Questions about H.Pylori, Testing, Diet, Intestinal Metaplasia and Hiatal Hernia

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Steve H.
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Joined: Thu Apr 26, 2018 1:45 am

Questions about H.Pylori, Testing, Diet, Intestinal Metaplasia and Hiatal Hernia

Post by Steve H. » Sun Sep 30, 2018 12:57 pm

Greetings,

I am new to this forum and I would like you to know that your work on h.pylori has already placed your name in history books and your services on this forum are highly appreciated. I consider it to be a true service to humanity for which you will be surely blessed by God. The provided information, advices, and recommendations from someone having the subject authority and the stature of Dr. Barry Marshall and his team, seems like a God sent favor specially at the time when one is inflicted with this awful bacteria and related sickness.

I would like to share my story in detail with history, in order to get advices and also for others to get information which may correspond with their issues. I would really appreciate if both Barjammer and Helico Expert go through my post.

In 2006, I started having acidity, pain right under the rib cage in the middle and heart burn, the primary care physician tried some medications like Gaviscon and Omeprazole, my symptoms would get better but once I stopped the medicine the symptoms would re-appear. So, I went to a top rated GI in November, 2007 and he advised an upper GI endoscopy.

The post procedure diagnosis for the endoscopy was: Gastritis, Duodenitis, Gapping lower esophageal sphincter and reflex esophagitis.

The biopsy report stated: Helicobacter like organisms are identified in the lamina propia. Specialized type of gastric mucosa showing mild chronic inflammation in lamina propia.

Diagnosis: Antrum and body of stomach: Mild chronic helicobacter pylori associated gastritis.

So, the GI put me on the antibiotic regime for 10 days, I think it was Amoxicillin 1000mg once a day + Ciprofloxacin 500mg and Esomeprazole 20mg twice a day, after the treatment ended he told me to continue with Esomeprazole 40mg for two weeks and then 20mg for two weeks after that. The treatment ended, I started feeling better after a while but I do not think that a test was done to check if H.pylori was eradicated or not, since the symptoms were not there, I did not worry about it. (Since I had H.Pylori again in 2018, I am assuming it was not completely eradicated but the second endoscopy that was done in 2014 does not mention H.pylori which means it was not found or detected).

After a few years, I started having the acidity and reflux again, I had a stool test done which showed that I had giardia lamblia, so I visited the GI again in May, 2014, another Upper GI endoscopy was done. The post procedure report stated: Hiatal Hernia, Pangastric erythema, Observations were all normal but GEJ:- Z line@35 cm, Hiatus at 37 cm: small hiatal hernia and the Stomach observation showed Fundus, Body, Antrum with Mild pangastric erythema.

The biopsy report of Distal Duodenum stated: Duodenal mucosal fragments showing mild chronic Duodenitis. The villi are reasonably tall. No increase in intraepithelial lymphocyte noted. No granuloma or giardia lamblia seen. There is no evidence of malignancy.

The biopsy report of Antrum stated: Gastric antral mucosal fragments showing non-specific changes. No activity noted. No Helicobacter pylori organisms are seen. There is no evidence of granuloma or malignancy.

In February 2018, I went for a complete medical and wanted to know where do I stand with Hiatal Hernia so I went back to the GI again, I told him at times there were symptoms of GERD so we decided to go for another upper GI endoscopy.

The post procedure result stated: small hiatus hernia/Mild esophagitis with ragged Z line/Mild gastric erythermia.
Observations were:
Esophagus - Mild distal esophagitis with one linear erosion
GEJ - Ragged Z line @37 cm, Hiatus at 39 cm: small hiatus hernia
Stomach - Fundus: normal, Body: Mild erythema seen, and Antrum: Mild erythema seen.

The biopsy report stated: The lamina propia shows moderate inflammation comprising of lymphocytes and plasma cells with focal neutrophils. Helicobacter pylori-like organisms are also noted. There are multiple foci of intestinal metaplasia. There is no evidence of granuloma or malignancy.
Diagnosis:
Antrum:- Moderate chronic focal active Helicobacter pylori associated gastritis.
Intestinal metaplasia is also seen.

