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H Pylori Gastritis Questions / Dental Hygiene

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anonymous94
Posts: 5
Joined: Wed Aug 28, 2019 4:48 am

H Pylori Gastritis Questions / Dental Hygiene

Post by anonymous94 »

Hello! US patient here, 25 years old Male. I just had two questions.

I have had gastritis and consistent burning/abdominal pain where my stomach is for about a week now, bloating, gas, no hunger, and so forth. I also have GERD but I know that HPylori is not related to LES function and that it is a separate issue. I am going in on the 29th for a breath test for HPylori, I was wondering if these painful stomach ( Not GERD Related ) symptoms would resolve upon successful eradication of the bacteria eg: no more burning pain in my lower abdomen? I know that it will not be immediate but I am honestly scared of having to deal with two kinds of pain chronically, acid reflux is bad enough as it is but I manage that well enough.

I also read interesting info and others' questions about Hpylori presence in dental biofilm/plaque and have a bit of problems with it around some of my teeth, I am getting that deep cleaned/scaled and was wondering if this would further improve odds of not being reinfected. As the bacteria seems to transfer through saliva? I would not want to just re-catch the infection with a potential reservoir of it in my mouth after taking drugs and was curious of your professional opinions on the matter as I am by no means a microbiologist.

Info about HPylori and dental plaque:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024772/

To quote the conclusion:

" Although H. pylori has long been known to be detected in the oral cavity, the significance of such findings was controversial. If the oral cavity is an important extra-gastric reservoir of H. pylori, then this finding may have major implications because the oral cavity can serve as both a source of re-infection and route of transmission. Because plaque-associated H. pylori would be resistant to systemic H. pylori eradication therapy, it can affect the success rates of the anti-H. pylori therapy. Thus, it is imperative to identify the role of dental plaque, saliva, and periodontal disease in H. pylori infection. Once these factors are clearly understood and whether the oral cavity is a major extra-gastric reservoir of H. pylori is confirmed, then newer treatment modalities, such as periodontal therapy, may be incorporated in the protocol for the management of H. pylori infection. The initial studies on the role of periodontal therapy in the management of H. pylori infection have shown promising results, suggesting that oral H. pylori may play an important role in re-infection of the gastric mucosa. These observations also create new avenues for both future research and more effective management of H. pylori infection. "



Thank you for your time.

Helico_expert
Site Admin
Posts: 3714
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori Gastritis Questions / Dental Hygiene

Post by Helico_expert »

We do not believe the dental plague H. pylori theory.
Because
1. H. pylori only colonises the stomach.
2. Because H. pylori can produce ammonia, if H. pylori is in the dental plague, then there will be no teeth corrosion as H. pylori will be protecting the teeth from acid producing bacteria.
3. The antibiotics will be absorbed in human body and flow in the blood stream. The reason you have metalic taste in the mouth when taking antibiotics, is because the antibiotics are in the saliva and you are constantly tasting it. Therefore, the H. pylori in the mouth should also be eradicated.

lastly, we have never pay attention to patient's oral H. pylori and we have a cure rate of over 95% among the most difficult multi drug resistant cases. (not the common patients normal doctors treated).

in regards to your symptoms. it may or may not be because of H. pylori (most of the time it is). Hopefully by eradicating H. pylori, your symptoms can go away too.

anonymous94
Posts: 5
Joined: Wed Aug 28, 2019 4:48 am

Re: H Pylori Gastritis Questions / Dental Hygiene

Post by anonymous94 »

Okay! Thanks for the reply and information, I thought it would be best to get some feedback from those that specialize in the field and on this bacteria. I really appreciate the quick response and the efforts here. :D

Helico_expert
Site Admin
Posts: 3714
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori Gastritis Questions / Dental Hygiene

Post by Helico_expert »

Anytime at your service.

chetanvenki
Posts: 19
Joined: Tue May 21, 2019 9:05 pm

Re: H Pylori Gastritis Questions / Dental Hygiene

Post by chetanvenki »

Good insights on oral HP.

However there are studies suggesting HP lives in Sinus as well and it will reinfect the stomach even though the antibiotics eradicate HP. My GI have this opinion on my case where I failed 4th round of therapy. Please clarify.

Helico_expert
Site Admin
Posts: 3714
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori Gastritis Questions / Dental Hygiene

Post by Helico_expert »

Very interesting. I think Prof. Marshall mentioned about H. pylori in the sinus before. I need to find the literature on that one.

