resistant stain of H Pylori

[maya_khan]

1 yr ago i felt mild heart burn esp after eating meals this heart burn usually started 20 mmins aftr meals.
with ths i also started to feel feet burn
as the time passes on ,my symtoms started to be more severe as i reported diarrhoea ,mild stomach pain and nausea.
i consyltd many docs they simply gave me H2 receptor antagonist(med used in peptic ulcer and GERD).i started to take these medicines my heart burn became controlled but my nausea and diarrhoea became more & more severe .then i went to agastro entrologist ,he took my various test e.g for hepatitis, thyroid gland,RBC countetc.all were clear except H Pylori anti body ,it was positive.for ths he gave me world recognised triple drug therapy i.e amoxicillin 1000mg bid,clarithromacin 500mg bid with omeprazole.
as i took tht treatment my symptoms started to disappear the nausea was totally finished
but after 4 months i felt again heartburn etc...i went through stool antihgen test it was positive tht meant the bacteria satin was resistant so i again took tht therapy with 4 tabs of bismol(bismuth subsalisalyte) 4 times a dayand omeprazole 40 mg
i felf better but now again i felt ill so i went through endoscopy & again H P ylori antibody is positive
my symtoms are still thr i lost my 7 kgs becoz of ths
now i need ur suggestins abt ths very resistant stain of bacteria
i have also an idea if we culture ths bacteria  nad then apply diff antibiotics over it to find frm which therapy it will diminished ....can it be possible
so i need ur suggestins abt it and also if u know any alternative therapy plz sugggest me.....

[boron]

FBS in diabetes is above 120 mg/dL, so this may be pre-diabetes. Symptoms correlate with diabetes symptoms a lot, EXCEPT this warm feeling. Hypotension is also not typical for diabetes, unless you're constantly dehydrated. ("Carcinoid syndrome" came accross my mind. In this syndrome a hormone-secreting tumor develops in the pancreas or in the intestine. Secreted hormones may cause this warmth and hypotension. If it grows in the pancreas, it can also cause diabetic symptoms. I'm not very convinced in this diagnosis though).

Again - endocrinologist. You need post-exercise glucose level checked. Maybe after the exercise your glucose suddenly falls, and this would explain pretty much all of your symptoms.

[maya_khan]

i thnk tht these are all the symtoms of diabetes wht do u thnk as my FBS level is also a prediabetic value

[maya_khan]

increased appetite but still not gaining weight
low BP
weakness
fatigue
feeling of fever but thr is no fever
whenever i do exertion ,sweating starts frm head to toeand with tht my heat beat increases to tht extent tht i can feel it for its remedy i drink sumthing and it becomes ok(its occurs very rare not everytime when i do physical work)
i am going to check my FBS for 3 consequent daz so tht we can reach to a result then if u suggest i will visit sum doc
i am really very obliged to u for ur help

[boron]

Well, one unexpected thing: Glucose: 106 mg/dL is INCREASED. Upper normal level is 100 mg/dL.

I can't get other idea than to see an endocrinologist.

If you put all your current symptoms in one post here (in detail), I can think further.

[maya_khan]

i recently checked my blood glucose level as u asked frm me its 106 ...(fasting blood sugar level)
and i have no special feeling for salt ....
i dun thnk so tht i am suffering frm dehydration or addisons diesease
whts ur suggestion

[boron]

100/50 is a low BP. Do you think it may be from DEHYDRATION?
Look here how to check for dehydration:
http://www.allhealthsite.com/26/complications-of-diarrhea-dehydration-malnutrition-etc-2/

But also: Do you find some unusual brown coloration on your skin? What was your glucosa level in blood?

Read this:
http://www.mayoclinic.com/health/addisons-disease/DS00361/DSECTION=symptoms
Are you craving for salt?