After getting this report the GI started me on Amoxicillin 1gm + Clarithromycin 500mg + Esomeperazole 40mg and Bismuth Subcitrate (120mg - Two Tablets each time), all medicines were to be taken twice a day for 14 days, followed by Esomeperazole 40 mg once a day for a month. The 14 days that I took the antibiotic treatment regime were awful, I felt so bad plus I was horrified with the thought of intestinal metaplasia and the fact that H.pylori can cause cancer. During this period I also used Mastic gum and Manuka honey. Anyways, I finished the treatment and stopped taking Esomeperazole, Mastic gum and Manuka honey, like 15 days after I finished the antibiotics. So, one month after I had stopped taking the PPI, I went for a Urea Breath Test with C13, the result stated: DOB= -0.22 Negative-, which was a big relief for me. Two months after the UBT, I had a H.pylori Antigen (stool) test done and it was also negative. The test was done with Rapid Immunoassay method.

Question 1. Can I be sure of H.pylori eradication with both UBT and stool test being negative for h.pylori?

It has been two months since that test. Currently, I am not taking any medicine but I do feel uncomfortable in the belly after eating certain things, also I do feel that my digestion process is slow, and at times I have reflux which is like twice or thrice in a month usually after eating something heavy.

Question 2. Could hiatal hernia be causing the reflux or this feeling in the belly?

I hardly ever have constipation but this uncomfortable feeling in the belly scares me enough to think, what if h.pylori is back? or if something else is going on in the digestive system.

Recently, I was introduced with this doctor, who is also a naturopath (or herbal practitioner) and specializes in h.pylori treatment, he told me that H.pylori does not go away with antibiotics and a colony is always left somewhere, I told him about the UBT and H.pylori antigen stool test being negative, he said the only reliable test is done using Elisa method and the result should have IgM and IgA all negative. All this has further confused me, I would appreciate your input on it.

Question 3. I would also like to know which test or method would be able to fully confirm h.pylori eradication?

Question 4. Will my stomach feel normal again and will the intestinal metaplasia reverse back? When should I get another endoscopy to check on the intestinal metaplasia? and what would you recommend as a treatment for reversing intestinal metaplasia.

Question 5. What are the chances of a person being re-infected with h.pylori and what could be the causes of re-infection? It has been almost seven months but I still have burning sensations in my belly at times, can it be ulcers and how long will it take for it heal?

Question 6. What should be done about hiatal hernia, would you recommend anything for it?

Question 7. Is there a diet that you recommend that one should follow after eradication of h.pylori?

Moreover, at the same time I had H.pylori infection, I also started having prostate issues which I never had earlier and I feel H.pylori is the causative factor. The urologist after doing Ultrasound, Urine flow and other test said I had an enlarged prostate and weak urine flow, symptoms of prostatitis. I have read online and also few post on this forum regarding h.pylori and prostate issues, I am sure you must have gone through some studies and research papers regarding h.pylori and prostatitis.

Question 8. I want to find out if h.pylori eradication would help with prostatitis and what are the treatment options for prostatitis after h.pylori eradication?

Right now, I am 51 years old but I have young children and this health condition worries me a lot. I do not have a family history of cancer. My wife never had h.pylori or any symptoms of it, but still just to confirm she had the H.pylori Antigen (stool) test and her result was also negative.

Question 9. Should I also get my children tested, they are all under 12 years of age.

I appreciate your time and I convey my best wishes to Helico Team and the readers of this forum.

Stay Blessed.
Last edited by Steve H. on Wed Jan 23, 2019 4:30 am, edited 1 time in total.

Helico_expert
Site Admin
Posts: 3508
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Re: H.Pylori: Questions

Post by Helico_expert » Mon Oct 01, 2018 11:40 pm

First of all, thanks for sharing your story.

Question 1. Can I be sure of H.pylori eradication with both UBT and stool test being negative for h.pylori?
Yes. based on that two tests, I believe your HP has been eradicated. Each of that test is over 90% accuracy.

Question 2. Could hiatal hernia be causing the reflux or this feeling in the belly?
Yes. Hernia can sometimes cause reflux symptoms. unfortunately there is nothing much you can do about it. You may have to rely on H2 blocker or PPI.
Recently, I was introduced with this doctor, who is also a naturopath (or herbal practitioner) and specializes in h.pylori treatment, he told me that H.pylori does not go away with antibiotics and a colony is always left somewhere, I told him about the UBT and H.pylori antigen stool test being negative, he said the only reliable test is done using Elisa method and the result should have IgM and IgA all negative. All this has further confused me, I would appreciate your input on it.
This is not true. Antibiotic is the only way to get rid of H. pylori. With a follow up negative test, H. pylori is confirmed gone. ELISA test is stool test. IgM is almost always negative because it is used to detect early infection. Most HP infection happened during childhood time. IgA is usually present in the stomach, not stable in blood. IgG is normally the marker to test for H. pylori.

