Helicobacter Forums

Hi,

I apologize in advance for getting a lot of web-based information. But recently I have been reading up on the coccoid form of H. Pylori, and have some questions related to a proposed long term treatment plan that my medical team is considering for me. I am concerned it may make things worse, so I would greatly appreciate your input:

- Is it established or still debated that coccoid form of H. Pylori maintains virulence and is in fact more pathogenic toward cancer than the spiral form?
- If subclinical levels of amoxicillin cause H. Pylori to transform to coccoid form, does amoxicillin desensitization (due to allergy, the process of which very tiny amounts of the abx are administered leading up to clinical dose over several hours) cause H. Pylori to morph into coccoid form before reaching therapeutically clinical levels, thus rendering it basically untreatable by amoxicillin for duration of treatment?
- How long can H. Pylori remain in coccoid form? What does it consume or need to come out of its coccoid form?
- How long would a high-dose amoxicillin/PPI regimen need to be maintained in order to eradicate all H. Pylori in its coccoid form?
- What other antibiotics can cause H. Pylori to transform to coccoid form? (I have been getting recurrent UTI infections and on other antibiotics, and wondering if those are also producing the same effect)
- If I keep getting treated by antibiotics that continue to cause H. Pylori to transform to coccoid form and those treatments keep failing, are the failed treatments actually speeding up and guaranteeing my progression toward cancer?
- Is it worth the risk to go on a year of high-dose amoxicillin and PPI? Or is it greater risk that amoxicillin desensitization process will cause the treatment to fail and speed up cancer progression? How long would be adequate to ensure annihilation of all forms of H. Pylori in the stomach?

Thank you, and sorry for so long.

It is true that H. pylori can have cocoid form. However, the clinical implication is weak.

We only treat resistance cases and we never find out their physical form. We manage to get over 90% cure rate among these difficult cases.

the tip for successful treatment is high dose PPI, high dose amoxicillin and high dose bismuth. You can add one more antibiotic to boost the cure rate.

Hello there,

It's good to see this information, and I gave similar information to this forum 5-6 months ago.

In particular, amoxicillin converts the drums from the spiral form to the coccoid form, which is more dangerous as a virulence.

A pubmed study: "Despite the good in vitro bactericidal effect of amoxicillin on spiral forms of H. pylori, this antibiotic has little effect on induced coccoids that may develop after inappropriate in vivo antibacterial treatment. Hence, for successful therapy, it is essential not only to eradicate the spiral forms, but to eliminate the viable coccoids. ''

I've been looking for answers to your questions, but I haven't found them.

In addition, many diagnostic methods are based on recognizing only the spiral form: this form no longer retains its urease enzyme and is not recognized in the breath test. we get a false negative result. likewise stool antigen test

Pathology: many staining methods recognize only the spiral form.

I am very curious about the answers to these questions.

What do we have to do to kill this form? Because this form of chronic inactive gastritis persists after treatment.

What kind of treatment should be applied to kill this form and researches should be done.

As far as I know, this form cannot reproduce, but it survives with PCR and continues to damage in a more virulent form.

In my country, many ca patients are called negative, whereas they are infected with hp.

Certainly serious research is needed on this form.

Our salvation will be through the discovery of drug treatments that do not convert spiral to coccoid.

Like i previously said, the clinical implication is weak.

You dont need to worry about cocoid form. The antibiotics will kill both spiral and cocoid forms.

There are studies explaining the cause of inactive gastritis after treatment with coccoid form.

https://www.ncbi.nlm.nih.gov/pubmed/12428792

There are also many studies showing changes in form after antibiotics.

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4138673/

I don't understand If the pathogen causing the infection dies, why is inactive chronic gastirt still after treatment? There are studies explaining this with this form, I know your opinion on this issue.

Thank you very much helico_expert for making us return and for keeping this form up to date.

thanks for sharing the articles.

I know the existance of cocoid form. However, in our clinic where we only treat the most difficult H. pylori cases, we are able to eradicate 95% of the cases. Perhaps the 5% is because of cocoid form.

so, I think cocoid form is not clinically important for majority of the patients.

As H. pylori is eradicated, the gastritis will gradually subside. This "subside" is also referred as "inactive gastritis". So doctors can predict the absence of H. pylori by seeing inactive gastritis.

Helico_Expert,

How long it will take Inactive gastritis heals after treatment?

Because inactive inflammation (same active inflamition) will contribute to the progression of metaplasia.

An incredibly complicated; example two years ago, the endoscopy revealed a diagnosis of inactive gastritis.
the same diagnosis again this year + metaplasia

Professor Marshall had said that one day it would be a much more effective treatment with fatty acids, I remember that.

This and similar studies are very promising;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368202/

Thanks for sharing the interesting article.

In the present study, LipoOA increased the outer membrane permeability of H. pylori but had weak effects on the permeability of the plasma membrane and hence poor killing of H. pylori.

Perhaps one day a new method can be used to kill H. pylori. But this method is not matured yet.

How long will it take for inactive gastritis to heal? that's subjective. It depends on individual's immune response. Usually it'll go away within a month. But, it may be longer for metaplasia patients. I have no data on that.

3 different fatty acids were investigated; article also attracts attention LipoLLA

The others fatty acids have no activity, but LipoLLA was found to be much more effective than amoxicillin.

Can you review it when available? I wish this project was under your leadership.

honestly, i am not expert enough to review this novel treatment method.

However, from the following articles,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267350/

https://www.dovepress.com/the-impact-of ... rticle-IJN

It seems like LipoLLA is able to reduce bacterial load and avoid the disruption of guts microbiota, but it is still not able to eradicate all of them.