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欧洲幽门螺杆菌治疗共识 5

Can IgG test go negative without treatment?

There are several types of tests for H.pylori. The major ones have a their own forum.

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Can IgG test go negative without treatment?

Post by wordydee » Tue Sep 25, 2018 12:13 pm

I am new here so I'll just start off and give some of my background. I am 36 years old, male, caucasian and developed a small duodenal ulcer 3 years ago. I was tested negative for h pylori with biopsy twice. However, I had been taking PPIs, bismuth, and antacids days prior to these tests so I am worried the result is a false negative.

Strangely in 2013, 2 years before the ulcer I started having gastritis and was tested positive for h pylori IgG on the serum test:

H pylori IgG Antibody: 3.2 where >2.3 or greater is positive.

The IgM was 0.4 and IgA was 0.9, both negative.

Also I have not been treated with antibiotics.

So my question is is there a chance I could still have h pylori infection, maybe low level?

If I have the igG h pylori antibody, can a previous infection spontaneously go away even if I have never taken triple therapy antibiotics?

I have had a negative breath test (took bismuth about 2 1/2 weeks prior and h2 blockers 48-72 hours prior).

My gastroenterologist doesn't think it is h pylori. I still have pains under the ribcage --- after 3 years of taking ppis and h2 blockers.

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Re: Can IgG test go negative without treatment?

Post by Helico_expert » Tue Sep 25, 2018 12:38 pm

ulcers can be caused by NSAIDs (or aspirin, ibuprofen, etc). are you taking any of those? some people take small quantity of it to prevent stroke.

IgM is when you JUST infected with a pathogen, then your body will produce IgM. Because it is more likely that you had been infected with H. pylori many years ago, so it is almost certain that IgM will be low. IgM will only be high if you are recently infected.

IgA is antibody secreted in the mucosal area, like stomach, intestine, mouth, lung and eye. It may be used as a diagnosis in the blood, but not as good as IgG.

IgG is the primary antibody use for diagnosis. But because the B-cell that produce the IgG antibody has memory. So it'll always stay in your blood in case you get infected with the pathogen again. It's how vaccine works.

so, to truly know if you still have H. pylori, you'll need to either do breath or stool test.

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Re: Can IgG test go negative without treatment?

Post by wordydee » Wed Sep 26, 2018 7:07 am

I didn't take any NSAIDS or similar drugs.

So my question is does it ever go away on its own or can it go away without antibiotics?

I'm thinking I have h pylori still living, just at low levels, thus causing the symptoms. I don't digest well and probiotics make me worse. Heartburn and pain under rib cage on right side. I do have a small hiatal hernia but would that cause pain?

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Re: Can IgG test go negative without treatment?

Post by Helico_expert » Wed Sep 26, 2018 9:37 am

you get ulcer because your stomach lining is not producing enough mucus to block the acid.

your stomach lining not producing mucus could be because of
1. H. pylori damaging the linings.
2. NSAIDs blocking mucus secretion.

when mucus level is low, stomach acid can then digest the stomach and lead to ulcer. stopping the acid can prevent self digestion and ulcer can heal.

so, if H. pylori is not eradicated, the mucus will always be low. to prevent ulceration, you'll have to take PPI for the rest of your life. This is what happened 30 years ago before discovery of H. pylori. PPI companies hated Prof Marshall for discovering the cure. In old days, people used to take PPI for decades. Now, only a course of treatment.

in addition, now we learnt that if you take PPI for too long, it affects your ability to absorb calcium. ultimately leads to osteoporosis. Also, without acid in the stomach, other bacteria can start to grow in the stomach. The acid acts as a barrier to kill of bacteria that we accidentally eat. Lastly, acid acts as a defender to kill off cancer cells that cannot produce mucus. Studies have shown that low acid producer is more likely to get stomach cancer than high acid producer.

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