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C14 UBT and opinions needed

Breath tests are the most accurate way of detecting H.pylori without actually having an endoscopy (stomach examination). Breath tests are especially useful after treatment to make sure H.pylori is cured. Urea breath tests are known to be completely harmless. Either C14-urea or C13-urea tests are used. Read about them at the diagnosis section at http://www.helico.com/diag_breath.html where a diagram can be found. C14-urea breath tests use a radioactive tracer but such a tiny amount that it can be used safely at any age. It is a 15 minute test, convenient and inexpensive. The C13-urea test uses a stable isotope of carbon which is also harmless but requires two breath samples and takes about 30 minutes. Both tests have accuracy greater than 90%.

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Ice006
Posts: 11
Joined: Sun Mar 27, 2022 4:20 pm

C14 UBT and opinions needed

Post by Ice006 »

Hi guys, found this site through an online search and it looks like an amazing resource/place for all things related to H. Pylori.

I just wanted to ask some questions before going ahead with treatment I was prescribed a few months ago and haven't started doing yet. I was looking to find the answer to one specific question, but didn't realize there was a website like this, so since I have a bunch of other questions, I thought I may as well ask since you guys seem very knowledgeable about this.

I'll start by saying, I've been having gut issues for years now and have slowly/gradually changed my diet over the past 4-5 years (starting out by cutting out sugar, grains and just eating whole foods, but also still eating pretty high carb, and then eventually the past 3 years doing a ketogenic diet). On all the diets I had similar symptoms (bloating, gas, belching, mild burning sensation in my stomach when I haven't eaten for a while, heavy feeling in stomach/gut even after eating a small amount of food, average/mediocre energy most of the time no matter what I ate, not feeling satisfied/satiated after a meal, stools that are semi-formed/sticky/loose and diarrhea for stretches of time etc.). I thought a dietary issue was the cause and I could fix it that way, but none of that has really worked the way I wanted it to (Great energy, better mental clarity, better bowel movements are the main things I wanted to improve), so after a lot of reading 4-5 months ago I ended up doing a consultation with an online doctor and asked for tests such as H. Pylori and any other tests they deemed relevant for gut issues.

I didn't see a regular GP, though, as I went with a low carb high fat doctor because the last time I went to a regular GP, the doctor I saw said a high fat diet is bad and I had to stop doing it. I never went back as I tried to tell them I was already having issues before going LCHF, and overall, I feel better on LCHF. I was a bit upset being told to stop my diet when they weren't listening to why I was there. Anyway, the LCHF doctor was much better, and he was the one that ordered a more comprehensive set of tests. When he looked at my previous test results from a couple of years ago, and compared to the current ones I had now that were more comprehensive, he said it looked like I had a malabsorption issue as I'm not getting the nutrients from the food I eat. Same thing I tried to tell the GP I saw a couple of years ago, but for whatever reason, they wouldn't listen :(.

Anyway, I had both a stool and breath test (C14 here in Australia), and the stool test came back negative for most things (H.Pylori, parasites, and whatever else they tested for expect for Faecal Calprotectin which had a score of 186 I think it was, which apparently indicates inflammation). As for the H. Pylori breath test, that came back with a positive score of 66 (not sure if the same measurements are used in all countries, but here in AU, apparently it's on the lower end of the scale). I also fasted without water a lot longer than I was told to, probably for about 12-14 hours or so. Not sure if this is too long as I was told to fast for 4-6 hours without water and food.

Basically, I wanted to ask, looking at my symptoms, and the negative stool test and positive/not so high breath test, would you guys say I do have H. Pylori? I've held off getting the H. Pylori eradication medication as I don't usually like taking anything pharmaceutical, but from what I've read, going the natural route might not do much, and this is one instance where antibiotics would be better. I've also read the opposite where people have had to take numerous rounds of antibiotics as the treatments didn't work, so I am a bit worried about that. I am willing to take it, though, as I've had enough of not feeling optimal even though I've had a very clean diet for the most part, and it can get very depressing at times when you are trying that hard and not seeing results.

Here is some questions I have :

1. I haven't had antibiotics since I was younger (probably 15 or so years ago is the last time, but I don't think I finished the whole course for whatever reason. I didn't know back then that you should finish the course if given one. Would that be an issue if it was that long ago?), anyway, would not having it for that long of a time be better or worse? Would I have a better chance of getting rid of the Helicobacter Pylori since I haven't had any antibiotics in a long time?

