Eradication and biopsy results with chronic gastritis

[AlSi79]

I think that the above message is spam again...

Just wanted your second opinion on this: I met a GI-specialist today and this doctor said that the resistance to Clarithromycin would be unlikely even though I needed to stop takin Erythromycin in 2009. He also said that since there was no H.pylori found in histology (biopsies taken from 4 sites, including 4 specimens from corpus and 4 from antrum - my doctor told me that he wanted to take extra samples just to be on the safe side) and because the inflammation was inactive are good signs that the treatment has succeeded even though the endoscopy was done only 3 weeks after I had stopped taking the first treatment. He said that usually the inflammation activity tells if the eradication has succeeded even if no H. pylori is found in histology. What is your experience and view on this approach?

He said that if the follow-up test is positive, the second therapy would be: Lansoprazole 30 mg x 2/day + Amoxicillin 1g x 2/day + levofloxacin 500mg x1/day for 7 days. I read somewhere that 10 days would be better. What do you think?

I stopped the PPI yesterday so two weeks to go for the follow-up test...

Thank you for sharing this info here on this site!

[Helico_expert]

Be strong! I am sure you'll go through this like many other members in this forum.

The description from your histology result sounds promising. Your specialist knows what he is talking about. So, I think your chance of getting a positive breath test will be low.

Nevertheless, if you do get a positive breath test, the treatment you listed is good. it will be better to include bismuth to give it a little more boost. and you are right, 10 days will be better than 7 days.

Stay positive!

[AlSi79]

Thank you for the pep-talk!

Just out of curiosity:

If after 3 weeks of eradication therapy the histology (biopsies taken 3 weeks and one day after taking the last pills) shows no sigs of h.pylori and there is chronic but inactive (activity 0) inflammation in antrum and corpus, what are the chances that it will become active again?

The lab is of high quality and they do the HE-staining and AB-PAS-staining and Giemsa tests.

[Helico_expert]

If there is no H. pylori, the inflammation will gradually go away. Just make sure everyone under the same roof is also clear of H. pylori to avoid reinfection.

[ikajess]

Hi Helico_Expert,

Is reinfection easy after H Pylori was eradicated? I am wondering if it would be necessary for my boyfriend to get tested?

I had the antibiotic treatment in November 2015, had another endoscopy /colonoscopy beginning of March which confirmed H Pylori was eradicated / diagnosis: chronic mild inactive gastritis. / a tiny atrophy in the duodenum and confirmation of lactose intolerance.

I am still left with many symptoms - GERD, dyspepsia, I feel like I cannot digest fats anymore, and still feel extreme discomfort depending on what I eat. My doctors ran a complete blood test and all came back normal, however I feel very very tired, have a warm body, palpitations etc...

I am not either gaining my weight back and looks like all the fats of my body are gone :-/

My questions are:

1. Can the lactose intolerance have caused a little atrophy?
2. Will I recover completely at some point?
3. What can I take to help my stomach healing completely? Eventually to resolve dyspepsia?
4. When doing an endoscopy, does the specialist also check if there may be some disfunction/issue with other organs like the liver, gallbladder or pancreas? I have told my doctor, she said any issues would be observed in blood test results...
5. Why do I still have dizziness and feel exhausted?

A big thank you in advance for your response.

Jessica

[Helico_expert]

it's not easy to get reinfection. however, given enough time and enough exposure (eg. kissing), one will eventually get infected. So, probably you should get your boyfriend a check up too.

I dont think lactose intolerance causes atrophy.

i believe your stomach condition will eventually back to normal. however, the recovery time is different for everybody. it depends on the damage done by HP.

there is no other scientific proven methods to improve your dyspepsia. Perhaps you can try natural therapy, like mint tea, lemon juice, probiotics.

endoscopy only check stomach and duodenal. there is no access to other organs. Your doctor is right. the blood test will be able to tell your organs functionality.

not sure why you still experience dizziness and exhaustion. Try do some exercise and get some good air?

[AlSi79]

Dear experts,

As I still need to do the breath test (UBT) to confirm the eradication, I have a few questions:

1. Is 2 weeks off PPI mediacations enough to give the reliable result and has it been validated in any medical studies?

2. I was suffering from cold last week and needed to take antihistamine (acrivastine that is H1-antagonist) and terbutaline sulfate (class of medications called bronchodilators. It helps to open airways and make breathing easier.) to help me breath normally. Can these have effect on the UBT test result? I got a list from my lab that says something about H2 receptor antagonist but that list is full of stomach medicines - no allergy medicines / antihistamines on that list. So are allergy medicines ok?

On May 4th. it has been 6,5 weeks after eradication therapy and 2 weeks from PPIs (never used any other stomach medicines) so can I take the test then and will it be reliable?

Thank you!

[AlSi79]

I am so scared that my UBT test will be positive... The pain has started again so it´s not a good sign. I also read that the "inactive" gastritis without h.pylori doesn´t mean a thing if the histology is done less than 4 weeks after the eradicatio and mine was done 3weeks + 1 day after finishing the therapy...

Bismunth salt is not used in Finland so the second treatment, is only with levofloxacin 500mg x 1/ day + amoxicillin 1g. x2/day+ PPI x2 for 7 days ...
If the second treatment doesn´t work I need a new endoscopy for sensitivity testing and I am so scared... After that I guess they only try once and then let it be and I can just wait to get the stomach cancer...

[Helico_expert]

worry is the last thing you need. worrying isnt going to help and instead, worry is just going to stress you up and make your situation worse. So, try to think positively.

The fact is that H. pylori doesnt give you cancer straight away. It'll take decades for cancer to develop. If you have no relatives that have gastric cancer, your chance of getting one is close to zero.

although the anti histamine and H2 blocker both works on histamine, but their pathway is different. Nevertheless, i would wait it out for another 2 weeks just to avoid false negative result.

[AlSi79]

Hello experts,

Just to let you and someone reading this post to know that my 13C-UBT game back as negative. So it seems that my triple therapy worked even though I had taken Ermycin which I needed to stop after two days. My treatment was: Amox 1g. x2, Chlaritomycin 500mg. x2 + PPI x2 ("standard triple therapy").

Tests done after eradication:

I had histology done 3 weeks and 1 day after eradication therapy which game back negative.

The 13C-UBT was done 6 weeks + 6 days after eradication therapy and 2 weeks + 1 day (15 days) after last dosage of PPI which I took for 3 days because I needed to take NSAID when I had a flu.

Last question: Would you as an expert trust that I have got rid of this bug after these test results?

Thank you!