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H PYLORI test result - Antigen DETECTED

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SJ66
Posts: 27
Joined: Sat May 19, 2018 4:44 am

Re: H PYLORI test result - Antigen DETECTED

Post by SJ66 »

Many thanks. I understand about getting advice from my doctor. But, please may I trouble you again?

Briefly, this is my HPylori story:

I was in Asia (Thailand) for many years with my family and I got sick there last April 2018 for ca. 6 weeks. (I was on my own then as my family had returned 6 months earlier to UK). No one in Thailand knew what was wrong with me, no doctor, no consultant. I wasn’t getting better, I was getting worse. That’s when I started to fully research my symptoms; read about Prof Marshall’s work; and miraculously found this brilliant Foundation, which gave me hope. I then did a private blood test (IgM) in Thailand which came back positive.

I flew home to UK in June 2018, ordered a stool test via my GP, and my ‘mystery illness’ was confirmed as positive for HPylori antigen in stool. It’s sad to say that I’ve had to educate my doctor on this pathogen!

So, in eradicating/killing HP again:

1. Does it matter where in the world/region I was infected/contracted HPylori?
2. Would it matter what combination of ABX are used?
3. I’ve already had 14 days of Metronidazole in August 2018
4. I took Ranitidine, Metronidazole, Amoxicillin, Pepto - wasn’t that combo QUAD? (I was the one who decided to add in Pepto Bismol, my GP just said okay)
5. If my 2 family members test positive on stool test, should they do Triple therapy for 7 or 10 days (and add in Pepto Bismol)?
6. Do you take Pepto away from the ABX, eg 1 or 2 hours before or after taking the ABX?
7. Rabeprazole - you take that WITH ABX morning and night?

I very much appreciate all your help and advice.
Regards, SJ

Maria.b
Posts: 46
Joined: Wed Apr 25, 2018 2:50 pm

Re: H PYLORI test result - Antigen DETECTED

Post by Maria.b »

Sorry to jump post not figured out how to start new post yet so had my 15 month endoscope today and biopsies were taken but confused as this dr said my stomach is now in much better condition than the previous endoscope showed and she saw nothing with the naked eye previously iwas diagnosed with prominent intestinal metaplasia wirh a different gastro dr via him seeing it and biopsies could she have missed it? Or is it possible its reversed back. Thanku for yr support x

Helico_expert
Site Admin
Posts: 3637
Joined: Wed Mar 02, 2011 7:20 am

Re: H PYLORI test result - Antigen DETECTED

Post by Helico_expert »

1. Does it matter where in the world/region I was infected/contracted HPylori?
2. Would it matter what combination of ABX are used?
3. I’ve already had 14 days of Metronidazole in August 2018
4. I took Ranitidine, Metronidazole, Amoxicillin, Pepto - wasn’t that combo QUAD? (I was the one who decided to add in Pepto Bismol, my GP just said okay)
5. If my 2 family members test positive on stool test, should they do Triple therapy for 7 or 10 days (and add in Pepto Bismol)?
6. Do you take Pepto away from the ABX, eg 1 or 2 hours before or after taking the ABX?
7. Rabeprazole - you take that WITH ABX morning and night?
1. To a certain degree, it matters where you catch the HP from. For example, Chinese strains are more probably more carcinogenic than other strains; Asian strains are probably more antibiotic resistant; etc. But since it's a chronic infection, it's not a big problem.

2. Yes, it matters what antibiotics you use. You should systematically change the antibiotics so the doctor can have a good guest of what antibiotic your strain is resistant to. So, follow the guideline. Try the common antibiotics first eg. Triple therapy first (PPI + Amox + Clarithromycin) (Can add pepto bismol to make it a quadruple therapy);

3. Therefore, you should not use metronidazole in your H. pylori treatment. Except when it is used together with Tetracycline. There are studies that show PPI + bismuth + Tetracycline and metronidazole combination can overcome the metronidazole resistance.

4. Ranitidine is not a very strong acid blocker. If possible, switch to rabeprazole. And ask for double dose (20mg TID).

5. If your family members (older than 16 years old), living under the same roof, they should get treatment to prevent reinfection. Children below 16 years old is not recommended for treatment as we believe the that the antibiotics may do more harm to them than good. Children almost never gets any digestive problems. So if they have no symptoms, dont worry about it. wait till they are over 16, then they can decide if they want a treatment before university.

6. you can take pepto bismol together with all drugs.

7. you can take rabeprazole together with antibiotics. Just try to spread out the time taking the antibiotics as evenly as possible. That will keep the antibiotics in your blood constantly high.

