Helicobacter Forums

Hello Everyone,

Three months back. I started to develop gastritis like symptoms most notably these hunger pangs that would get worse if i did not eat something. i went to my doctor and he gave me 20mg prilosec to take. I came back a month later with improved symptoms but hunger pangs were still present. He gave a script for a h. pylori breath test but told me I didnt have to stop taking the PPI. The nurse said this as well. The nurse said that PPIs wouldn't affect h.pylori bacteria in the stomach. Anyway I went to get the test done and the result was negative. Not only this, but my doctor wanted to double my dosage of prilosec to 40mg for no reason.

Im going to another doctor to get a second opinion and hopefully get this sorted out if it is h.pylori. I am pretty sure it is h.pylori as I have never had symptoms like this in my life. I have never had much GI issues but I guess h.pylori can cause no symptoms. Am I too hasty for gettng a second opinon on this?

hmm.. not sure if your doctor and nurse understand how breath test work. anyway, the reason why H. pylori is able to survive in the stomach is because it has this enzyme, urease, that is able to break down Urea into CO2 and NH3. The NH3 will then neutralize the acid.

H. pylori is very smart. When there is no acid, there is no need to keep the urease active. So it turn off the channel to absorb urea. So no more CO2 and NH3 production.

When you take PPI, there is no acid, so CO2 and NH3 production is turned off. Then when you do breath test, you are asked to swallow an Urea pill that is labelled with either C13 or C14. If H. pylori's urease is active, the Urea will be broken down to release the C14-carbon dioxide. But if the urease is inactive, then urea will not be broken down.

Therefore, although PPI "will not" eradicate H. pylori, it turns off urease activity. which leads to false negative of breath test.

you need to wait a month without PPI and see another doctor who knows the principle of how breath test works.

My appointment with my new doctor is in early July. Should I discontinue the Prilosec otc 20mg now? Will there be any adverse side effects from just stopping. That is my worst fear.

I also thought that the period was 14 days you had to be off PPI before you could get a breath test?

Thanks for your detailed response.

Here is the guideline of how long should stop PPI before breath test.
https://www.helico.com/PYtest_guide_2013.pdf

For prilosec, or omeprazole, it's 7 days. But, usually the longer you wait, the more accurate is the breath test result.

You can switch PPI to ranitidine. It's a H2 blocker, or weaker acid blocker, in comparison to omeprazole. You can continue ranitidine until the night before breath test.

Ok thank you for your response.

Can I immediately switch from Prilosec to ranitidine or do I have to wait?

you can gradually stop PPI. for example if you are taking it twice a day, you can switch to once a day. or if you are taking once a day, you can try alternate day.

meanwhile, you can take Ranitidine in the same time to control your symptoms during the switch.

Ranitidine is a fast acting drug, but it wont stay in the body for long.

prilosec is a slow acting drug, but will stay in the body longer.

Thanks for the advice.

Which Ranitidine works best?

Also I am a runner. In the past few months I have gotten bad stomach cramps during and after runs. They go away after I stop. I was able to run a 22:12 5k with these cramps but I could have gone faste without these cramps. Could these be related to h.pylori? They started the same time I had the other gastritis symptoms?

I am not sure if H. pylori is related to the cramping. But in regards to H2 blocker, I think it's subjective. You can try ask the pharmacist to recommend some.

So I went to my new doctor and he totally understood my concerns. They told me to stop taking any PPI and come back in two weeks for a breath test.

It’s relieving to say the least

looking forward to seeing your breath test result