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Biopsy finds bacteria, but stool test pre and post negative???

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Alfred001
Posts: 10
Joined: Mon May 25, 2015 7:08 pm

Biopsy finds bacteria, but stool test pre and post negative???

Post by Alfred001 »

My symptoms started in the summer of 2011 and in dec 2011 I did a stool test that was negative for h pylori.

Then in nov 2013 I have an upper endoscopy that shows small ulceration on the cardia. A sample of it is taken, as well as a sample from the duodenum.

The pathologist's report said (and here I'm translating from Croatian, so it's a little tricky) that by dying with Giemsi he found "rare bacteria resembling H.p." Now, the report is ambiguous (at least to me) even in the original language. Does rare mean sparse or uncommon/rate type and does "resembling" mean that they resemble HP because they ARE HP or that they're NOT HP, but look reminiscent?

Two subsequent h pylori stool tests (feb and dec 2014) come back negative, even though I was given no antibiotics.

A march 2014 endoscopy showed a mildly hyperemic stomach lining, it was biopsied (one sample) and showed no HP. (for what it's worth, the pathologist complained about the size of the sample)

So, what's going on here? How could the biopsy find HP if stool tests both before and after were negative?

Is it possible that the bacteria were indeed NOT HP and that's why the stool tests were negative? And what bacteria WERE tehy then?

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

Re: Biopsy finds bacteria, but stool test pre and post negative???

Post by Helico_expert »

Hi,

Thank you for sharing your story.

It's good that your endoscopy and histology report did not report anything else. The pathologist may be seeing something similar to H. pylori, but actually not. This is supported by your following two negative tests done.

What about the gastritis? how was it described? the keyword is "active". That would mean some pathogen is present. Otherwise it's probably just mild gastritis and they come and go.

Unfortunately we cannot tell what type of bacteria by just looking at the shape. These bacteria may present temporarily because we constantly swallow saliva. The mouth bacteria can contaminate the stomach for a short time. But because of the strong acid, they can quickly die out.

Alfred001
Posts: 10
Joined: Mon May 25, 2015 7:08 pm

Re: Biopsy finds bacteria, but stool test pre and post negative???

Post by Alfred001 »

Helico_expert wrote:
Mon Jun 20, 2022 3:46 pm
Hi,

Thank you for sharing your story.

It's good that your endoscopy and histology report did not report anything else. The pathologist may be seeing something similar to H. pylori, but actually not. This is supported by your following two negative tests done.
But my concern is that this may be a different type of helicobacteria, like for example Helicobacter felis and that that is why the stool tests were negative.

My symptoms started in summer 2011 and a dec 2011 HP test was negative, yet in nov 2013 the biopsy showed some HP-like bacteria - so the point is if the symptoms started in summer of 2011 and the symptoms are a consequence of an infection, that infection must have been present at the dec 2011 test that was negative, suggesting that whatever bacteria I have, the test doesn't detect them.

And Helicobacter felis has the same pathological effects, including cancer, that HP have.

So the question becomes, does the stool test detect other types of helicobacteria or only HP. Because if it doesn't, then it seems to me plausible I have an infection with some other type of helicobacteria.
What about the gastritis? how was it described? the keyword is "active". That would mean some pathogen is present. Otherwise it's probably just mild gastritis and they come and go.
I don't see a classification of my gastritis on any of the documentation I have, but my gastritis hasn't gone since 2011. I've had symptoms since then up till today.

Granted, the symptoms have been getting better and better, but they lasted for years, so it wasn't just a transient gastritis.

Today, most of my symptoms have waned and there almost aren't any, EXCEPT that I still have abnormally low weight. I still weigh 11 lbs less than I weighed in elementary school, so something is clearly still wrong.

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

Re: Biopsy finds bacteria, but stool test pre and post negative???

Post by Helico_expert »

Interesting concept. From time to time, we encountered people who carry non human Helicobacter. Although it's rare, it's not impossible.
You are right about the stool test. They may not be sensitive enough to pick up non human Helicobacter. If you have access to breath test, that would be more sensitive. Perhaps you can suggest your gastroenterologist to do a rapid urease test during the endoscopy.

breath test and rapid urease test both rely on the urease enzyme in all stomach Helicobacter. So unlike stool test, which test for particular H. pylori protein, may be too specific for human Helicobacter.

Nevertheless, animal Helicobacter can cause similar problems in human and they can be treated the same way. The good news is, they are usually less likely to be antibiotic resistant strains.

Good to hear that your symptoms have improved. Hopefully you will gradually gain back the weight you wanted. The symptoms may come back occasionally. We dont really know why. I believe it's the permanent damage done and can sometimes be triggered by particular food or stress.

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