Helicobacter Forums

Brownchikano wrote: ↑

Thu Mar 25, 2021 9:17 am

Maybe do another stool/breath test?

you can repeat the stool/breath test a month later to double confirm.

In my case I did tested negative 13 dpm last month. Does it mean that there are 13 hpylori in my system and they can spread again? It may look like a silly question but I just wanted to understand the true sense of being negative.

H. pylori has very strong urease enzyme. So that dpm is reflecting on how much urease activity there is. Since H. pylori has such strong urease acitivity, you'll get a reading of dpm in hundreds or even thousands.

However, the urease activity is relying on acidic condition. If your stomach is not acidic enough, sometimes, you can get very low reading like 30-50.

so make sure you are not taking any PPI during the test.

Lastly, H. pylori is not the only organism that has urease enzyme. Ecoli has it too. That's why E coli causes UTI. But the urease activity from other bacteria is very weak compare to H. pylori. So your low reading is probably due to these other background bacteria.

So in conclusion, you can use this dpm reading to tell you how accurate is your test. the lower the dpm, the more likely that it is true negative.

if the cut off is 50 and you got 13, I think that's pretty low and you are likely to be free of H. pylori.
if the cut off is 15 and you got 13, then I think you probably need a repeat a month later.

Thanks for insights. Very helpful

Hi Helico_Expert,

How likely is it to get re-infected given I was tested negative last year with UBT (13 DPM) in March and in September via Endoscopy? I was doing quite well for the last 5 months or so, however, developed symptoms since last week with bloating, continuous burning pain and a bit of reflux. I don't remember taking any spicy or oily food, however, had been under work-related stress for quite a few weeks. Do you think I should go and get tested or try out PPI for some time? Can stress be a trigger for my symptoms? Below were the Endoscopy findings for your review:

1. Mucosa Type : Body and transitional

Inflammation : There is a very mild patchy chronic inflammatory cell infiltrate within the lamina propria.
Helicobacter : Nil
Metaplasia : Nil
Ulceration : Nil
Atrophy : Nil
Other : Some PPI effect-type changes are noted.
Maignancy : No malignancy or dysplasia seen.

2. Sections show duodenal mucosa with very focal surface gastric metaplasia and very mild active inflammation in the lamina propria, consistent with mild peptic duodenitis. The villous architecture appears preserved elsewhere, and there is no increase in intraepithelial lymphocytes. Parasites or granulomas are not seen. There is no evidence of dysplasia or malignancy.

3. Sections show colonic mucosa with no significant morphological abnormalities. The subepithelial collagen plate appears within normal limits and there is no increase in intraepithelial lymphocytes. Significant inflammation or features of chronicity are not seen. Microorganisms or granulomas are not identified. There is no evidence of dysplasia or malignancy.

Appreciate your insights.

Many thanks

If everyone under the same roof have good dental hygiene, especially brushing teeth in the morning, then the risk of you catching H. pylori again is very low.

It is common to have relapse of symptoms after H. pylori eradication, especially you mentioned metaplasia in your histology report. But we are hoping the frequency of such "episode" will get less and less and eventually gone.

Anyway, you can get a breath test check up first before taking the PPI treatment.

Many thanks for your response and feedback.

My UBT came back negative with 27 DPM. The doctor advised to take Nexium 20 mg once daily in the morning and try implementing a fodmap diet. I have started Nexium a few days ago however there is a very slight improvement in the symptoms. Do you suggest taking Nexium on an empty stomach or after a meal for better results?

Thanks

It doesnt matter when you take the Nexium tablet. Best is take it on the same time everyday. That will maintain the constant drug concentration in your blood.

Thanks for your insights

Hi Helico_Expert,

For past few weeks I have been pretty unwell with similar symptoms to H Pylori I had back in 2020. Even though my Endoscopy and UBT tests came back negative in March last year, it's making me think that I may have got H Pylori again. It could just be my food that is giving me severe burning pain and burning sensation from the upper to the lower stomach. I do feel a lot of gas at times in my stomach with burning pain and feels inflammation in my stomach.

I have gone back to a very bland diet with boiled vegetables and gluten-free bread, cut on carbs and increased the intake of fruits and yoghurt in the hope to reverse my symptoms.

From my histology report in March 2022, it was noted that sections show duodenal mucosa with very focal surface gastric metaplasia and very mild active inflammation in the lamina propria, consistent with mild peptic duodenitis. Do you think this could be the culprit? Do you think focal gastric metaplasia would increase with time even in the absence of H Pylori, unless otherwise?

Appreciate your insights and advice.

Many thanks,
Imran

I have answered somewhere else

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