Nevertheless, I believe antibiotics would travel all around your body via blood flow and would reach the sinus too.

anonymous94
Posts: 5
Joined: Wed Aug 28, 2019 4:48 am

Re: H Pylori Gastritis Questions / Dental Hygiene

Post by anonymous94 »

Just a small update while I wait for results from stool/breath test! I was reading info about phototherapy in helping to eradicate H. Pylori, have any patients ever been treated with this in combination with antibiotic therapy before? I understand that most will recolonize a few days after illumination, but was wondering if it had ever been used alongside antibiotics, possibly drug-resistant strains.

Helico_expert
Site Admin
Posts: 3714
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori Gastritis Questions / Dental Hygiene

Post by Helico_expert »

The phototherapy is very new idea. I am not sure if it is already on market. but I think the cure rate may not be great because H. pylori can hide deep in between cells where light cannot reach. But I could be wrong. I need a better review on this.

anonymous94
Posts: 5
Joined: Wed Aug 28, 2019 4:48 am

Re: H Pylori Gastritis Questions / Dental Hygiene

Post by anonymous94 »

Hello again! Sorry for the wait, I had some events in between tests for this bacteria.

I am still having my symptoms, mainly just the burning/gnawing feeling, and I am feeling just a little confused. I have been checking off possible causes for my symptoms all month. Most of the gastritis causes are ones that i'm scrolling by as if checking off a grocery list! I don't smoke, drink or use NSAIDS or other pain-relievers frequently, I do not stress, I am not vitamin deficient, and my diet is relatively bland/gentle to begin with as I also have GERD. I'm not really an adventurous eater.

More concerning is that I seem to have had a negative result on both H. Pylori tests, both a stool and breath test. However, I had a major question that would be very relieving to have an answer to, as I cannot seem to locate any specific data when it comes to cut offs or percentages. I believe that I have taken one dose of PPI or Bismuth sooner than two weeks before my stool and breath tests, but it was not very much. Maybe one pill or capful of PPI and bismuth, very far from the actual tests. I believe it was more of a 10 days before my test, rather than 14. My doctor said that this would not affect my results, but I am skeptical and would like a second opinion.

How impactful would these small doses be on a possible false-negative test result? And would me undergoing perhaps a blood test to check for H. Pylori antibodies be sufficient to conclude what is causing my gastritis? I know that the antigens for this bacteria linger in your blood for a very long time, however I have never been diagnosed with this bacteria before, so I was wondering if it would suffice for an initial test. I have to take bismuth and PPI/other medicines just to keep the pain down during daily life, so timing a stool or breath test is very difficult, and I do not think I could abstain for two weeks, or convince my doctor to give me another test when they already insisted that it was negative despite knowing that i'd taken those medicines prior.

I also had a CT scan of my abdomen, with mention of " Gastritis and gastric wall thickening. " I am following up with an endoscopy soon to biopsy samples, and am just very concerned. Could my GI possibly examine those biopsies for H. Pylori as well while he's in there?

It seems that I have crossed off every possible other cause for my burning pain, and was really hoping that it would be H. Pylori. It seems like the only other options that remain are possible atrophy and cancer, and that's just awful. Thank you for your time.

Helico_expert
Site Admin
Posts: 3714
Joined: Wed Mar 02, 2011 7:20 am

Re: H Pylori Gastritis Questions / Dental Hygiene

Post by Helico_expert »

Sometimes, it just need some time to heal. It could take up to weeks, months, or years. It depends on the severity of the damage done. You have to understand that usually people catch this bug during childhood. So you have already been infected with this bug for decades. During this long infection, some damages can be permanent. especially when you are above 40.

How accurate is the tests?
You mentioned that you have done stool and breath test and both showed negative. I think the chance of getting a false negative is low. I agree with your doctor that 10 days without PPI or antibiotics is probably good enough. However, it is better to get a score of the result. How negative is your negative result? if 50 is the cut off value, a score of 1 is a negative, but a score of 49 is also negative. But I would be suspicious to see a score of 49. Then what is the cut off for positive? If a score above 200 is positive, and you get a 49, I think that's ok. A test with a "grey" zone is much accurate than those without.

Should you do another endoscopy for histology?
I assume your previous endoscopy report is ok. no abnormality. if so, then you dont need one until next year or longer. If you have some abnormality, eg.. ulcer or intestinal metaplasia or atrophic gastritis or polyps, then you probably need an annual or more frequent endoscopy check depending on the severity.

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