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Stefan86
Posts: 7
Joined: Thu Sep 23, 2021 6:09 am

Not sure what to do, please help?

Post by Stefan86 »

Hi everyone, this is my first post here on this forum. I’d like to explain my story from the start. It was beginning of May when I took some antibiotics for a supposed urinary infection and then 2 weeks later a diclofenac 50mg and ibuprofen 400mg on an empty stomach (for my herniated disc) that started my problems with my stomach. Vomiting everyday since.. Indigestion, bloating, brain fog, the works. I did a bunch of tests, candida was found in my stool (did 4 tests) but not h.pylori (2 tests). As symptoms continued I decided to do a gastroscopy about a month ago where the gastroenterologist took some biopsy samples from different regions of my stomach. (He said I have mild gastritis btw.) When results came in he said I tested positive for helico but only in the antrum part of the stomach, the other biopsy location(s) tested negative. The thing is it seemed strange that the negative test was done by some external lab while the positive test he said he did himself… not sure how or where though, its such a small clinic (I live in Eastern Europe btw). So I wasn’t sure whether to believe him or not although why would he lie right? Lol. In any case, we couldn’t get along so he told me here’s your money back (not what I was after) and go look elsewhere, very rude guy with sadly little patience for patients..

So I decided to be sure myself and went to a real lab to do a breath test, this was last week. The result came back as positive but only barely. The cut off value was 1.50 (whatever that is?) and I got 1.60 (method used was some NDIRS). What does this mean exactly? Do I have little amounts of helico? Is it still necessary to treat it with antibiotics? I went to me GP and she said well its still positive so she prescribed me the following regiment for 14 days:

Amoxicilin 1g, every 12hrs
Clarithromycin, 500mg, every 12hrs
Bismuth subcitrate potassium, 240mg, every 12hrs
A probiotic with boulardii, 2 tablets, 2 hrs after taking the antibiotics
And a PPI (pantoprazole 20mg), before all of the above also every 12hrs

I have some issues though which has prevented me from proceeding with the treatment yet. Since this all began in May I have taken multiple times PPIs when I couldn’t handle the high amounts of acid in my stomach, but the problem is I don’t tolerate these drugs well at all and I’ve tried them all, unbearable side effects, I don’t know why. Now I’m worried how will I handle consuming a PPI for 2 weeks twice a day just so I can get rid of my supposed helico? I believe I read that the PPI is necessary to not destroy the antibiotics in my stomach, or make them more effective? But for some strange reason anyway for over a month now, whenever I vomit I don’t feel any acid anymore like before! Its like its alkaline now.. like I developed hypochlorhydria or something, how is this possible? But I still vomit everyday, undigested food (although my stool is more or less normal). I’m so lost and confused and no doctors thus far could answer my questions, like I said they’re very arrogant and don’t “have time” for us patients who want to know a little more about our problem, they just want to get you out of their office asap! This is why I’m seeking any feedback/help here on the internet and hope someone can shed some light on these concerns of mine as I’m already in a problem and don’t wish to make it worse but rather better.

Thank you all in advance!

-Stefan

PS.1. Could my problems be more due to gut candida or no way?
PS.2. Probiotics also give me terrible side effects (tried many kinds all the same reaction) and all doctors/pharmacists say this is impossible, so why am I an exception? :(

EDIT: I forgot to mention that I lost about 6-7kg in a very short time following this incident in May and still struggle to maintain or increase my weight. I'm a 35 yr old male btw, around 180cm and went from 75 to about 68-69kg. Also, last year I had a similar problem after a course of antibiotics I lost about 6kg (from 81 to 75)! Was it due to helico, candida or something else?

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

Re: Not sure what to do, please help?

Post by Helico_expert »

Here are some pointers.

1. Endoscopy results sound good. No serious abnormalities.
2. ibuprofen can inhibit the stomach mucous secretion, which lead to acid burning stomach and ulcers.
3. PPI can lead to false negative breath test. You need to stop PPI or any acid reducing agents (including herbs) for at least 2 weeks before breath test.
4. UBT result of 1.6 is borderline positive. We usually would recommend to repeat the test two weeks later.
5. If you have already started treatment, dont stop. Just keep going and repeat the breath test one month later.

Stefan86
Posts: 7
Joined: Thu Sep 23, 2021 6:09 am

Re: Not sure what to do, please help?

Post by Stefan86 »

No I have never treated helico before, to repeat no treatments yet at all!
I didnt take any PPIs for 3 weeks before doing the breath test. So with 1.6 being borderline positive as you said, should I still undergo treatment? Should I do a blood test (IgG or IgA?). Are my problems related to helico at all if the result is so low and I had negative stool tests? The thing is I still have digestive issues so if its not helico then what else could it be? or it is helico and I should treat it lol? I only ask bcuz the treatment is definitely not an easy one and I'm afraid of going down another hellish path and regretting it if there's no real reason to do so..

