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Re: RUT: positive or negative?

Posted: Fri Aug 09, 2019 7:15 pm
by Sajal
Is HELIC ammonia breath test accurate and reliable?

Re: RUT: positive or negative?

Posted: Sat Aug 10, 2019 11:11 pm
by Helico_expert
I have not used it before. But it's not the recommended test in the guideline.


https://www.ncbi.nlm.nih.gov/pubmed/30118459/
CONCLUSIONS:
The ammonia breath test evaluated on this study does not have diagnostic accuracy and is not recommended as a diagnostic tool for Helicobacter pylori infection.

Re: RUT: positive or negative?

Posted: Sun Aug 18, 2019 5:10 pm
by Sajal
Hello again...
I had conduct the endoscopy couple of weeks ago. RUT (dry rut test) was negative after observing for three hours but it turned positive when I saw it after around 20 hours from the test. Also, histology reports came out positive for h pylori.

My previous endoscopy (RUT)which I had contacted in april this year showed negative for h pylori. Moreover, a recent Helic ammonia breath test also showed negative.

I am very much confused. I still have symptoms? Should I go with the histology (biopsy) results or the RUT and breath test?

My GI is suggesting me sequential therapy (amox+ ppi for first four days and then clarithromycin+ metronidazole+ ppi for another 7 days)

I am not even sure whether I am positive or negative for h pylori.

Please suggest

Re: RUT: positive or negative?

Posted: Sun Aug 18, 2019 11:19 pm
by Helico_expert
Histology is the recommended gold standard. So i would trust histology result out of all.

I assume you already had metronidazole and clarithromycin before. So perhaps the proposed sequential is not appropriate.

perhaps you can try PPI + Bismuth + tetracycline + metronidazole

This time, try higher dose PPI, eg rabeprazole 20mg TID.

As for your symptoms, you will have to wait till your HP is fully eradicated.

Re: RUT: positive or negative?

Posted: Mon Aug 19, 2019 1:34 am
by Sajal
I haven't used metronidazole yet ,but I would like to go for quadruple therapy anyway as I have heard that eradication rate of quadruple therapy is far more than any other antibiotics therapy. What is the actual eradication rate of PBMT therapy?

What about the side effects of metronidazole and tetracycline?

Also, please tell me the exact dosage for this therapy?
Should I take it for 14 days?

Re: RUT: positive or negative?

Posted: Mon Aug 19, 2019 8:37 am
by Helico_expert
PBMT is what we normally prescribe. You need to see a doctor and get their approval. They are responsible for your well being, not this website. Always remember that if you experienced any side effect, your doctor is the one to go to.

P = PPI, Rabeprazole 20mg TID
B = bismuth, 240mg QID
M = metronidazole 400mg TID
T = tetracycline 500mg QID

The common side effects include bad taste in the mouth, change of urine color, very dark stool, diarrhea, constipation, nausea, dizzy, lack of energy, etc.

Re: RUT: positive or negative?

Posted: Mon Aug 19, 2019 5:53 pm
by Sajal
What I am going to use is 'colloidal bismuth subcitrate'. It comes with a composition of 120 mg/tablet. The manufacturer's description states its dose as 120 mg.

https://m.indiamart.com/proddetail/pylo ... 32997.html



Should I take 2 tablets a time for four times a day, or 120 mg at a time would be sufficient?

Re: RUT: positive or negative?

Posted: Mon Aug 19, 2019 11:36 pm
by Helico_expert
Yes, you can take 2 tablets. BUT please talk to your doctor about it and have him aware of this. So he can monitor your side effect.

Re: RUT: positive or negative?

Posted: Tue Aug 20, 2019 5:07 pm
by Sajal
I have ordered a box of colloidal bismuth subcitrate i.e., 56 tablets(120 mg/ tablet).
I have read that standard dose of colloidal bismuth subcitrate is 120 mg QID in PBMT. However, I have read people on this forum have gone for higher dose of bismuth.
Does higher dose of bismuth gives higher cure rates?
Is 120 mg of colloidal bismuth subcitrate QID sufficient?

Re: RUT: positive or negative?

Posted: Tue Aug 20, 2019 7:57 pm
by Helico_expert
higher dose = higher cure rate = higher risk of side effect.

but we have been prescribing 240mg and QID for many years. Nevertheless, you still have to let your doctor know and look after you.