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Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report
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Penicillin allergy

The cure of Hp usually requires antibiotics. Other things have been tried and have a weaker effect.

Moderators: barjammar, Toni, luci2010, Ondek-Expert, kkimura

Plotun
Posts: 56
Joined: Sun Sep 27, 2020 2:48 am

Re: Penicillin allergy

Post by Plotun »

Helico_expert wrote:
Wed Dec 16, 2020 7:23 pm
It usually takes a long time to develop. But metaplasia is hard to visualise. You can only diagnose metaplasia by histology.
Thank You very much. I spoke to another GP this morning, and he has recommended another immunochromatography stool test next week to make sure that H.Pylori is eliminated. Also, he said that there is no need for another endoscopy for now because I am still young ( I am 30 years old) and it usually take decades to develop IM (people in 40"s and 50"s). He reassures me that most people first develop IM and atrophic gastritis since there is no more acid production. I have probably increased acid production since my gastritis is mostly antral predominant. Last endoscopy revealed normal fundus and corpus.

Plotun
Posts: 56
Joined: Sun Sep 27, 2020 2:48 am

Re: Penicillin allergy

Post by Plotun »

Helico_expert

Why does h.pylori invade the antrum first and cause antral gastritis? And how long does it take to spread all around and cause pangastritis? Is this process also slow?

Helico_expert
Site Admin
Posts: 4463
Joined: Wed Mar 02, 2011 7:20 am

Re: Penicillin allergy

Post by Helico_expert »

Personally, I think that's a myth. I believe H. pylori is everywhere in the stomach. But, your stomach is normally upright during meal time. So the acid secreted from the top and accumulate at the bottom, which is the antrum. So perhaps the antrum is having more exposure to acid and higher chance for ulcer.

Plotun
Posts: 56
Joined: Sun Sep 27, 2020 2:48 am

Re: Penicillin allergy

Post by Plotun »

Helico_expert wrote:
Sun Dec 20, 2020 1:02 am
Personally, I think that's a myth. I believe H. pylori is everywhere in the stomach. But, your stomach is normally upright during meal time. So the acid secreted from the top and accumulate at the bottom, which is the antrum. So perhaps the antrum is having more exposure to acid and higher chance for ulcer.
But why some H. pylori positive people (even elderly) develop antral gastritis and duodenal ulcer without corpus or fundus atrophic gastritis? If H. pylori is everywhere in the stomach shouldn't they develop CAG and IM (because H.pylori destroys parietal cells) later in life?

Helico_expert
Site Admin
Posts: 4463
Joined: Wed Mar 02, 2011 7:20 am

Re: Penicillin allergy

Post by Helico_expert »

If you have H. pylori, you will have inflammation (or gastritis or inflammation of the gastric).
it's most probably not biopsied and so not diagnosed in the corpus area as it looks "normal" most of the time by naked eye.

It is not HP that destroy the parietal cells. It's the inflammation that is causing the destruction.
so the different disease outcome from patient to patient is because everyone's immune system react differently to H. pylori.
for those who has mild reaction, probably very little to no symptom.
for those who has strong reaction, probably will get ulcer or IM or even atrophic gastritis.
for those who has really strong reaction, probably will get rid of H. pylori immediately.

Plotun
Posts: 56
Joined: Sun Sep 27, 2020 2:48 am

Re: Penicillin allergy

Post by Plotun »

Helico_expert wrote:
Sun Dec 20, 2020 11:57 am
If you have H. pylori, you will have inflammation (or gastritis or inflammation of the gastric).
it's most probably not biopsied and so not diagnosed in the corpus area as it looks "normal" most of the time by naked eye.

It is not HP that destroy the parietal cells. It's the inflammation that is causing the destruction.
so the different disease outcome from patient to patient is because everyone's immune system react differently to H. pylori.
for those who has mild reaction, probably very little to no symptom.
for those who has strong reaction, probably will get ulcer or IM or even atrophic gastritis.
for those who has really strong reaction, probably will get rid of H. pylori immediately.
Thank You again Helico_expert.


Today I made an appointment with the GI doctor and did a control stool test. The test result was negative again and GI concluded that H.pylori is eradicated after the second consecutive negative stool test. It appears that treatment with black seed powder capsules and pantoprazole have succeeded in eradicating H.pylori. My symptoms mostly subsided and my overall condition has improved, the only drawback is that I've developed GERD. GI said it is quite common in practice to develop GERD after H.pylori eradication and prescribed me Rabeprazole 40 mg daily for one month.

Helico_expert
Site Admin
Posts: 4463
Joined: Wed Mar 02, 2011 7:20 am

Re: Penicillin allergy

Post by Helico_expert »

congratulation. That's good to know. We have tried blackseed before. Unfortunately our volunteers remain HP positive.

Plotun
Posts: 56
Joined: Sun Sep 27, 2020 2:48 am

Re: Penicillin allergy

Post by Plotun »

Helico_expert wrote:
Tue Dec 22, 2020 10:00 am
congratulation. That's good to know. We have tried blackseed before. Unfortunately our volunteers remain HP positive.
Thank You.

I wonder if a high dose of Pantoprazole (80 mg instead 40) contributed to the higher eradication. I took 2 g black seeds per day because a clinical study showed that 1 and 3 g have a weaker effect.

Helico_expert
Site Admin
Posts: 4463
Joined: Wed Mar 02, 2011 7:20 am

Re: Penicillin allergy

Post by Helico_expert »

maybe higher dose PPI did get rid of H. pylori.
we know in some rare cases, PPI alone can eradicate H. pylori.
the mechanism is unknown. Perhaps when you take high dose PPI, other bacteria start to grow in your stomach. Because H. pylori is a slow growing organism and is already used to an environment without competition, the increase of other bacteria growing in the stomach out compete H. pylori.

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