2. I read something about having H. Pylori in your mouth. I have quite a bit of dental plaque behind my front teeth that seems to form pretty quickly even after getting a teeth clean no matter if I bush everyday (I usually always have a dry mouth when I wake up despite drinking water before going to bed, but not sure what is causing the rapid build up). Do I need to get the tartar/calculus or whatever it's called removed before taking the H. Pylori eradication treatment? I can't really afford to go to a dentist right now, but will make an effort to do so if you guys think that should be done first?

3. How long after the antibiotics should I take the next breath test? Also, is it safe to keep taking the C14 breath tests as I was told the tablet they have you take contains radiation?

4. I'm not sure about what to eat while taking the antibiotics as I'd rather stay on my high fat keto diet, and I only ask because I've read eating fatty meat isn't good for H.Pylori (if true, why is this?). I haven't had a cold of flu for the 3+ years I've been doing this way of eating, either (I used to get 4-5 bad colds/flus a year when on a carb based diet), so I'd rather continue on with it while taking the H.P eradication treatment if it's not detrimental to having it work. I will also add that sometimes I have cheated for 1-2 months at a time (sugar and some carbs) as I've felt depressed due to my main symptoms not resolving, but I do mostly go 9, 10 month stretches where I am strictly keto.

5. I was also told to take a bunch of supplements (vitamin c, d, creatine, glycine, magnesium etc.), should I take them after the H. Pylori eradication treatment? Would taking supplements during lower it's efficacy?

Thanks for any help or advice you guys can give me.

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

Re: C14 UBT and opinions needed

Post by Helico_expert »

Thanks for sharing your story.

UBT of 66 dpm is not high. In Australia, value below 50 is negative; value above 200 is positive. You are in the grey area where the result is indeterminant. The stool test is helpful. with the combine result, I think you are more towards negative end. The low positive values indicate that maybe you have some other bacteria in your stomach reacting with the breath test pill. Perhaps your stomach is not acidic enough?

Nevertheless, you can also think of having an endoscopy to see if you had any abnormality. If you are below 50 years old, it's a good baseline for future reference.

in regards to H. pylori in the gum. That theory is unproven. H. pylori only colonise in the stomach. My theory is that if H. pylori lives in the dental gum, then you would have best teeth because H. pylori has the ability to neutralise acid from corroding your teeth. Anyway, none of these are proven. Also, when you take antibiotics, it will be absorbed into your blood stream and travel all around your body, including your gum.

Usually after antibiotics treatment, you'll need at least 2 to 3 weeks without any medication to repeat your breath test.

Ice006
Posts: 11
Joined: Sun Mar 27, 2022 4:20 pm

Re: C14 UBT and opinions needed

Post by Ice006 »

Hi Helico_expert,

Thanks for the reply. Sorry for the long initial post. I thought providing more information would help.

Darn, so I am now not sure what to do. I was actually learning towards starting the antibiotics treatment just to see if it would make a difference. I was actually going to go and get the prescription filled today. Could it hurt to take it if I don't have H. Pylori?

The Doctor said a similar thing to what you did, that the results were indeterminate/equivocal , but he also did say the breath test was the more accurate of the two and it was worth treating empirically (do you agree with this?).

What does an Endoscopy involve? I did a quick google search and found there is different types, what type would I require in your opinion? Not sure I really want one, but if it's necessary, I guess I will have to look into it. Will this give a more accurate result? And yes, I am under 50.

When you say no medication 2 to 3 weeks after the antibiotics treatment, do you mean supplements such as the ones I mentioned as well? He also didn't mention that I should have a follow up breath test. It's just something I figured that I need to do. I assume I'd have to ask a doctor to order one?

How would I check to see if my stomach is acidic enough? This is actually something I thought about before, I even bought some Betaine HCL supplements a few months ago, but only used them for a couple of weeks as the doctor I had a consult with didn't think that was the issue. I never tried a high dosage, though, as I didn't want to cause any damage. Do you think I should try them again at a higher dose?

Edit : I also wanted to ask about Iron. Is that a food source for H. Pylori? If not, what are it's main food sources? It's just one of the deficiencies that is strange to me as my zinc and copper levels are good, but Iron is very low (10 umol/L) despite eating meat everyday as a main part of a ketogenic diet for the past 3 years. I'm wondering if that could be an indicator.

Ice006
Posts: 11
Joined: Sun Mar 27, 2022 4:20 pm

Re: C14 UBT and opinions needed

Post by Ice006 »

Would it hurt any to just try the antibiotics, or should I not take it unless my results are more certain? I guess I could book in with another regular GP (the online consultations I had are more expensive as the Doc is on the other side of AU) in my town and ask for a second opinion, but I doubt they'd know much about H. Pylori.

