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How can ulcer biopsies NOT be positive for Pylori

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

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

berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

How can ulcer biopsies NOT be positive for Pylori

Post by berttt1 »

Waiting on my biopsy results and Im confused. If most of us (or at least a good percentage) have Pylori in our stomachs - how can a test tell the difference between an actual Pylori case and the "presence" of it. Is there a high number in a biopsy? How does this work.

Hope Im being clear. Thanks

Plotun
Posts: 59
Joined: Sun Sep 27, 2020 2:48 am

Re: How can ulcer biopsies NOT be positive for Pylori

Post by Plotun »

Because there's a difference between active and inactive chronic gastritis. Active chronic gastritis means that h.pylori is present as immune cells try to eliminate the bug. Inactive means there's no h.pylori hence there's no immune cells at the biopsy result.

berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

Re: How can ulcer biopsies NOT be positive for Pylori

Post by berttt1 »

So the biopsy is not looking for h pylori but immune cells? OK

Plotun
Posts: 59
Joined: Sun Sep 27, 2020 2:48 am

Re: How can ulcer biopsies NOT be positive for Pylori

Post by Plotun »

berttt1 wrote:
Sat Jan 23, 2021 7:34 am
So the biopsy is not looking for h pylori but immune cells? OK
No, biopsy detect h.pylori, there's a method called immunohistochemistry that is used for detection.

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

Re: How can ulcer biopsies NOT be positive for Pylori

Post by Helico_expert »

great explanation.

you can do specific immuno stain to detect H. pylori directly. It's made up of special antibody that target specifically at H. pylori. So the pathologist can see H. pylori.

However, the immune response, active gastritis, already good enough to give a hint that there is pathogen. Since H. pylori is almost always the reason for the gastritis, many pathologists do not go ahead to do further staining.

berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

Re: How can ulcer biopsies NOT be positive for Pylori

Post by berttt1 »

Biospsy came back negative for pylori - though I have 2 small ulcers.
Could medicine type ulcers create gas/heartburn symptoms?
I feel like crap and was hoping for a diagnosis. Now Im at square 1

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

Re: How can ulcer biopsies NOT be positive for Pylori

Post by Helico_expert »

Could medicine type ulcers create gas/heartburn symptoms?
Are you saying your ulcers are caused by medicine, such as NSAIDs?

yea, when your stomach has ulcers, it act weirdly and produce gas and give heartburn symptoms.
Just take PPI for a month and see if that helps.

berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

Re: How can ulcer biopsies NOT be positive for Pylori

Post by berttt1 »

Thank you much.

berttt1
Posts: 38
Joined: Wed Jan 20, 2021 7:43 am

Re: How can ulcer biopsies NOT be positive for Pylori

Post by berttt1 »

Im a bit concerned because even though my biopsy came up negative for pylori - my doctor has me on ppis to clear up the ulcer. Ultimately Id like to do a breath test - but if i stay on PPIS for a month it will be nasty to come off of them.

Also my doctor said "PPIs for a month will clear up the ulcer" which - I believe is far too short a time to clear up 2 ulcers. So Im definitely confused by his statement.

Anyway - I hope its OK to reach out like this. Thanks much.

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

Re: How can ulcer biopsies NOT be positive for Pylori

Post by Helico_expert »

it's a standard protocol to take PPI for a month to help the ulcer to heal. If you think it's not enough, you can continue for another month.

It's not urgent to get a diagnostic of H. pylori quickly. You can do follow up the H. pylori test when you are absolutely ready.

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