to explain to him that H Pylori doesn't go dormant - no luck.

He said next step is gastroscopy and taking a biopsy.

Going to try and find another GP who would do a blood test. I think it's the best option whilst on Nexium. I think it's highly unlikely that I don't have it, considering my parents were born in a country with 80% infection rate despite me being born in Australia.

[aus212]

Just had the anti-body blood test, if positive, I should proceed with treatment? (ignoring claim from other GP that it kinda goes dormant)

[Helico_expert]

unfortunately, blood test only test your infection history, not your current status. your body will carry anti-h. pylori antibody for months or years. So, you shouldnt use blood test to diagnose H. pylori infection after antibiotic treatment.

[aus212]

unfortunately, blood test only test your infection history, not your current status. your body will carry anti-h. pylori antibody for months or years. So, you shouldnt use blood test to diagnose H. pylori infection after antibiotic treatment.

Hi,

I've never been treated for h pylori before though, so is the blood test a good enough means to detect a current infection in that case? Or can it go dormant/away by itself?

[Helico_expert]

Since you have not been treated before, yes, you may use the blood test result to get a treatment. Without using the cocktail treatment, it's almost impossible to get rid of H. pylori.

[wajahat04]

It is possible that H. pylori can be transmitted via kissing. However, the chance is going to be very very rare. H. pylori dont normally present in the mouth unless the person has constant reflux....??


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