Helicobacter Forums

The symptoms are usually caused by the damage of the stomach.
When you are infected with H. pylori, it attracts the immune cells to come in to fight off the bacteria.
But H. pylori is very smart in hiding away from the immune cells.
So the immune cells gradually become too stressed and agitated, they decided to destroy everything to get rid of H. pylori.
This leads to massive inflammation and some inflammation can lead to more acid secretion and even stomach cell death
when the stomach cells are damaged, especially the splinter that prevent the acid reflux is damaged or weakened, patients can experience acid reflux.

the ammonia that H. pylori produce is just enough to protect itself from the acid. not enough to neutralise the whole stomach.

we have seen people going through many treatments. If you do it systematically, under the guidance of good gastroenterologist, you can get rid of the H. pylori.

Hi HelicoExpert

As mentioned earlier previously I had two 7 days triple therapy treatment for h pylori in 2020 and 2021. Subsequently symptoms improve significantly and i was off PPI for a long time. During this period i had done 3 Stool and one breath test and all were negative

However symptoms return in Aug 22 and endoscopy in September 22 showed h pylori gastritis and histology showed "occasional " h pylori organism on the biopsy sample

Subsequently i finished the 2 weeks antibiotics + ppi course (Amoxcilline 1g + Levofloxacin 250mg and Dexilant 30mg all twice a day) on 23 October. However I have been on dexilant 30mg twice a day 7 October.

I take first Dexilant at 8:30am before breakfast and second around 7pm before dinner

I was considering stepping down to one a day. Whilst symptoms have slightly improved I find that acidity symptoms comes back in the evening (pain or tightness or slight burn in the epigastric). Usually around 6pm. This is inspite of taking Dexilant in the evening. Usually having dinner provide some relief.

How long to you think I should keep taking dexilant twice a day and how many months usually it takes for h pylori chronic gastritis to heal? Assuming all of the bacteria has been killed.

Why do my symptoms keep fluctuating - some days I feel fine but on other it looks like I am back to square one.

hmmm... the symptoms are depending on the damage accumulated.
some damage can be permanent.
However, most of our patients reflect that through time, the frequency of "episodes" of the gastric problem gradually go away and they return to normal.

I am still very confused that

(A) how could I have 3 Stool Test and one breath test (all with no ppi in at least 14 days before the test) come back negative but histology saw occasional helicobacter organism and mild chronic gastritis associated with helicobacter

(B) how can the serology test also be negative taken on 17 September 22 if I had h pylori infection in jan 2021. I thought antibodies stay in the blood for years

(C) how can serology test taken on 17 September 22 be negative but biopsy taken on 29 September show occasional helicobacter organism

Either the reliability of Stool, breath and blood test is really questionable and accuracy probably depends on bacteria load or

Pathologist has mistaken some other bacteria for helicobacter. This seems unlikely because (a) you would expect them to be professional in their field, (b) bacteria was seen over the chronic gastritis and (c) I am suffering from gastritis symptoms

Have you come across any case such as mine ?

(A) how could I have 3 Stool Test and one breath test (all with no ppi in at least 14 days before the test) come back negative but histology saw occasional helicobacter organism and mild chronic gastritis associated with helicobacter

This can happen when your stomach acid is naturally low (or when taking PPI). When there is no acid, H. pylori turn off the urease gene and breath test can give false negative. Also, when the stomach acid is low, other bacteria can start growing and when H. pylori is under competition, the number can reduced and lead to false negative stool test.

(B) how can the serology test also be negative taken on 17 September 22 if I had h pylori infection in jan 2021. I thought antibodies stay in the blood for years

Blood test negative is normally very accurate. Normally people can carry the antibody for months or years after H. pylori eradication. So having a negative blood test would mean you have been free of H. pylori for months.
Nevertheless, the antibody load can sometimes deplete very quickly depending on individual's immune system. If you look at the Covid stories. There have been report saying that some people antibody depleted quicker than general public and need a booster vaccination within 3 months.

(C) how can serology test taken on 17 September 22 be negative but biopsy taken on 29 September show occasional helicobacter organism

It is puzzling to have contradicting results. It is true that professional judgement is more accurate than other lab tests. Nevertheless, if your stomach is no longer acidic, eg. atrophy, then other bacteria can present in the stomach and may be mistaken by H. pylori. Nevertheless, a professional pathologist should be able to pick that up. To double confirm, normally the pathologist would do a specific immuno stain to highlight the H. pylori. Not all bacteria that looks like H. pylori should be classified as H. pylori.

The thing is I was off PPI for at least 14 days before all of my Stool and breath tests so low acidity shouldn't be an issue.

Also the serology was done on 17 Sep and biopsy sample taken on 29 September so how can in less than 2 weeks from negative blood test to positive histology for helicobacter?

I am wondering as most people post eradication treatment still have symptoms but are Negative via Stool or breath tests may be their symptoms are from residual h pylori left which slowly multiples. Most people will not do an endoscopy post treatment to find out if it has cleared 100%

yea.. since you have multiple negative results from UBT, stool and serology, it is likely that your pathologist made a mistake. no test is 100%. to proof that if your pathologist made a mistake, you can ask him to re-examine your biopsy be applying specific HP stain.

These are really helpful advice.
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