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Blood Test Positive and Stool Test Negative -redo?

Blood tests (for antibody) are used to screen for H.pylori. They remain positive for many months after treatment so can only be used as the initial test. Urine antibody is a "pregnanacy style" urine test. Accuracy is slightly less than blood tests. A negative blood test is good evidence that Hp is NOT present. Use it to exclude the diagnosis (but no test is 100% perfect remember).

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sunshine37
Posts: 35
Joined: Sun Jun 07, 2015 7:34 am
Location: United States

Blood Test Positive and Stool Test Negative -redo?

Post by sunshine37 »

I was diagnosed with GERD a month ago, after having serious problems with a sudden onset of acid reflux for 2-3 months this spring. The doctor prescribed Nexium 40 mg once per day and a special low acid diet with 6 small meals, including whole grains and fresh veg/fruits. (This helped a lot at first, but I was still having some acid reflux, even with the medicine). At that time, I was scheduled for a blood antibody test for H. Pylori and the stool test, as well. The blood test came out as a strong positive (my result was 2.2, whereas 1.1 was the mimimum threshold for a positive, showing possibilities of an ongoing infection). However, the stool test came out negative, which I realized after was probably due to my having taken Nexium, the PPI, during that time. Based on the blood test and the symptoms while on Nexium, my doctor diagnosed me as having H. Pylori and prescribed the same Nexium 40 mg once daily, along with claritthromycin 500mg (2x 14 days) and metronizadol 500mg (2x 14 days) (one was substituted for penicillin, as I am allergic). I have not yet taken the antibiotics, as I am concerned whether or not I need to redo the stool test, as it was probably affected by the PPI, as blood tests do not show an actual infection but only the antibodies.
Last edited by sunshine37 on Mon Jun 15, 2015 6:56 am, edited 1 time in total.

Helico_expert
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Re: Blood Test Positive and Stool Test Negative -redo?

Post by Helico_expert »

very true and very logic thinking. Blood test only tells you your history of infection. You could be exposed to H. pylori a long time ago but for whatever reason, you no H. pylori in your stomach. According to the guideline, you should only take antibiotic when proven of infection. If you can, try replace Nexium with other weaker H2 blocker and repeat either stool or breath test. please check the following guide for choice of H2 blocker.

http://www.helico.com/PYtest_guide_2013.pdf

So, do you need a treatment with GERD symptoms, positive blood test, but a negative stool test on PPI?

It's really up to you if you want to go through with the treatment. If it is not H. pylori, the antibiotics may kill off whatever unknown bacteria that's causing you trouble.

sunshine37
Posts: 35
Joined: Sun Jun 07, 2015 7:34 am
Location: United States

Re: Blood Test Positive and Stool Test Negative -redo?

Post by sunshine37 »

Thank you for confirming that I need to retake the stool test. My doctor finally agreed to that, so I am going off the Nexium for 7 days. Is that sufficient for preparation for the stool test? I have seen 14 days listed from sources here in the USA as the time to be off the PPIs, but I am not sure which number of days is correct. Please verify. :) I may take the weaker H2 blocker, such as Zantac, during the week before the stool test retake. Thank you for the list. Even though it is for the breath test, I hope the numbers and medicinal information applies to the stool test, as well.

Also, I take ginger, fennel and anise most days for upset stomach and want to make sure that these will not affect the test. I am also taking probiotic kefir every day.

After the stool test, I am planning to take the anitibiotic treatement anyway, just to be on the safe side. I feel that I may be getting an ulcer, possibly due to the H Pylori, even though I have not been diagnosed as having one. I am having a lot of pain in my upper stomach, while the heartburn and acid has been less (probably as I was taking the Nexium).

Also, I have seen that the combination (conventional) treatment that I will be taking is 90 % effective in Australia, but have read from the American College of Gastroenterology website, I believe, that this same treatment is decreasing to be only 70-85% effective here in the USA. I may have contracted the H Pylori while in Australia, so maybe I have a different strain that in the USA and my chances may be better with the treatment. Is that possible?

Also, I read a paper on the National Institutes of Health website http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925854/ that there are many things that help with preventing H Pylori enzyme and also inhibiting its adhesion to the mucosa and etc., and I am planning to take some of those at the same time as the antibiotic, as it was advised that it may help the effectiveness of the antibiotic when they work in tandem, as these alternative therapies help, but do not eradicate the H Pylori, while the antibiotics sometimes also do not eradicate it fully. The alternate therpaies that seem to help, generally, are: Reservatrol, Green Tea, Licorice Root, Manuka honey and (Hexane from from Golden Crest Honey, which is comparable to Amoxillan-I don't think I am taking this one), Propolis, Protiobitcs (Bifidobacterium, Lactobacillus Acidophilus, Lactobacillus Casei, Bacillus Subtilis, Weisella Confusa), pea protein (bioactive peptides), Polysaccharides (Fucoidan, Spirulina, Chlorella, Black Currant, Green Tea, Panax Ginseng). Also, 1,4 N Acetylglucosamine (inhibits the enzyme-was able to find this ingredient in a good probiotic from Integrative Therapies). Also, noted that H Pylori needs iron... so, trying to avoid excesses of that.

