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Ulcer without H Pylori?

Ulcers of the duodenum and stomach are called peptic ulcers. H.pylori causes most ulcers; other causes are aspirin and arthritis type drugs (NSAIDS). Ulcers can also be in the oesophagus but these are not caused by H.pylori.

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pr1
Posts: 6
Joined: Mon Dec 14, 2020 3:18 am

Ulcer without H Pylori?

Post by pr1 »

Hello,
can you have an ulcer without any H Pylori having been found in your stomach?
Please below an excerpt from a recent biopsy (which I've translated into English):

1) GASTRIC BIOPSY
We have 3 fundic gastric mucosa fragments of normal height,
comprising well-preserved glandular structures. The chorion
is the seat of a slight increase in lymphocytes and
plasmocytes.
A non-specific cryptitis site can be noted, characterized
by neutrophile polynuclears which are aggressive towards
rare epithelial structures.
Helicobacter pylori (Dako Rabbit polyclonal), pre-diluted, pH,
FLEX revealing/disclosure (?)
Inexistant bacterial items.

2. ULCERATION BIOPSY
We have 1 fundic gastric mucosa fragments of normal height,
comprising well-preserved glandular structures. The
chorion is the seat of a slight increase in lymphocytes and
plasmocytes.
1 seat of intestinal metaplasia of small-intestin type can
be observed. The glands appear densified, their coating
is pseudo-stratified. The surface coating is pseudo-papilliar.
The cytonuclear atypias as discrete.

Immuno-histo-chemical analys:
P53 (DO-7 Dako clone), pre-diluted, pH6, FLEX revelation: savage
(?) marking.
Ki67 (DO-7 Dako clone), pre-diluted, pH6, FLEX revelation:
marks the crypts' nuclei, underlining the pseudo-stratification
and a sligh anysocaryosis, marks several nuclei on the surface.

These aspects suggest low-grade dysplasia.

CONCLUSION
Non-specific gastritis.
Gastric ulceration: site of intestinal metaplasia with
low-grade dysplasia.


Can H Pylori "camouflage" somehow in the stomach?
Can other bacteria/viruses survive in the stomach and cause ulcer-like symptoms?
Many thanks.

pp9441185
Posts: 1
Joined: Mon Dec 14, 2020 1:43 pm
Contact:

Re: Ulcer without H Pylori?

Post by pp9441185 »

I agree with you. The Ulcer without H Pylori. It is too strange to hear about it. You should get full of knowledge about Ulcer and H Pylori.

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

Re: Ulcer without H Pylori?

Post by Helico_expert »

50% of the stomach ulcer is cause by NSAIDs, especially among those who take low dose NSAIDs to prevent stroke.

NSAIDs are non-steroidal anti-inflammatory drugs, eg. aspirin, ibuprofen, etc.

******************************

H. pylori can only colonise on healthy tissues. If the doctor only investigate the tissue around the ulcer, then there is a chance of missing H. pylori.

But the terminology "aggressive" (perhaps what we normally call, active gastritis) can be a hint of presence of H. pylori.

if your stomach is making acid, then perhaps you should get a breath test to confirm the presence of H. pylori.

pr1
Posts: 6
Joined: Mon Dec 14, 2020 3:18 am

Re: Ulcer without H Pylori?

Post by pr1 »

Hi Helico Expert,

I don't remember taking large doses of NSAIDs anytime in my life, although, 15 years ago or so, I used to take Prontalgil and Nurofen (not together) whenever I had an headache, which I often did. But always in reasonable amounts.

30 years ago, I travelled extensively throughout Asia (China, Pakistan, Tibet, ...) and South America. I may have become infected with H Pylori at that point, perhaps while eating contaminated food. I remember being sick (in the belly) very often.

I am undergoing a gastroscopy at the beginning of next week at a different hospital than the previous one. Let's hope that, this time, they find the cause of my symptoms (ulcer ?) and the germ that causes them, if there is a germ.

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

Re: Ulcer without H Pylori?

Post by Helico_expert »

try ask for CLOtest and pH measuring from the gastric juice.

pr1
Posts: 6
Joined: Mon Dec 14, 2020 3:18 am

Re: Ulcer without H Pylori?

Post by pr1 »

Hello,

Greetings from the Northern Hemisphere and Happy New Year.

I underwent a gastroscopy on December 21st. According to the intern who later
visited me in my hospital room, the surgeons found a "scar" in my stomach. I later learned
that that scar was allegedly due to an old ulcer.
Tissue samples, which were taken from my stomach, were dispatched to a biology lab
in one of leading hospitals in Paris (Cochin). Unfortunately, I won't get
results before a few weeks because delays are long, I'm told.

A couple of days ago, I had a video conference with my gastro-enterologist during
which I complained about the unprecedented acuteness of my symptoms (migraine, bloating,
painful digestion, back-aches, neck-aches, electric shocks in the abdominal region...)
He re-iterated the diagnostic he made early December, which was that I suffered from
chronic constipation, probably dating back to my childhood, and prescribed a strong laxative.
Furthermore, he said that ulcers didn't cause the bloating I experienced.

About 8-hours worth of abdominal purging, the usual symptoms resumed: bloating,
migraines, ... This morning, I woke up with a huge headache, a belly-ache, pain in my
shins, etc. So much for constipation.

Hopefully, the sample analyses will reveal the root cause. Or maybe they won't.

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

Re: Ulcer without H Pylori?

Post by Helico_expert »

Some damages, such as a "scar", can be permanent. If the scaring tissue no longer able to produce mucus to protect itself from acid, you will probably always fill the pain.

Most importantly is to make sure that you are free of H. pylori. Then you can try treating your symptoms by PPI or other medications

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