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Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report
The 5th Chinese Helicobacter treatment consensus
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Treatment

Blood tests (for antibody) are used to screen for H.pylori. They remain positive for many months after treatment so can only be used as the initial test. Urine antibody is a "pregnanacy style" urine test. Accuracy is slightly less than blood tests. A negative blood test is good evidence that Hp is NOT present. Use it to exclude the diagnosis (but no test is 100% perfect remember).

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Sgiacc
Posts: 7
Joined: Sat Jun 09, 2018 11:22 am

Treatment

Post by Sgiacc »

Hello Helico Expert

I was having symptoms a few months ago... nausea.. loss of appetite and diarrhea...i had a blood test done and it came back negative for H pylori... my Dr then put me on PPI’s to control my systems. I didn’t see any improvements and was finally sent to have an endoscope done and I was tested positive for h pylori and moderate chronic gastritis. I started my treatment of quad therapy and I’m on day 10 and I have no appetite and very tired. I also missed a few doses of on of the anitibitoics (Clarithromycin) but still took the other 2... do you think hay would affect my treatment? I was told to take the meds for 14 days but I would like to stop treatment today and hope that would be enough! The side effects are worse than what I was feeling before.. I don’t have any improvements.. does this mean the meds aren’t working properly either? I won’t have another scope done until August to test if it is gone.

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Treatment

Post by Helico_expert »

blood test is normally very accurate. what else did the endoscopy show? any histology done? there is a test, CLOtest, that can be done on spot during endoscopy to check for H. pylori. only need 10 min to see result. Did the specialist do that?

i suspect your diarrhea problem is not due to H. pylori but something else. you are taking strong antibiotics at the moment. you may be experiencing some side effects. But I think it's important to finish the course. Otherwise your other guts bacteria may develop resistance.

Let's finish the course and see how you feel. Normally diarrhea, caused by pathogen, is self limiting disease. it'll go away by itself within a week.

Sgiacc
Posts: 7
Joined: Sat Jun 09, 2018 11:22 am

Re: Treatment

Post by Sgiacc »

Thanks for your reply!!
No other tests were done. Would a breath test be accurate enough after my treatment... do i continue taking the ppi’s due to the inflammation in the duodendum? I finished my meds on day 11 as my Dr said if I couldn’t handle it anymore then just stop. What does the histology and clO test show? Should I ask to get his done at my next scope?

Looking forward to hearing from you

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Treatment

Post by Helico_expert »

histology and CLOtest can show if there is H. pylori. Just not sure how is it possible that you get a negative blood test and diagnosed with H. pylori during endoscopy. Nevertheless, if your previous scope did not show any abnormality, there is no need for a second one. You can control your acid symptom with acid blocker.

Sgiacc
Posts: 7
Joined: Sat Jun 09, 2018 11:22 am

Re: Treatment

Post by Sgiacc »

The biopsy tested positive.. could this have been inaccurate? Like a false positive?

Sgiacc
Posts: 7
Joined: Sat Jun 09, 2018 11:22 am

Re: Treatment

Post by Sgiacc »

Sorry not sure if my reply was posted properly... my biopsy was positive for h pylori... could this have been a false postive? I don’t understand all this :?
I also decided to continue the meds but with the ones I wasted it would only bring me to 13 days... do you think I take take pepto bismal on day 14 to make up for the shortage of abx?

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Treatment

Post by Helico_expert »

it could be false positive if the result is not fully understood.

Nevertheless, if you already started your treatment, please finish the treatment first.

if you missed one day of treatment, it's fine too. we normally give 10 days treatment. 13 days is already good enough.

Sgiacc
Posts: 7
Joined: Sat Jun 09, 2018 11:22 am

Re: Treatment

Post by Sgiacc »

Thanks so much for all your help!!!

Sgiacc
Posts: 7
Joined: Sat Jun 09, 2018 11:22 am

Re: Treatment

Post by Sgiacc »

Hello Helico expert!

I’m on day 13.. I don’t have enough meds for my second dose today or to go to day 14...
I still have no appetite... and haven’t seen an improvement..
What are the chances that the antibiotics didn’t work at all?i know you mentioned that 10 days is enough.. could it be the meds making me feel worse? I am still having reactions to foods that I didn’t have before.. can the bacteria still be there? Can I take something else tonight and for my day 14 to make sure it’s gone? Will pepto and the clairitomycin work? I have enough of the clairithomyxin but no more metrodianzale or amoxicillin. I hope this all makes sense!

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Treatment

Post by Helico_expert »

You can take whatever you have left to complete it treatment. It's ok to take them without Amoxicillin. If you have H. pylori, and it survived 13 days of strong antibiotics bombardment, it really doesnt matter if you take another 13 days of treatment (because of antibiotic resistance). But, part of me still think that you have false positive H. pylori test.

So what you can do now is to finish all the left over drugs today.
tomorrow onwards, relax and be positive. Drink lots of water and eat lots of fruits.
wait for a month without taking any medicine and repeat the breath test. No need for endoscopy (if there is no abnormality).

If you are feeling a bit of reflux, you can take ranitidine to control the acid.

let's hope that it's the antibiotics that is making you feel bad. The side effects will gradually go away within a week.

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