Edit : Should I also ask for another breath test? It's been 4 months since I had that previous one done?

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

Re: C14 UBT and opinions needed

Post by Helico_expert »

I wouldnt recommend antibiotics without proper diagnostic. mis use of antibiotics will only lead to more antibiotic resistance.

Breath test is most accurate when the stomach is acidic. The H. pylori treatment always come with PPI and antibiotics. The PPI will stop the acid secretion and help the antibiotics work better. sometimes, the patient will be asked to continue PPI until the symptoms are relieved.

Therefore, you'll need to stop PPI and antibiotics for at least 2 weeks before the breath test.

The upper gastro endoscopy will send a tube down your throat to have a look around for abnormalities. The gastroenterologist will take a few biopsies for histology examination. Some gastric juice can be extracted to check for acid pH. However, this is not a common procedure and can be done upon request.

supplements are fine to take. They will not interfere with breath test.

Interestingly, iron deficiency is associated with H. pylori infection. There are reports of iron level back to normal after H. pylori eradication.

Ice006
Posts: 11
Joined: Sun Mar 27, 2022 4:20 pm

Re: C14 UBT and opinions needed

Post by Ice006 »

Hi, thanks again.

I won't take any antibiotics just yet then. I've booked in to a regular GP for next week. Not sure what to say to them. I guess I'll tell them I am there for a second opinion. I'll say another Doctor recommended I take antibiotics, but my results were indeterminate in the breath test and negative in the stool test and see what they say.

Do you think I should take another breath test (I kind of want to take another one since the previous one was in Nov. last year) and/or ask to see a gastroenterologist?

If I were to get an endoscopy, I'd have to ask for the gastric juice to be extracted if I want to see/check acidic levels?

I also can't remember when I was taking the Betaine HCL supplement last year. I think I stopped taking it a week or two before the previous breath test. Not sure if that can skew UBT test results?

Thanks for the help so far.

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

Re: C14 UBT and opinions needed

Post by Helico_expert »

you can always repeat the breath test in a month time after stopping PPI and antibiotics.

you can also check the possibility of having an endoscopy to find out the reason of your symptoms if not because of H. pylori.

Ice006
Posts: 11
Joined: Sun Mar 27, 2022 4:20 pm

Re: C14 UBT and opinions needed

Post by Ice006 »

I haven't started taking any antibiotics yet. I was just sort of saying, should I take the breath test again before deciding on whether or not to start the treatment pack? I was already questioning the taking the antibiotics because of the indeterminate UBT result, but was willing to take them and try it out, but you've sort of given me second thoughts on it now that maybe I shouldn't unless I get a more definite result.

Having said that, if I have low stomach acid, which I very well might, not sure if that also skews the UBT result to make the result seem negative when it's not? Not sure if I am understanding correctly about low stomach acid in regard to the UBT.

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

Re: C14 UBT and opinions needed

Post by Helico_expert »

Good question! if you do have low acid to start with, that would give a false negative UBT. But this is not common if you are young. Endoscopy will resolve this problem.

If you want to do another breath test, do it at least one or two months after the previous one. This will give a chance for the stomach or the bacteria to readjust the condition.

Ice006
Posts: 11
Joined: Sun Mar 27, 2022 4:20 pm

Re: C14 UBT and opinions needed

Post by Ice006 »

Helico_expert wrote:
Wed Mar 30, 2022 12:36 pm
Good question! if you do have low acid to start with, that would give a false negative UBT. But this is not common if you are young. Endoscopy will resolve this problem.

If you want to do another breath test, do it at least one or two months after the previous one. This will give a chance for the stomach or the bacteria to readjust the condition.
I'm heading to the doctor tomorrow. I will ask for a referral to a Gastroenterologist. As for my age, I am very early 40s, so not sure if you'd consider that young (I do ;)).

If/when I do see a Gastroenterologist, what should I ask them to do/test for?

I will also ask for another breath test as it's been 4-5 months since I had the previous one done. I just don't know about the results, though, as I am not sure if I have low stomach acid or not.

Also, in regard to the H.Pylori eradication treatment, I was mainly focused on the antibiotics, but what about the PPI inhibitors? Can they cause any long term issues if you've never taken them before and only take them during the length of the treatment (a week or two)?

You probably can't give me an answer to this last question, but If taking a supplement such as HCL & Pepsin (which I did 6 or 7 months ago), and there was no improvement in digestion (I only took it for a 2 or 3 weeks and stopped as I saw no improvement), any idea if that would mean my stomach acid isn't low? No problem if you can't answer that question, just thought I'd ask anyway.

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