Do you also agree with my idea to take these along with the antibiotics? I think it might be a good idea...

I have a few days until I can retake the stool test, so have time to gather these things, as well. :)

Helico_expert
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Re: Blood Test Positive and Stool Test Negative -redo?

Post by Helico_expert »

Hi sunshine,

the idea of stopping PPI and antibiotics before breath or stool testing is to allow the bacteria to grow up in mass. If the bacterial load is too low, it's more likely that you'll get a false negative result. So the longer you wait the better.

in regards to the alternative therapy, nothing works better than antibiotics in removing H. pylori completely. However, alternative therapy is known to ease the side effects. there is no solid evidence of which is better. So you can try any of those listed alternative supplement to help with the side effects.

in terms of penicillin allergies, i assume your doctor prescribed you Metronidazole and Clarithromycin? you can discuss with your doctor about adding pepto bismol. H. pylori can never become resistant to pepto bismol. you can always use it in combination with other antibiotics.

sunshine37
Posts: 35
Joined: Sun Jun 07, 2015 7:34 am
Location: United States

Re: Blood Test Positive and Stool Test Negative -redo?

Post by sunshine37 »

thank you, Helico_expert...i appreciate your help. :)
I will speak with my doctor about adding the pepto bismol to the mix.

Yes, I think I will take the alternative therapies, along with the antibiotics, as well, to help with the side effects. :) Also, will stop taking the kefir, as that may help the bacteria to build up faster, as well. However, I am not sure about waiting more than 7 days without the nexium to retake the stool test, but I will try.

Yes, the doctor did prescribe me those medicines you listed. She advised me to take the antibiotics for at least 7 days out of the 14, depending on how I feel (there was another medicine that i had been taking that conflicts with the Clarithromycin, so I had to stop taking that one), but I think it is better to take them the entire 14 days.

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

Re: Blood Test Positive and Stool Test Negative -redo?

Post by Helico_expert »

studies showed no difference between 10 and 14 days. probably no difference between 7 and 10 too. But, the idea is, the longer you take the antibiotics, the better chance you eradicate H. pylori. In the same time, you are increasing risk of experiencing more severe side effects.

sunshine37
Posts: 35
Joined: Sun Jun 07, 2015 7:34 am
Location: United States

Re: Blood Test Positive and Stool Test Negative -redo?

Post by sunshine37 »

thank you very much for responding. i will try to go the complete two weeks.... hopefully, the alternative therapies will help to curb the side effects.
Last edited by sunshine37 on Thu Jun 18, 2015 8:02 am, edited 2 times in total.

sunshine37
Posts: 35
Joined: Sun Jun 07, 2015 7:34 am
Location: United States

Re: Blood Test Positive and Stool Test Negative -redo?

Post by sunshine37 »

Helico_expert wrote:Hi sunshine,

the idea of stopping PPI and antibiotics before breath or stool testing is to allow the bacteria to grow up in mass. If the bacterial load is too low, it's more likely that you'll get a false negative result. So the longer you wait the better.

in regards to the alternative therapy, nothing works better than antibiotics in removing H. pylori completely. However, alternative therapy is known to ease the side effects. there is no solid evidence of which is better. So you can try any of those listed alternative supplement to help with the side effects.

in terms of penicillin allergies, i assume your doctor prescribed you Metronidazole and Clarithromycin? you can discuss with your doctor about adding pepto bismol. H. pylori can never become resistant to pepto bismol. you can always use it in combination with other antibiotics.
Regarding the pepto bismol, I read that one side effect is constipation. Would this work against the other antibiotics at all in removing the bacteria from the body? (I heard from a nurse that diarrhea is the way that the bacteria leaves the body).

Also, I read on the treatment regimen for traditional bisumth-based therapy that the bismuth is "De-Nol [Colloidal bismuth subcitrate ]* 120mg qid outside U.S.)" ... Does qid mean 4 times per day? Also, is this version of bismol comparable to pepto bismol? (I also see that pepto bismol made soluble by combining with common foods can help with antibiotic-induced clostridium difficule, see: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538885/ ..maybe good as a preventative of that, as well).

I am taking one more week off the Nexium before retaking the stool antigen test, for a total of 14 days, which should help to get a valid test result. Thank you. :)

addseo2015
Posts: 2
Joined: Fri May 22, 2015 12:53 pm

Re: Blood Test Positive and Stool Test Negative -redo?

Post by addseo2015 »

Glad to see great responds.
It's so useful information.
Thanks for posting.

Helico_expert
Site Admin
Posts: 4489
Joined: Wed Mar 02, 2011 7:20 am

Re: Blood Test Positive and Stool Test Negative -redo?

Post by Helico_expert »

bismuth comes with many form. Denol or pepto bismol are fine to use against H. pylori. It is true that it may prevent C. difficiles. However, the main side effect of bismuth is actually very dark stool. Some doctors may think you have internal bleeding because of the dark stool color. But it's no big deal. We strongly agree to use bismuth against H. pylori because H. pylori can never acquire resistance to it.

qid = 4 times a day

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