Helicobacter Forums

Hi,
I am kind of new to H Pylori and the forum. I tried to find a topic about using PPI after triple therapy but could not find it. Please direct me if we already have a similar one somewhere in the forum.
So I got a positive blood test about 4 weeks ago and my PCP put me on prevpac. On next appointment, he scheduled a stool test 6 weeks later (after finishing prevpac) but he told me to continue with Nexium for 8 weeks.
Since I obsessively researched and read around about H. pylori since the blood test, I remember reading that PPI can cause false negative test. It has been about 2 weeks after prevpac and I still have most of my pre-prevpac symptoms (lump in the throat, sharp-burning pain in noses and nasal congestion, feeling of hot liquid coming up, waking up every 4 hours.)
So, I am curious what are the routine after finishing triple therapy. Do you take PPI for 4 weeks, wait 2 weeks and then retest or do you wait without taking any medication? Also, I am wondering if I should ask for a referral for a gastroenterologist? or when does endoscopy come in?
sorry for the long story. I am just confused and can't think what to do..

welcome to the forum. You can follow this guide or discuss with your GP about it on how PPI should be administered after antibiotic treatment.

http://www.imvs.sa.gov.au/wps/wcm/conne ... OD=AJPERES

Then again, this guide is only apply for urea breath test. I would assume it affects the stool test too.

PPIs have also been found to adversely affect the sensitivity of the UBT and stool antigen test.

http://www.medscape.com/viewarticle/465198

you should ask for a referral for a gastroenterologist when there is a diagnosis or suspect of stomach ulcer. The specialist can then book you for an endoscopy session to have a look in your stomach. He can also get some biopsies out and do some test. If you do see an gastroenterologist, ask if he can do a antibiotic sensitivity test on the bacteria culture from your biopsy. Then he can prescribe you the most effective antibiotic combination.

Thanks so much for the response and the information!
I just made an appointment to see a Gastroenterologist next week and hope I will know more about what to do next.
My doctor suggests me to be on PPI since he suspects I have an ulcer. So I am on Nexium again. I am wondering if using high dose of PPI would give more chance for re-infection ( If it is gone after first around of antibiotics. still waiting to get re-test.)
I am also a bit puzzled about incubation time of H pylori. I grew up in a developing country and moved to North America to study a few years ago. I assumed I got infected in childhood but I am wondering why it takes so long for the symptoms to show up. ( I am 25 and it has been less than a year since my first heartburn.) And I also would like to know how sensitive the blood test is. All of my immediate family members got tested and they are all negative. Does that mean I have predisposition ? ( I don't think I have that bad of a hygiene now or even as a kid )

it has been established that human get H. pylori infection during childhood. more than 50% of the world population is infected with h. pylori but only about 10% has symptoms. Many people died without knowing they are infected because the infection never bother them.

Nevertheless, it is more common for adults to develop symptoms. Higher risk among elderlies.

Blood test is normally very sensitive. However, it cannot be used to test if you are currently still infected. Because your antibody will remain positive for months or even years.

It is interesting to learn that all your immediate family members are negative. Perhaps you got it from someone who bring you up? babysitter? nanny? childcare? someone who spend a lot of time with you especially feeding you?

Lastly, just want to remind you that you have to stop PPI, according to the guideline i sent you earlier, before your next endoscopy and breath/stool tests.

If we have to stop PPIs how do we cope with heartburn for 3 weeks?

you may follow this guideline to control the heart burn

http://www.imvs.sa.gov.au/wps/wcm/conne ... OD=AJPERES