Helicobacter Forums

All the best, keep us posted with your result.

Update: I did 7 days of 2x 1g Amoxicillin, 2x 500mg Claritrhomycin, 2x 40mg Pantoprazole.

- I started feeling somewhat better after only a few days of the treatment. Then a week after the treatment ended my symptoms got worse. I understand that acid rebound after H. Pylori eradication could be a factor.


- It's been 26 days since the treatment ended and I did another vacA/CagA stool test today. The test line is faint but visible, so I maybe it's time for a quad therapy. I've read that 28 days is the accepted timeframe for H. Pylori retesting so perhaps I should wait another week and test again in case there's residual vacA/CagA from before.


- A week ago my gastroenterologist put me on 40mg of Esomeprazole 3x per day for 10 days just to test if my reflux is an acid problem or not. Despite what he describes as a "total acid blockade" I'm still getting a lot of reflux of some kind and a strong bitter taste. I wonder if the reflux is being caused by what looks like an ongoing it's bile reflux, as per: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1382972/


- The alternative of course is a urea breath test, but as far as I've read I would have to go off PPI's for 2 weeks. Which might be hell on earth considering the acid rebound after such a high PPI dosage.


Note: my partner who's a medical doctor tested negative for vacA/CagA a month ago, so it's somewhat unlikely I was reinfected.

only about 50% of H. pylori is cag +ve. I am not sure how sensitive is the vacA/cagA test. Better double check with breath test.

you may follow this guideline to change your PPI to something weaker and then do your breath tests.
http://www.imvs.sa.gov.au/wps/wcm/conne ... OD=AJPERES

The assay sensitivity of the VacA CagA stool test is 50-70 ng/ml of H. Pylori Protein.

I've had two positive stool tests (last week and now this week). Is that not enough confirmation? I could easily go to a doctor today and get a quadruple therapy (I imagine they'd prescribe bismuth/tetracycline/metronidazole/omeprazole).

I obviously don't want to jump the gun considering how strong tetracycline is.

Nevertheless, I had azithromycin for an ear-infection last summer during my first H. Pylori symptoms, so it wouldn't be surprising if the clarithromycin-based triple therapy didn't work.

you are right. most of the failed cases of triple therapy is because of H. pylori resistance to Clarithromycin. So I would believe it is very easy for H. pylori to become resistant to Clarithromycin, azithromycin and other erythromycin analog.

Anyway, bismuth/tetracycline/metronidazole/omeprazole (or Pylera) sounds like a good combination. Keep us posted with your treatment outcome.

My new gastroenterologist is taking a proper stool test to the lab. It'll be interesting to see how it compares to the home test kit.

I'm still put out that the previous gastroenterologist insisted that being on Omeprazole in the 5 weeks prior to my gastroscopy couldn't affect the H. Pylori biopsy results.

Although PPI have no direct antimicrobial effect at the concentration present in the gastric mucosa (360), they indirectly interfere with H. pylori distribution in the stomach by changing the pH of its bacterial niche, leading to its disappearance in the antrum. The recommendation is not to consume these drugs 2 weeks prior to endoscopy.

consumption of PPI or antibiotics) may also jeopardize the accuracy of histological diagnosis

http://cmr.asm.org/content/20/2/280.full

Do keep us posted with your proper stool test result.

Lab test was negative and another home test today was negative. Time to recover! Still lots of stomach acid and on a heavy dose (60mg) of Esomeprazole.

So to recap, here's the data from my experience


October - gastroscopy biopsy: Negative (however Omeprazole was taken for 5 weeks prior... false negative?)

December - IgG serum: Positive (even though I had never been treated for H. Pylori before)

December - VacA/CagA: Negative

March - VacA/CagA: Strong Positive

March - Treatment: 7 days of 2x 1g Amoxicillin, 2x 500mg Claritrhomycin, 2x 40mg Pantoprazole

April - VacA/CagA: Weak Positive

May - Lab stool test: negative

May - VacA/CagA: negative


Many thanks again for the support here.

Sounds like you are having fun. Hope you recover soon.