Helicobacter Forums

Histology is the gold standard. Then again, it is not always 100%. Perhaps you want to try blood test or breath test again ?

Nevertheless, how do you feel now? Has your symptoms improved?

No, symptoms have not improved.
I have read that blood test would reveal positive for months even after eradication.
My B12 levels are also severely deficient

You are right. Blood result may remain positive for months or even years. But blood test is relatively cheaper and a negative result will give some comfort.

I went for endoscopy again after getting negative histopathology report and culture. This time RUT is positive but histopathology shows no sign of h pylori.

So, now I have two histopathology reports showing negative and one RUT that turned positive. Also, the symptoms ( burping and acidity) are still there.

I am confused what do I believe. I have heard RUT is very accurate and that's why I cannot ignore it despite getting two negative histopathology reports.

it is indeed very confusing. Histology is meant to be the gold standard in an invasive test. Because even without H. pylori, there is usually sign of inflammation to hint for the presence of a pathogen. Of course, if you are immuno compromised, then there wont be any inflammation, and pathologist may make a mistake.

nevertheless, I would trust two histology report over 1 RUT. Sometimes, when the stomach is not acidic enough, some other organism can start growing. These contaminants can give false positive RUT. But the color change will be a lot weaker than H. pylori. So I wonder how positive is your RUT.

meanwhile, if you are not taking any PPI or antibiotics, can you do a breath test to triple confirm?

As far as I can remember, the change in colour took place within 10 minutes. Also, the change of colour was same as I had seen in previous test. It did not feel like only a slight change.
I was suspicious of the previous histology that was done along with culture because I remember I had gone for follow up test after completing quad therapy 2 months before. It was positive by RUT as well as in histology. In the meantime I dis not do any other abx treatment, but when I went for culture, it came out negative along with histology. How can the bacteria be eradicated without doing any abx?
That's why to reconfirm the negative results, I went for endoscopy again, but it only added to my existing dilemma by giving positive RUT and negative histology.

Unfortunately, there is no breath test available here in India and stool test are not considered reliable by Gls as it is done by local pathologist.

Also, I am B12 deficient. Can that affect my results of RUT or histology?

B12 deficient will not affect RUT or histology.

another explanation for the false negative histology is because the gastroenterologist did not take the biopsy from a healthy tissue.
H. pylori can only colonise on healthy tissue. Gastroenterologist normally only grab a tissue from abnormal tissue for histology. As a result, they can sometimes miss H. pylori.

Can you ask your gastroenterologist to order a specific immuno stain on the histology? it's a special stain to highlight H. pylori.

Unfortunately, they do not do staining here in India.
Also, The two times I have been diagnosed negative for h pylori was from two different GIs.

I only have mild gastritis and erosions in duodenum. All the doctors here believes that my problem is not h pylori related. They say that there is no need to eradicate h pylori unless one does not have ulcers.

What can I do now? Symptoms are still there.

It's very difficult to make accurate judgement when there is incomplete diagnosis.

Your GI doctors should be experienced enough to give good judgement.

If you are indeed free of H. pylori, do you feel better when taking PPI? perhaps you can try different types of PPI to see which one of them help you better.

My GI thinks I still have infection, but I have already exhausted all the antibiotics. Therefore, he advised me to stay on ppis forever.

I have tried two rounds of abx therapy: amox,clarithro, and ppis ; amox, metro, tetra, bismuth, and ppis.

Ribafutin is not available here in India. What options do I have now?