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Negative at urea breath test

Posted: Sat Oct 16, 2021 1:50 am
by Abubakar
Hello, hope you all are doing well.
It all have started exactly two years ago at 15/10/2019. Treated for the entire last year considering as GERD. Diagnostic hampered due to covid situation. Came to know inflammation in the stomach by endoscopy 01/01/2021. Took triple therapy which made the symptoms way worse after one month. Started to suffer from many new symptoms. Did another endoscopy & biopsy at August. Endoscopic finding was subepithelial haemorrhage at stomach. Took quadruple therapy and after one month post ABX and 14 days of ppi did a urea breadth test which says negative. Hope it is a true negative by the grace of Almighty.
My DOB is 0.41, cutoff is 4.
I did not take any supplement, probiotic or any known inhibitory food except 1/2 cup green tea, chew little ginger and 3/4 spoon local honey daily.
Is there any chance of false negative by interpreting my DOB?
Want to hear your kind opinion helico expert.
Hope and pray for the healing of each and every person in the world who are going through this disaster.

Re: Negative at urea breadth test

Posted: Sat Oct 16, 2021 9:59 am
by Helico_expert
Hi,
0.41 is pretty low. The lower the number, the more accurate it is.
If you want, you can always repeat the breath test again next month.

it is also common to have the symptoms persist after HP eradication. The symptoms are caused by the damage done by H. pylori, and it takes time for the wound to heal. The more severe the damage, the longer the time it needs to heal.

Re: Negative at urea breadth test

Posted: Sat Oct 16, 2021 12:18 pm
by Abubakar
Thanks a lot for your quick response.

Can you please give your opinion about the findings of my endoscopy and histopathology-

First endoscopy (01/01/2021)- the mucosa of the body and fundus appeared inflamed.

2nd endoscopy(20/08/2021)- subepithelial haemorrhages are seen at the body and fundus.

Histopathology- the lamina propria contains increased number of mononuclear cells. The gastric glands are unremarkable. No malignancy is seen. No hp is seen.

No hp is seen in biopsy probably as I didn't stop ppi.

Your kind opinion regarding the damage, chance and time for heal will be highly appreciated.

Re: Negative at urea breadth test

Posted: Mon Oct 18, 2021 12:14 pm
by Abubakar
Waiting for your kind reply.
How severe is my damage according to the findings of endoscopy and histopathology report aforementioned? And according to UBT as I am now free of hp, should I now focus on gut repairing and perform an endoscopy couple of weeks later to check the healing progress or need to do another endoscopy and more elaborate histopathological investigation right now?
Eagerly waiting for your kind opinion.

Re: Negative at urea breadth test

Posted: Tue Oct 19, 2021 1:13 pm
by Helico_expert
This is Prof Marshall's response.
This is an interesting question often asked by people who have residual changes after infection with Helicobacter pylori infection. Quite often the appearance of the mucosa is a little red and with the take your spot and this can last the rest of your life. It is a vascular change just like sun damage to the skin on the back of your hands for example.
The histology, after infection with Helicobacter pylori and is likely to continue to contain mononuclear cells of different kinds and these are “memory cells” which are functional residual immune cells capable of proliferating if Helicobacter pylori came back. However they don’t live there dormant and there is always a degree of in “mild chronic inactive gastritis”. The key to Helicobacter pylori is the presence of active neutrophils are indicative of actual Helicobacter in the mucosa. These disappear after affective treatment.
The other are useful thing to do is to have a serology done every 6 or 12 months for a couple of years until it goes to the negative range. It’s going to stay positive for quite a while after treatment but if it gradually declines then that’s excellent evidence that Helicobacter has actually been eradicated. The good news is that Helicobacter reinfection is unlikely, less than 1% per annum in most countries.

Re: Negative at urea breadth test

Posted: Tue Oct 19, 2021 10:43 pm
by Abubakar
Thanks sir for your valuable opinion.

If those red spots or inflammation in the mucosa are like sun damage and will last for rest of the life then what about the debilitating symptoms like fullness after eating a small meal, stomach burning, indigestion, bloating, burping, constipation and many more. Will these last for the rest of life. How to get rid of all of these? How to heal stomach lining?

Can you please clarify a little more about subepithelial haemorrhages in the stomach. How severe form of gastritis this is?

Thanks once again in advance.

Re: Negative at urea breadth test

Posted: Wed Oct 20, 2021 9:11 am
by Helico_expert
I think you have to find out the reason for the inflammation.
Since you dont have H. pylori, perhaps, the inflammation is from food allergies?
you may want to see a immunologist or dietician to figure this out.

Re: Negative at urea breadth test

Posted: Wed Oct 20, 2021 2:11 pm
by Abubakar
I have mentioned it in my first post. I have been suffering from h pylori induced gastritis.
Did an endoscopy at 01/01/2021. Finding was inflamed body and fundus. Took triple therapy, which failed to eradicate.
Did another endoscopy at 20th August. Finding was subepithelial haemorrhages in the body and fundus. Took sequential therapy and negative at UBT.
After more than one month, still suffering from all of the symptoms.
That's why I would like to know how severe is the subepithelial haemorrhage and after eradication, how is the chance and how much time it may need to be healed. And any suggestion about the healing supplement would also be highly appreciated.

Re: Negative at urea breadth test

Posted: Thu Oct 21, 2021 9:17 am
by Helico_expert
It's good to know that you have successfully eradicated H. pylori. At least the inflammation will gradually subside and the wound will gradually heal. unfortunately the healing is subjective. Some people feel improvement within weeks; some took months or years.

At the moment, you can only be treated according to your symptoms. So what do you feel when taking PPI? do you feel improvement?

Re: Negative at urea breadth test

Posted: Fri Oct 22, 2021 12:19 pm
by Abubakar
I am a bit confused about the ppi. Most of the people in the group's used to say they stop ppi after ABX or two weeks later. Even when I stopped ppi for 14 days before UBT, I didn't experience any difference. After UBT I started to take licorice root capsule twice a day for the last one week. But I have been experiencing upset stomach with upper abdominal burning for the last 3/4 days.
After UBT test my doc asked me to take dexlansoprazole 30 twice for months. And I don't know why now even after negative UBT, he told me to consult with a senior doctor. Yesterday I made a visit to another GI specialist. But he didn't prescribe any ppi, rather dompiridone, sucralfate.
So now what should I follow?