Helico_expert
Site Admin
Posts: 3637
Joined: Wed Mar 02, 2011 7:20 am

Re: H PYLORI test result - Antigen DETECTED

Post by Helico_expert »

Sorry to jump post not figured out how to start new post yet so had my 15 month endoscope today and biopsies were taken but confused as this dr said my stomach is now in much better condition than the previous endoscope showed and she saw nothing with the naked eye previously iwas diagnosed with prominent intestinal metaplasia wirh a different gastro dr via him seeing it and biopsies could she have missed it? Or is it possible its reversed back. Thanku for yr support x
It is possible for mild metaplasia to reverse back to normal.

but it is not accurate for visual diagnosis.

Nevertheless, if your doctor is happy of what he is seeing, I think it's good progress and good improvement. You can book another endoscopy next year.

Maria.b
Posts: 46
Joined: Wed Apr 25, 2018 2:50 pm

Re: H PYLORI test result - Antigen DETECTED

Post by Maria.b »

Thanks for ur reply i ask as the first time i had the endoscope intestinal metaplasia was visual by the eye and was wrote as prominent this time she didnt see anything and was done by different doctors so just abit shocked with the result yesterday and i still have some issues with my stomach 15 months later

SJ66
Posts: 27
Joined: Sat May 19, 2018 4:44 am

Re: H PYLORI test result - Antigen DETECTED

Post by SJ66 »

Hi Helico_expert

Many, many thanks for your excellent reply.

Update: my GP has just phoned. Last week she wrote to the Gastro unit at hospital and they have responded that they want to see me for further investigation/testing. GP mentioned breath test, endoscopy, biopsy.

Also, as per your suggestion, the GP has now arranged for stool tests for the rest of my family. This is major progress as there has been a constant response of ‘oh, it’s not necessary to treat family’, ‘HPylori can’t be caught/passed to other family members’!

I’m so grateful to this Foundation and team.

If I may, I’ll keep you updated on tests, findings, etc.

Regards,
SJ

SJ66
Posts: 27
Joined: Sat May 19, 2018 4:44 am

Re: H PYLORI test result - Antigen DETECTED

Post by SJ66 »

Hi Helico_expert

Would really appreciate your opinions:

To recap:

June 2018 - HPylori blood & stool - POSITIVE

Aug 2018 - Antibiotics/Pepto/Ranitidine x 2 weeks

Oct 2018 - HPylori stool - NEGATIVE

Mar 2019 - HPylori stool - NEGATIVE

Sept 2019 - HPylori stool - POSITIVE

Oct 2019 - 13C Breath Test - NEGATIVE

(I don’t take PPIs, Pepto, or antacids).

Should I assume I’m HPylori NEGATIVE?

Would appreciate your comments. Thank you so much.

SJ

Helico_expert
Site Admin
Posts: 3637
Joined: Wed Mar 02, 2011 7:20 am

Re: H PYLORI test result - Antigen DETECTED

Post by Helico_expert »

ya... the positive stool test is very suspicious. Perhaps you are always negative. Can you contact the laboratory to get an exact value how positive is your positive stool test? If you can, please also ask for the cut off value, and the positive and negative control value.

SJ66
Posts: 27
Joined: Sat May 19, 2018 4:44 am

Re: H PYLORI test result - Antigen DETECTED

Post by SJ66 »

Hi Helico_expert

Thanks for your fast reply.

I did ask my doctor about more in-depth info re the stool test. She said all the information the hospital lab returns is either positive or negative, antigen detected/not detected. The lab is in a large NHS hospital in London.

Also, there’s that relatively new test which is:
GI-MAP (GI Microbial Assay Plus) DNA stool analysis by qPCR that’s being done in USA by Diagnostics Solutions.

Here’s a bit more info from their website:

GI-MAP Advantages:

True DNA/PCR Assay
Rapid TAT – Results in 7–10 business days
Quantitative PCR Pathogen Testing
High Sensitivity and Specificity
Antibiotic Resistance Genes
H. pylori and Virulence Factors

The GI-MAP stool test utilizes cutting edge, Quantitative PCR technology to provide a true DNA/PCR based stool test. This technology has high sensitivity, specificity and a rapid turnaround. The GI pathogens include bacteria, parasites and viruses. The GI-MAP measures opportunistic organisms, normal flora, fungi, parasites and antibiotic resistance genes. And the Plus refers to immunologic markers for GI health and function including SIgA, Elastase, Calprotectin and Anti-gliadin testing.

Personally, I thought stool and breath test were the ‘gold standard’ tests?!

What do you think I should do?

Thanks again.
SJ

Helico_expert
Site Admin
Posts: 3637
Joined: Wed Mar 02, 2011 7:20 am

Re: H PYLORI test result - Antigen DETECTED

Post by Helico_expert »

I heard about GI MAP. it's an interesting "diagnostic" technology. However, it has not been recommended in the guideline. The sensitivity of this test has not been tested.

I think you should ignore your stool test. multiple negative breath tests are good enough.

Breath test is the gold standard among non invasive test.

You have recently done an endoscopy examination. So you can book yourself another one in 6 or 12 months time to monitor the condition.

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