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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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H Pylori

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

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

deadlyc
Posts: 10
Joined: Tue Nov 03, 2020 2:27 am

H Pylori

Post by deadlyc »

I'm a Vietnamese that moved to Texas, United States when I was 4 in 1983. I started burping a lot more than normal about 1.5 year ago. There was also random stomach ache from may be from food indigestion and bloating. I started researching the issue which lead me to H Pylori. I got a GI-MAP stool Analysis done back on August 2019 and these are the notable result:

-Helicobactor Pylori - 1.5e5 and is consider high, Virulence Faator, oipA Positive (That is the only one that is listed positive)

-Opportunistic Bacteria - A few that are considered High

-Candida spp. - 3.29E4 and is consider High

Antibiotic Resistance Genes, phenotypes - Amoxicillin, Clarithomycin, Fluoroquinolones, and Tetracycline are all absent.

Antibiotic Resistance Genes, genotypes - b-lactamase, Fluoroquinlones, Vancomycin, and Macrolides are all absent, except Macrolides with ermB ( this specific strain is presence)


I started eating better and also starting lifting weights around that time. I also tried different natural products. My symptoms got better and it kind of went away a few months later with very few issue. I went took a breath test and H Pylori is still there. At that time, I was prescribed a triple Antibiotic therapy, but I was afraid to take it. I read stories that people got worst, etc. My symptoms went away and only had minor burping issue once in a while, so I didn't want to take a chance.

I stopped taking those natural stuff, but continue to workout and eat right and I was fine until a 1.5 months ago. My shoulder got hurt and I haven't been able to workout. I tried, but it didn't heal as quick as expected, so I stopped working out completely. I didn't eat right like I should, but didn't go junk food crazy or anything. I started getting that burping issue that I had 1.5 years ago. My stomach doesn't really hurt, but I can feel that the food wasn't digested properly and feel bloated. I can kind of taste the food when burping a few hours later. This doesn't happen every meal, but it's happened more often and I know something is not right.

I finally see my doctor today for my annual physical exam and also ask about my should. It's much better than before, but not 100%. He told me that I have a muscle strain/impingement and it will get better with time and just don't lift heavy weight. I will start working out tomorrow again and slowly get back in shape and hopefully the burping go away. I also notice that I rarely get sick from the normal cold virus, etc when I was working out.

What I want to ask is do you think I should get the Triple Antibiotic Therapy and get rid of H Pylori once and for all? Is there a high risk of getting worse after the treatment. Thanks for your help.

Helico_expert
Site Admin
Posts: 4195
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori

Post by Helico_expert »

H. pylori cannot be eradicated by natural therapy.
H. pylori is the root of many gastric diseases.
if you dont get rid of H. pylori, your gastric symptoms will never go away.
The younger you get rid of H. pylori, the better the recovery.
a lot of people neglect it because it causes little symptoms. But the damage is accumulating. by the age of 50, most damage is already permanent and cannot go back to normal.
Lastly, it's a pathogen that you can spread to other people if you are not careful.

So, I would recommend you to take the triple therapy to get rid of it.

deadlyc
Posts: 10
Joined: Tue Nov 03, 2020 2:27 am

Re: H Pylori

Post by deadlyc »

Thanks for the quick reply. I realize I will have to use antibiotics once my symptoms start showing off again. Based on my GI-Map stool test and Antibiotic Resistance Gene data, what antibiotics and medicine do you recommend that can rid of H Pylori with minimal harm to other helpful microbes? Do I need Prebiotic or probiotic?

Helico_expert
Site Admin
Posts: 4195
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori

Post by Helico_expert »

Gene testing for antibiotic resistance is not established. And since the antibiotic resistant pattern is different from country to country, you need to speak to your local specialist. They will know what is the best 1st level antibiotic treatment for you to try.

deadlyc
Posts: 10
Joined: Tue Nov 03, 2020 2:27 am

Re: H Pylori

Post by deadlyc »

Thanks for the advice.

Ajeeth916
Posts: 9
Joined: Mon Nov 23, 2020 4:15 am

Re: H Pylori

Post by Ajeeth916 »

Hi,

I have been suffering with heartburn, bloating, passing gas and belching for about 2 months now.

