Multiple eradication failures - is old dental work a culprit? And more questions...

After first line treatment, various "second line" treatments can be used. The policy for H.pylori is: Make sure the infection is real (breath test for follow-up). Always give a high dose of PPI (acid blocker) when using amoxicillin. In the second treatment, give a different drug in place of clarithromycin.

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ankiwo72
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Joined: Fri May 17, 2019 2:45 am

Multiple eradication failures - is old dental work a culprit? And more questions...

Post by ankiwo72 » Sat May 25, 2019 7:09 am

Hi

I know that there were many old posts (at least 8 years ago) covering the issue of oral H. Pylori and at the time the conclusion was that H. Pylori could not live in the mouth. Is this still the conclusion or has any new medical evidence surfaced to the contrary?

If H. Pylori cannot live or colonize the mouth, can kissing still spread the bacteria if the infected person has no active reflux? I am sad that I have not been able to kiss my husband for so long and wonder if I will ever be able to again. He has had H. Pylori treatment and his was cured on the first try! So why is mine still going?

I have failed 5 treatments thus far, and at my last dental checkup about 6 months ago was told that one of my old crowns had a breach near the gum line. I don’t remember if it was due to receding gums or a crack in the structure of the crown, but I was not told to do anything further except that I might want to get a new crown at some point in the upcoming future, but it was not urgent. In any case, could H. Pylori colonize space beneath an old crown while being unaffected by antibiotics during eradication treatments, and then be reinfecting my stomach after the treatments finish?

Are there foods that can actually reduce bacterial count in the stomach, or are antibiotics the only thing that can keep it in check? I know some people manage to live with the bacteria without problems but if I know it causes chronic gastritis in me, will gastritis inevitably return if I do not eradicate the bacteria? Continual treatments aimed to lessen the load but not fully eradicate, I fear will only strengthen the bacteria over time.

Lastly, does Vitamin D deficiency cause treatment failure? I saw a mention on that idea in a research article but not sure if it is accepted medically.

I am just trying to figure out where my body is going wrong.

Thank you!

Helico_expert
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Re: Multiple eradication failures - is old dental work a culprit? And more questions...

Post by Helico_expert » Sun May 26, 2019 3:05 pm

Hi, I am sorry to hear that you are very unfortunate that you caught a very difficult strain.

1. H. pylori cannot live in the mouth. Keeping oral with good hygiene can reduce the risk of transmitting H. pylori. As long as your mouth is cleansed, then kissing is not a problem.

2. Can H. pylori live in between the cracks of your tooth? my guess is no. H. pylori only lives in the stomach. Since it is so slow growing, any bacteria in the mouth will be able to outgrow H. pylori very quickly.

3. If you are on Antibiotics, the antibiotics will be absorbed in your body and into your saliva. So there is no hiding place for H. pylori, including the cracks between your teeth.

4. There may be food that is able to reduce the H. pylori load. However, that is not very useful as it can always grow back. So it is more important to completely eradicate it.

5. Some people can carry H. pylori without symptoms. They are very lucky.

6. If you have symptoms, you should get treatment. The symptoms will only get worse if it is untreated.

7. You need to find a good specialist that has access to a good laboratory that can culture H. pylori. Then an antibiotic susceptibility testing can be done and a high efficacy treatment can be prescribed.

ankiwo72
Posts: 48
Joined: Fri May 17, 2019 2:45 am

Re: Multiple eradication failures - is old dental work a culprit? And more questions...

Post by ankiwo72 » Thu May 30, 2019 7:48 pm

Thank you for your response.

Some follow up points:

- I had already done susceptibility testing and based Treatment #4 on the results, and treatment failed

- Treatment #5 was rifabutin/amox/omeprazole, which also failed

- Doctor is suspending treatments until he can do further research on why all my treatments may be failing despite having supplemented with Vitamin D, other household family members are negative to HPylori, and adhering to all 14-day treatment protocols (completing all abx, taking as directed, etc.)

Doc thinks there may be some sort of immunological component and will be looking more closely into my labs to see if there is anything that may be an underlying factor. I have a lot of allergies so my immune system is somewhat hyperactive. Do you know what he may have been thinking about? Thanks!

Helico_expert
Site Admin
Posts: 3500
Joined: Wed Mar 02, 2011 7:20 am

Re: Multiple eradication failures - is old dental work a culprit? And more questions...

Post by Helico_expert » Fri May 31, 2019 12:22 am

have you tried furazolidone? perhaps you can try

rabeprazole 20 mg TID
bismuth 240mg QID
Amoxicillin 1g TID
furazolidone 100mg TID

ankiwo72
Posts: 48
Joined: Fri May 17, 2019 2:45 am

Re: Multiple eradication failures - is old dental work a culprit? And more questions...

Post by ankiwo72 » Fri May 31, 2019 1:29 am

Unfortunately furazolidone is no longer available here in the US :-(

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