[maya_khan]

1 n half yr ago wen i was ok n was not affected by HP my BP was 120/80 totally normal as soon as i was infected it starts to become low n now normally (when i am feeling normal) it is 100/50
i have been checked my thyroxin level its ok
i am saying ulcer because HP stayed in body for abt 1 year so it made ulcer doc said all ths is because of HP i have taken triple therapy 2 times and i thnk after 2nd 1 it was removed 4 months are passed when i have taken 2nd therapy but my sysmtoms didnt recoved so then i gine through endoscopy and UBT i received their report 3 daz ago n it was negative
my own assumption is that HP made ulcer in my GIT to that extent tht it is not yet cured as endoscopy reveals mild erytheman edema in stomach and doudenal atrophy etc
hen HP wad in my body i repoted diarrhoea i stayed for 1 yr n so my diarrhoea n nausea now no diarrhoea n nausea but heatburn is still thr
i feel appetite and i eat but iam not gaining weight (may b because iam a student of pharmacy n have to do tough studies) its my assumption
no i dun feel sweat at night n u r rite my feet heet up  when i do sum work but it is also curing
ya i am eating these food + alot of fruit like peach apple mangoes etc
i have also sum other prob tht my eyelashes usually fall (its an unusual thng),hairs also and after these antibiotic therapies my hairs also start to discolour
abt 1 n half yr later i was very fresh had shinning white complextion had beautiful shinning black hairs but now at ths situation i am very much depressed
my age is 21 years

[boron]

Rice, bread and vegetable sauces.
Pasta, potatoes, polenta if you don't feel bloated. What do you think?

[boron]

100/50 ?!
This is a hypotension! Dizzines is expected symptom.
What's your usual BP?

How long was the period of diarrhea? Do you think this is why you've lost weight, or is it just from avoiding eating, or you don't have appetite? You say no diarrhea/nausea now.

Why are you saying "ulcer", if there was no one found by endoscopy? Also, what was doctor's explanation of gastric erythema and especially of duodenal atrophy? Celiac disease was excluded?

You also sweat at night? You mentioned burning feet in the 1st post - this goes with this heat after the exercise? Anyway, I think you should have your hormones checked. (thyroxine, cortisol, aldosterone, adrenaline, estrogenes...). How old are you?

[maya_khan]

for the low BP condition i want to add tht i also feel dizzines with all tht...and after when it becomes ok i sleep for abt the whole day ...

[maya_khan]

hi boron
i want u to know my latest results of endoscopy and urea breath test..i received their results yesterday.UBT result is negative and their is no evidance of h pylori in gastric mucosa
The endoscopy reveals small hiatal hernia in eosophagus, mild gastric erythema and edema in stomach and mild atrophy in duodenum..the biopsy also dont reveal sumthing serious its result is also inflammation of stomach
these all results shows tht now i am alright the main prob is now the symtoms of ulcer and extreme weakness
as i have told u before tht  i lost my 10 kgs and now i am only 43kgs.
i feel weakness& whenever i do exertion ,sweating starts frm head to toeand with tht my heat beat increases to tht extent tht i can feel it for its remedy i drink sumthing and it becomes ok...i thnk after physical work my B.P becomes too low coz nowadaz my normal BP id 100/50..wht u think abt it?
secondly i am continuously taking omeprazole for the heartburn prob,still i feel it sumtimes whenever i eat a bit spicy food.there is no diarrhoea and nausea
my food is became too limited tht i dun know how to increase my weight
as u know for ulcer patients,i cant take meat ,chicken,eggs ,and alot of thngs like tht
plz help me i will be very obliged to u..

[maya_khan]

i am also doing all ths wht u suggest me ....thnx a lot

[boron]

Well, try to eat. Have small meals. To prevent nausea or acidic pain, you should avoid animal food (meat, fish, eggs, dairy), also other protein food: nuts, beans and soy. Not totally exclude it, but limit it. This way food will pass the stomach faster. Also avoid acidic foods: fruits, any alco, vinegar, vit C, aspirins.

To prevent bloating, you should avoid anything sugary and potatoes.

You can still eat rice, bread, corn foodds, most vegetables. Water is OK.

The way of transmission of H. pylori is not known...Hygiene rarely harms, though.