It all started when the doctor gave me inhalers for my asthma symptoms and day 5 or 6 after using those inhalers I started getting nausea, loss of appetite, bloating and belching. I went to the doctor again he said I have gerd and prescribed me with Omeprazole 20mg for which I have allergic reactions and diarrhea. Then I was put on Ranitidine for which also I developed the same reactions. Then he prescribed me sucralfate and gaviscon extra strength liquid. I started having heartburn only after trying Omeprazole and Ranitidine.

I went to see another GP to get a second opinion, he prescribed me Rabeprezole 20mg at first for which I had itching and hives just for the first week, then I was able to tolerate it . But my heartburn symptoms didn't go away. My doctor increased my dosage to Rabeprezole 20mg two times a day but I still have heartburn. He thought I might have got Esophageal Candida, so he prescribed me for Nystatin oral suspension for 2 weeks, but my heartburn still prevails. My GP doctor has referred me for an endoscope now to understand whats really happening inside. I suffer from intense anxiety and he thinks it might be the season too.

I got to know all my symptoms: heartburn, bloating, passing gas, belching are a symptom of H.Pylori bacteria as I'm not responding well to my higher dose PPI therapy.

Please advise if its possible that I might have a H.Pylori infection thats causing all my symptoms. Also I'm on Rabeprezole 20mg twice a day now. Will it affect my endoscopy biopsy result for H.Pylori?

If so can I take a blood test or breath test before my endoscopy as I'm still waiting for my endoscope appointment date.

Note: I have never been treated for H.Pylori before or never had acid reflux symptoms in my life. This is the first time I'm experiencing all these. Please advise. These last couple months have been so exhausting.

Helico_expert
Site Admin
Posts: 4195
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori

Post by Helico_expert »

Yea, let's get a blood test and see if you have antibody against H. pylori.

If it's negative, then you dont have to bother about other test for H. pylori.

If it's positive, then you will need to find out if it is a true positive. Unfortunately there is no easy way of detecting H. pylori while you are on PPI. Endoscopy - histology may be able to give a hint of the infection, but may not be accurate while you are on PPI.

Anyway.. it is still worth for an endoscopy just in case.

Ajeeth916
Posts: 9
Joined: Mon Nov 23, 2020 4:15 am

Re: H Pylori

Post by Ajeeth916 »

Thank you so much for your reply.

I'll ask my GP if we could do a blood work before endoscopy.

And if its positive I'm gonna consider asking him to going off PPIs for a week before endoscopy. So that it doesn't affect the endoscopy results. I find it hard to understand why PPis or any other acid suppression drugs would have such significance in the H.pylori biopsy results. Because it makes sense if I had been taking antibiotics so I have to stop before endoscopy but why the PPIs?

Also I still have heartburn symptoms even while I'm on twice a day Rabeprezole 20mg. Is this normal if I have a H.Pylori infection.? Please advise.

Helico_expert
Site Admin
Posts: 4195
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori

Post by Helico_expert »

Here is some background.
H. pylori is the only organism able to survive in the stomach because it has a very powerful urease enzyme to break down urea to ammonia and carbon dioxide.
The ammonia is used to neutralise the acid.
However, H. pylori actually prefer to live underneath the thick mucous layer, where pH is 7.

So H. pylori has developed a way to turn on and off the urease gene.
When it's at the acidic environment, the urease gene is on, ammonia is produced.
When it's at the neutral environment, the urease gene is off, ammonia is not produced.

When you take PPI, there is no acid production.
1. Other bacteria could start to grow. Because H. pylori is such a slow grower, it is quickly suppressed by the other microbes. which means it will be harder to see H. pylori under microscope.
2. H. pylori doesnt need the urease gene function anymore. So rapid urease test (from endoscopy) will most likely fail and give a false negative result.

Ajeeth916
Posts: 9
Joined: Mon Nov 23, 2020 4:15 am

Re: H Pylori

Post by Ajeeth916 »

Oh I understand. It makes sense now. Thank you so much!.
I'll update on the blood results when I do it consulting my GP.

Thanks again.

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