Question 3. I would also like to know which test or method would be able to fully confirm h.pylori eradication?
Breath or Stool test are good to confirm HP eradication

Question 4. Will my stomach feel normal again and will the intestinal metaplasia reverse back? When should I get another endoscopy to check on the intestinal metaplasia?
This is a tough one. the report on reversibility of metaplasia is never ending debating. I think it is depending on the severity of the metaplasia. The mild or early phase of intestinal metaplasia is probably reversible. The severe one is likely non reversible. The only way to find out is to book yourself another endoscopy a year later to see the stomach condition again.

Question 5. What are the chances of a person being re-infected with h.pylori and what could be the causes of re-infection? It has been almost seven months but I still have burning sensations in my belly at times, can it be ulcers and how long will it take for it heal?
Assuming that you and everyone who lives with you have good hygiene, the chance of reinfection is very low. Just make sure everyone living under the same roof is free of HP. That will greatly reduce the reinfection risk. I dont believe sharing food and drinks with friends occasionally will catch HP. HP is actually very fragile outside human body.
You did not mention ulcer being reported in your endoscopy report. So you dont have ulcer. ulcer will take weeks to develop. and will take weeks to recover.
I think your stomach is adjusting itself to a HP free status. Give it more time to recover. some member in this forum took years before they are 99%.

Question 6. What should be done about hiatal hernia, would you recommend anything for it?
unfortunately there is nothing much you can do about it. just eat more digestible food. chew your food a bit longer before swallowing.

Question 7. Is there a diet that you recommend that one should follow after eradication of h.pylori?
Nope. there is nothing else you need to do after HP eradication. Just focus on eating healthy.

Question 8. I want to find out if h.pylori eradication would help with prostatitis and what are the treatment options for prostatitis after h.pylori eradication?
I dont think HP is associated with prostatitis.

Question 9. Should I also get my children tested, they are all under 12 years of age.
We dont recommend children to get tested. You can assume they have HP. Just avoid sharing food with them and make sure they brush their teeth all the time. Brushing teeth can significantly reduce HP transmission.

Steven
Posts: 10
Joined: Mon Aug 20, 2018 8:41 pm

Re: H.Pylori: Questions

Post by Steven » Tue Oct 02, 2018 4:10 pm

Question 6. What should be done about hiatal hernia, would you recommend anything for it?
unfortunately there is nothing much you can do about it. just eat more digestible food. chew your food a bit longer before swallowing.

I am in a similar situation regarding a hiatal hernia. Mine is 2cm. I am still suffering with reflux that is worse than before HP treatment whilst still taking PPI’s and Gaviscon as directed by the ENT doctor. The acid is getting in to the windpipe causing a terrible cough and pain. I am seeing a gastroenterologist to discuss further testing (swallow and/or PH) to see if the hernia is causing it.

If so, and if my symptoms don’t settle in the meantime, we will discuss the surgical options. There’s plenty of options out there including less invasive Stretta or TIF procedures that are proven to lessen and often cure GERD symptoms.

I’m hoping that this increase in symptoms is just a rebound effect from the HP treatment but we’ll see.

Steve H.
Posts: 17
Joined: Thu Apr 26, 2018 1:45 am

Re: H.Pylori: Questions

Post by Steve H. » Wed Jan 23, 2019 4:27 am

Thanks a lot Helico Expert, I am sorry for the late reply I had forgotten my password.

You answered all the questions. I appreciate your help and time. Please convey my best wishes to the Helico Team. Keep up the good work Guys.
Stay Blessed.

Helico_expert
Site Admin
Posts: 3508
Joined: Wed Mar 02, 2011 7:20 am

Re: Questions about H.Pylori, Testing, Diet, Intestinal Metaplasia and Hiatal Hernia

Post by Helico_expert » Wed Jan 23, 2019 9:48 am

you are welcome. I think you asked good questions.