[maya_khan]

thnx alot for ur guidance i want u to know that after diagnosis and treatment i only drink nestle pure water.i have also take care of hygeine in other food etc
my doc also said tht after alot of care abt hygeine it must a resistant stain not reoccurance
as for as endoscopy is concerned i have gone through it n i thnk at tht time the culture and sensitivity test was not done with my biopsy...in my country HP is resistant to clarithromycin..now i have gone through urea breath test n after its result we will decide further treatment i will let u know abt it
my main prob is weight loss , yr before i was 53 kgs n now i am 43 kgs wht to do with ths plzzzzzz help me...

[boron]

If you insist in antibiotic suceptibility test, you need to give a sample from gastric mucosa taken during endoscopy. Only this way actual bacteria may be obtained, cultured and susc. test made.

I seriously doubt that they can find H. pylori in vomit. In the stool, only H. pylori antigens are found, not live H. pylori.

But again, before undergoing any testing, you should be aware that there are two possibilities: H. pylori is antibiotic resistant OR you simply get reinfected, no matter which antibiotics you were cured with.

One study has showed that dental procedures may cause H. pylori reoccurence
http://www.isomed.com/english/news/news.htm

Another one says that "Previous studies have shown that the vast majority of
patients with recurrent HP infection have recrudescent infection rather than re-infection." This is said in the last sentence of article under the link below
http://www.sma.org.sg/smj/4108/4108a3.pdf

[maya_khan]

thnx for ur replies calgal and boron
now can any1 plz tell me on wht sample culture can be made vomit or stool
i want to tell u tht recently i have gone through endoscopy n my biopsy reports antibody positive for H PYLORI

[boron]

Antibodies to H. pylori may stay in the blood for years, so they may be all from previous infections, but also from new ones, so atibodies are not enough to determine if infection is fresh or not. I personally believe that breath test is the most reliable. Breath test doesn't determine the type of bacteria in the stomach, but it determines their presence/absence. H. pylori is the only harmful bacteria found in stomach so far (by may knowledge), anyway.

If antibiotics helped in all your previous infections, it means, you were probably cured at the time, meaning that H. pylori was not resistant, but simply re-occured. It happens also to others. The other possibility is, that most of bacteria were killed, but few were actually resistant and they slowly regrew and causes symptoms again. If this was the case, then biopsy should be made, and antibiotic susceptibility testing made.

Here's one pretty long and detailed article about H. pylori, you need to register (it's quick reg.). The link below opens a page, where antibiotic susceptibility is described.
http://www.medscape.com/viewarticle/450385_8  

[CalGal]

Despite the fact that culture is the gold standard in the diagnosis of H.pylori, there are a limited number of clinical laboratories that isolate this organism routinely. Culture is considered to be an essential method only for research purposes at this time more typically because of the cost. But at some point it's going to need to be done (almost routinely?) because of the need to establish susceptibility patterns in H. pylori isolates from patients in whom standard antimicrobial treatment has failed. You're going to have to contact labs individually to see if they have the capability and to determine the cost. You'll also have to find out in what 'form or presentation' they need the sample.

[maya_khan]

thnk u abt ur suggestion but at ths time i want to know that on my gastric levage or vomit can we culture H Pylori n then can we chek with certain gruop of antibiotics tht frm whom gruop it will erradicate becoz i have already taken triple therapy two times .side effects of antibiotics r very bad n  i dun want to do an other experiment with my body i just want to take tht therapy to which i am asure tht it will erradicate ths resistant bacteria....

[CalGal]

You may want to google the title "New Concepts of Resistance in the Treatment of Helicobacter pylori Infections," and find out what the latest article have to say about the problem.

But also keep in mind that H. pylori upregulates your acid pumps, so it's possible what you may be contending with is acid reflux as a result of the H. pylori infection. So you may need to be following a GERD diet and remain on a course of either H2 blockers or PPIs to try to depress the production of acid in your system.

Also check out the articles on the use of certain probiotic products and their helpfulness in eradicating H. pylori.

You may also need to check to see is there is some common 'source' with which you may be re-innoculating yourself in some manner.