Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Gastroenterology (Expert Forum)
Testing for H.Pylori
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Testing for H.Pylori
by Linda__0__0, Oct 23, 1998 12:00AM
: : Last spring I had a positive biopsy for H. Pylori when I had an endoscopy performed. I was treated for 10 days on antibiotics. Recently, I developed similar symptoms. My GI doctor wants to retest me using a new "investigational" test called "Helicobacter Pylori Stool Antigen". The "investigational" part has really caught my curiosity. Do you know anything about this test? Can't I just have another blood test done? Also, I thought once you were treated with antibiotics for H. Pylori..you shouldn't get it back again. Is that true?
: _______
: Dear Linda:
: H. pylori is a cause of ulcer disease. Eradication of the infection reduces the risk of recurrent ulcers. Whether it is necessary to treat patients with non-ulcer dyspepsia (epigastric pain but no ulcer found) is controversial because there is no convincing data that patients have decreased symptoms ( although specific subsets of patients with non-ulcer dyspepia may benefit from treatment). There is , however, evidence that H. pylori infection is a risk factor for the development of gastric cancer. This observation has resulted in many physicians treating patients with H. pylori infection even though they have not had an ulcer. There are many treatment regimens for H. pylori. They have about the same efficacy, eradicating the bacteria in 85-90% of those treated.
: There are three possibilities regarding your recurrent symptoms. 1) you belong to the subset patients who responded to the treatment for H. pylori, H. pylori was not eradicated due to bacterial resistance to the antibiotics or the treatment was not efficacious; 2) your H. pylori has been eradicated, but your symptoms might not caused by H. pylori infection; 3) reinfection with H. pylori.
: How does one determine if a patient has eliminated H. pylori infection after treatment? The Stool Helicobacter Pylori Antigen Test is a newly developed test for H. pylori. It has gone beyond the "investigational" stage. In fact, the test can be done in some laboratories, with high sensitivity (94%; means that 94% of those with the infection will have a positive test) and high specificity (96%; if you have a negative test then there is a 96% chance that you do not have the infection) For patients with a prior H. pylori infection (as in your case), the serology test is not helpful. Once you have been infected an ddeveloped antibodies to H. pylori, the antibodies remain forever, even if the infection has been cured. A positive H. pylori blood test just means that you were once infected and does not necessarily mean that you are still infected.
: The Breath 14C-urea Test is another nonivasive test to idebtify people with active H. pylori infection. The test is based on the enzymes that are made by H. pylori . this test is also highly sensitive and specific. Finally, the doctor can repeat the endoscopy and gastric biopsy .
: This information is presented for educational purposes only. Always ask specific questions to your personal physician.
: HFHSm.D.-jg
: *keywords: H. pylori, serology, tests
: 0.4
I went through the same situation two years ago. I had a positive blood test for H. Pylori and I was treated with Flagyl and Biaxin. Symptoms later returned. I had an EGD in July in which the biopsies showed a postive CLO test and I also had numerous ulcers, erosions and inflammation. I was treated with Helidac Therapy. Symptoms remained. I had another EGD last week. Once again, the CLO test was positive. I was a model patient taking the medications exactly as prescribed. Please tell me what are the choices for a third course of treatment. I understand there is a Flagyl-resistant strain of H. Pylori and I assume that is what I have.
______
If you have failed all the antibiotic regimens, then you may require chronic acid suppression to control your symptoms. Obviously eradication of H. pylri is best because it prevents symptoms. If your infection can not be eliminated, then the approach is to suppress symptoms. H2 receptor antagonists e.g. Tagamet should be tried first. Proton pump inhibitors would be the next line of treatment if the Tagamet failed.
This information is presented for educational purposes only. alwats ask specific questions to your personal physician.
HFHSM.D.-rf
8keywords: H. pylori infection
0.2