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

Re: Not sure what to do, please help?

Post by Helico_expert »

Did your doctor send a biopsy for histology check? hope he did.

anyway, I assume that visual examination showed no abnormality, which is assuring.

blood test is probably worth doing. If it's negative, then 1.6 is a false positive. If blood test positive, it means you had been expose to H. pylori before and MAYBE, i must stress, MAYBE, you have H. pylori now. blood test can only tell you history of infection and not current infection.

Most of the gastric symptoms are caused by H. pylori. However, there are cases where the digestive problem is not cause by H. pylori. Unfortunately we dont know what causes it yet. For these non-H. pylori dyspepsia patients, we will just have to give treatment according to the symptoms.

Stefan86
Posts: 7
Joined: Thu Sep 23, 2021 6:09 am

Re: Not sure what to do, please help?

Post by Stefan86 »

Yes he sent a biopsy to an actual lab for Ph (pathohistology) testing and the results came back fine, and also negative for helico.
But the ONE biopsy that he tested "himself" (no mention of a lab, so thats strange but ok.. :? ) was from my stomach's antrum region, which he says is where you would likely find h.pylori and not in other parts of the stomach, and he said this 24h urease test came back positive!

btw here is a video of my gastroscopy if interested :) https://youtu.be/-Qxfdm6MRWw
5 biopsy samples take @ 1:10 1:40 1:43 2:06 2:09

In any case I will do a blood test also tmrw just to be sure, but even if its negative I will still be at loss to what is causing my stomach symptoms.
I have no other explanation for my low stomach acid then an h.pylori infection, although initially I thought helico caused increased acid. But to be fair my symptoms started back in May and I did have then up till about end of August pretty extreme acid whenever I vomited and now I feel like I don't have any at all! Its so bizarre! What happened exactly, does science know?

I just have one question if I do end up doing the treatment. The drug plan involves taking a PPI and I do not tolerate the side effects of these drugs very well so can I omit them and still have success in eradicating helico? I also do not see the point in taking a PPI (that reduces stomach acid secretion) when I'm already LOW on acid lol. Wouldn't this be bad then and not advisable by logic or am I missing something here? I'd like to know this before starting the treatment.

Thank you again for your valued feedback Helico_expert!

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

Re: Not sure what to do, please help?

Post by Helico_expert »

I assume your doctor did a rapid urease test. which is usually accurate within 10-30 min.
24hrs is a bit too long. it's probably likely to be false positive.

your stomach doesnt produce acid all the time. Acid is only produced when you are hungry. you can ask your doctor to test your pepsinogen I and II during blood test. That may give a hint on your acid secretion situation.

Stefan86
Posts: 7
Joined: Thu Sep 23, 2021 6:09 am

Re: Not sure what to do, please help?

Post by Stefan86 »

So I got my blood test results back and its positive indeed. IgA is 39.9 U/mL (cut off is 30). IgG is 0.93 though (below 1) but they said that indicates if you had helico in the past while IgA is present infection.

I will start treatment tmrw likley, I just would like if you can answer my last paragraph in my previous post, can I avoid taking a PPI and successfully treat helico? I ask bcuz I dont tolerate PPIs well and also feeling that I have less acid I dont see the point of reducing my stomach acid even more? What is your opinion on this matter?

Thanks again.

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

Re: Not sure what to do, please help?

Post by Helico_expert »

without PPI, your treatment effectiveness drop by 50%.

What about H2 blockers? such as famotidine?

Stefan86
Posts: 7
Joined: Thu Sep 23, 2021 6:09 am

Re: Not sure what to do, please help?

Post by Stefan86 »

I tried many PPIs over the past few months but all the same intolerable side effects, as well as with H2 blockers, I can't explain why, how can I possibly know? And that was just taking it for 1 or 2 days. Now I'm instructed to take them 2x a day for 14 days and seriously have my doubts I will succeed!

In the case I have reeeeally reeeeally bad side effects can I stop the PPIs (or maybe skip a day or two) but continue the antibiotics to finish the 2 week course? I really want to need to get rid of this horrible bacteria that's being ruining my life for the past 5 months!

One doctor prescribed rabeprazole 20mg 2x daily. Another doc prescribed pantoprazole 20mg 2x daily. Which to pick here? I read rabeprazole is stronger..

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

Re: Not sure what to do, please help?

Post by Helico_expert »

rabeprazole stays in your blood longer, so people thinks it's better. But for people who are sensitive, i am not too sure if tha'ts a good thing.

Then again, the antibiotics are a lot less effective if you have acid in the stomach.

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