Steve H.
Posts: 17
Joined: Thu Apr 26, 2018 1:45 am

Re: Questions about H.Pylori, Testing, Diet, Intestinal Metaplasia and Hiatal Hernia

Post by Steve H. » Wed Apr 24, 2019 5:40 am

Hello Helico Expert,

It has been a year since I did my H. Pylori treatment. Two months after the treatment when I did UBT it was negative and 4 months after the treatment I did a stool antigen test which was also negative confirming eradication as mentioned in my previous post. Recently, I took Milk Kefir with Raw Cow's Milk for a week but when I read that raw milk can cause H.Pylori I stopped taking it, but since then I have a slight burning sensation in different places in my abdomen that comes and goes off and on. Even though my stomach was doing well before that, having maybe a little reflux once in a month, so now I am scared that I could be infected with H.Pylori again due to raw milk.

I can go for UBT or stool antigen test but last week I had a wisdom tooth extracted for which I was prescribed Cefadroxil Monohydrate 500 mg twice a day and Esomeprazole 20 mg twice a day for three days. So, I do not think I can get the above mentioned UBT and Stool antigen test done.

I was planning to get endoscopy done next month to check for the status of intestinal metaplasia as mentioned in my previous post, but now I am wondering if it would be okay to get it done next week as it would be a year and two months after the last endoscopy that way I will also know if the burning sensation that I am having is due to H.Pylori again. So, I would highly appreciate if you could answer a few more questions.

1. What are the chances of me being reinfected with H. Pylori again?

2. Will the medication that I took after the tooth extraction affect the endoscopy result in any way including H.Pylori result and Intestinal metaplasia result?

3. Can Raw milk really cause H.Pylori?

4. I got off PPI's a month after treatment as I did not need it, the doctor said it was okay. He advised Gaviscon if needed, which I took a few times. Is getting off PPI's okay?

5. Also, I wanted to find out if the report says Helicobacter pylori-like organisms also noted, what does that really mean? Can it be something similar to H. Pylori (like another type of Helicobacter organism) and not actually H.Pylori?

I appreciate your help and time, my best wishes to Helico Team and the readers of this forum.

Stay Blessed.

Helico_expert
Site Admin
Posts: 3508
Joined: Wed Mar 02, 2011 7:20 am

Re: Questions about H.Pylori, Testing, Diet, Intestinal Metaplasia and Hiatal Hernia

Post by Helico_expert » Wed Apr 24, 2019 8:58 am

You will not catch H. pylori back from drinking raw milk.
The farm animal have their own species of Helicobacter. They dont normally jump host. That's why Prof Marshall had so much trouble finding an animal model for experiment 30 yrs ago.. he had no choice, but to drink H. pylori himself to proof that H. pylori is the cause of gastritis and can lead to ulcer.

1. It's not easy for an adult to catch H. pylori again. Assuming that you look after your hygiene.
2. One week is good enough of waiting is good enough. You can proceed with endoscopy check. Make sure the specialist take some biopsy for histology check.
3. Raw milk is not the source of H. pylori infection.
4. It's ok to stop PPI. Just take it when you need it. But the proper protocol is to gradually stop it.
5. It's probably some bacteria from the saliva. But let's find out from your next endoscopy and histology report. If in doubt, you can ask the pathologist to do immuno stain to highlight Helicobacter.

Steve H.
Posts: 17
Joined: Thu Apr 26, 2018 1:45 am

Re: Questions about H.Pylori, Testing, Diet, Intestinal Metaplasia and Hiatal Hernia

Post by Steve H. » Wed Apr 24, 2019 4:57 pm

Thanks a bunch, you have been great. Still wondering what could be the reason for the burning sensation.

Helico_expert
Site Admin
Posts: 3508
Joined: Wed Mar 02, 2011 7:20 am

Re: Questions about H.Pylori, Testing, Diet, Intestinal Metaplasia and Hiatal Hernia

Post by Helico_expert » Wed Apr 24, 2019 7:26 pm

As long as you are free of H. pylori, if you have any acid symptoms... just take some PPI.

Steve H.
Posts: 17
Joined: Thu Apr 26, 2018 1:45 am

Re: Questions about H.Pylori, Testing, Diet, Intestinal Metaplasia and Hiatal Hernia

Post by Steve H. » Wed Apr 24, 2019 9:42 pm

Once again thanks. Stay Blessed.

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