RUT: positive or negative?

[Sajal]

Got that. Thankyou for that.
Can I mail you on your email id?

[Helico_expert]

I have already sent you email through your registered email.

[Sajal]

Actually I wanted to tell you that I have been to your stated place last year. They carried endoscopy but culture was negative. They did find chronic gastritis but gastroenterologist there informed me that they cannot do anything for me as my symptoms are due to functional dyspepsia. I returned hopeless and went for another endoscopy in my city and guess what? I was RUT positive. Since then I am all on my own.
I just cannot understand how can they termed it functional dyspepsia since I have had chronic inflammation in my antrum and duodenal area. As far as I know, the diagnosis of functional dyspepsia is given only when no abnormalities in the stomach and duodenum is found.
What do you suggest should I do now?

[Helico_expert]

chronic inflammation may or may not be because of H. pylori.
When the bacteria load is low, it can give false negative.

anyway, since you have a positive RUT, did your doctor prescribe you any antibiotic treatment?
do you have any other test that can double confirm your HP status?

[Sajal]

Tests are so confusing. I tested positive by RUT and negative by histology at the same time. My symptoms are still there. My City doctors as well as the doctors from your stated place have no answers to my agony. I am on my own I guess. Since I have done 5 rounds of antibiotics which includes all the antibiotics available in my country, I am clueless as to what should I try this time. My previous treatments are as follows:
1) Amoxicillin, Clarithromycin, Ppi
2) Metronidazole, Tetracycline, Amoxicillin, Bismuth subcitrate, Ppi
3) Amoxicillin, Rifabutin, Bismuth, Ppi
4) High dose dual therapy, plus bismuth (HDDT)
5) Amoxicillin, Levofloxacin, Bismuth, Ppi

You see, Furazolidone is not available in my country. I am thinking to go for another classic bismuth based quadruple therapy, i.e., Metronidazole, Tetracycline, Bismuth, Ppis. I have read several researches that have shown that classic bismuth based quadruple therapy works great even if you have tried it earlier. What do you think should I do?

[Helico_expert]

it's possible that the RUT is false positive.
how positive is the RUT? turn red within 5 or 10 min? or after 30 min?
within 10 min is most probably true positive.
after 30 min is probably false positive.

histology is normally the gold standard for invasive diagnosis. did the pathologist do a immuno stain? what other condition is stated in the pathology report?

You have tried many strong antibiotics. it's probably not a good idea to continue trying antibiotics without a proper diagnosis.

what about blood test? if you can get someone to measure your anti-HP antibodies every 3 months, and if the trend is going downwards, even if they are all positive, it's a sign of HP negative.

[Sajal]

RUT turned positive in less than 5 minutes of testing. Histology report did not show anything other than chronic mild gastritis.
Even if I assume that RUT was false positive, what could be the other possible cause for symptoms like acidity, constant burping and bloating?

[Helico_expert]

In Australia, when we look through the breath test data from people that present gastric symptoms, only 20% of them has H. pylori. So there are non-H. pylori related gastric problems. Unfortunately we do not know what causes the problem. For patients without H. pylori, they can be given medications to treat the symptoms.

[Abubakar]

dear sajal,
May I know your current status? How you are dealing with your H Pylori issue?

[kosa]

Hi Sajal,

I am going through the same issues. I am from Bengaluru, India.
My helic ammonia breath test has come positive but rut and biopsy are negative. I have very severe symptoms.
What is your current status. Please share an update.