Hi thebookguy,
The short answer is?reinfection.
H. pylori is a very interesting little bug, who used to go by the name
Camplyobacter pylori. It?s not totally certain how it is transmitted,
or why some people seem to be more susceptible to it than others. The
most likely mode of transmission is the oral-oral or oral-fecal route,
as well as contaminated water sources. (H. pylori bacteria can be
found in the stool of most people who carry this organism) There have
been some documented cases of contaminated endoscopes transmitting
this organism from patient to patient, per the CDC.
http://www.cdc.gov/ulcer/md.htm#infect
A perplexing aspect of this disorder is the cycle that perpetuates H.
pylori. Most folks with heartburn assume they suffer form an excess of
stomach acid, so they take an antacid to quell the ?burn?. The odd
thing is, that people with a very LOW pH (low stomach acid) also
suffer from the same symptoms of folks with a high level of stomach
acid. With the stomach pH lowered, and lowered even more in those who
had a low pH to begin with, H. pylori organisms eagerly multiply and
burrow into the stomach lining, where they live and create ulcers,
gastritis, and possibly stomach cancer due to H. pylori. H. pylori has
also been implicated in heart disease, gum disease, asthma, rosacea,
and chronic headaches.
?If a stomach ulcer has developed as a result of H. Pylori infection,
then acid-lowering treatments are also temporarily necessary to allow
the ulcer to heal, but to prevent its recurrence, acid levels will
have to be maintained on the normal or even high side from there on.?
http://www.acu-cell.com/dis-hpy.html
Interestingly, before today?s generation of stomach acid blockers like
ranitidine (Zantac) and esomeprazole magnesium (Nexium) some people
who had suffered severe heartburn, and were unsuccessfully treated,
would notice relief when being treated for other bacterial infections.
For example, a heartburn sufferer would feel wonderful when being
treated with antibiotics for a strep throat or bronchitis! This
actually led some researchers to discover a correlation between
stomach ulcers and gastric bacteria!
So, when you are treated with an antibiotic regimen to wipe out the
H. pylori infection, you feel great. Some doctors are learning that
this therapy is more effective if the patient takes a stomach-acid
reducer such as Zantac or Aciphex concurrently. Shortly after a
completed regimen, upon re-infection, you begin to experience the same
symptoms as before. If your symptoms are particularly bothersome, and
you are in a relationship with someone, you may consider having that
person tested and treated in tandem with you.
?When acid suppression is removed, the majority of ulcers,
particularly those caused by H. pylori, recur. Since we now know that
most ulcers are caused by H. pylori, appropriate antibiotic regimens
can successfully eradicate the infection in most patients, with
complete resolution of mucosal inflammation and a minimal chance for
recurrence of ulcers.?
http://www.cdc.gov/ulcer/md.htm#infect
You can see some interesting, and graphic pictures of the H. pylori
bacteria and its effects on the stomach here:
http://www.bact.wisc.edu/Bact330/lecturehelico2
Further information:
http://www.helico.com/
http://articles.findarticles.com/p/articles/mi_m3225/is_12_61/ai_62829342
Hope this has helped you understand H. pylori infection better! If any
part of my answer is unclear, please request an Answer Clarification,
before rating. This will allow me to assist you further, if possible.
Regards,
crabcakes
Search Terms
H.pylori re-infection |
Request for Answer Clarification by
thebookguy-ga
on
03 Jun 2004 17:44 PDT
Thank you for the research. However, I had already been aware of this info:~ )
I am wanting to know why I have the symptoms again & I feel sure the
bug & have had for some years in an active state but why the test said
no infection. I have the exact same symptoms. More than reinfection, I
don't believe the course of medicine was sucessful in ridding me of
the bug. This is normal. I believe it simply sent him hiding a bit.
He's back in force & the fecal test said no he's not.
|
Clarification of Answer by
crabcakes-ga
on
03 Jun 2004 18:04 PDT
Hi thebookguy,
Your clarification is a bit confusing to me, perhaps I'm missing
something. You said you are having symptoms again, and you said "I
have the exact same symptoms. More than reinfection, I don't believe
the course of medicine was sucessful in ridding me of the bug. This is
normal. I believe it simply sent him hiding a bit. He's back in force
& the fecal test said no he's not." What do you mean by "This is
normal"?
1) You don't think it could be a re-infection, but a continuation of
the original infection? You feel like the first course of antibiotics
did not effectively clear the infection?
2) Were *both*, the first and the second tests based on stool(fecal)
samples? Did you not have a blood test and/or breath or biopsy test?
Not all people who have H. pylori shed the bacteria in their
stool-many do, but not all patients do. It is possbile to be infected
and *not* shed H. phlori into the stool. The stoll antigen test is not
as sensitive as the biopsy test, and the blood test can still show
positive, even after treatment.
If you are still having symptoms, with a negative stool test, this
indicates you may be either re-infected, or still infected. The
antibiotics can destroy enoguh bacteria so that they will go
undetected in the stool.
I would suggest getting a biopsy for a definitive result. If you don't
care to have the biopsy, many doctors will re-treat anyway with
another regimen of antibiotics, perhaps trying a different trio. The
breath test is much easier than a biopsy: "For the urea breath test,
you swallow a capsule or drink water that contains urea. The urea is
tagged with radioactive carbon (carbon-14) or a form of carbon that is
not radioactive (carbon-13). If H. pylori bacteria are present in your
stomach, they will break down the urea, eventually causing you to
exhale carbon dioxide that contains the tagged carbon. If you have no
H. pylori bacteria in your stomach, the urea does not break down and
instead passes out of your body in your urine. The breath test is not
always available. This test is accurate and safe."
http://www.questdiagnostics.com/kbase/topic/medtest/hw1531/descrip.htm
Stomach biopsy.
" A small sample (biopsy) is taken from the lining of the stomach and
duodenum. Several different tests may be done on the biopsy sample. It
may be treated with chemicals to see if an enzyme that breaks down
urea is present. The presence of the enzyme indicates an H. pylori
infection. The biopsy sample may be stained with a special dye and
examined under a microscope to look for H. pylori bacteria. In rare
cases, a sample may be placed in a container that promotes the growth
of H. pylori bacteria. This is called an H. pylori culture. If
bacteria grow in the culture, tests (called susceptibility or
sensitivity testing) can be done to determine which antibiotic should
not be used to treat the infection. A stomach biopsy is the most
difficult and expensive method to test for H. pylori infection."
http://my.webmd.com/hw/heartburn/hw1531.asp
You seem to still either have the original infection, or you have been
re-infected. Without a more definitive test, there is no actual way of
knowing. It certainly sounds like you need another course of
antibiotics.
I'm sorry I duplicated information in my answer that you already had,
of course I had no way of knowing what you already had! I hope this
clarification has cleared things up for you.
Regards,
crabcakes
|
Request for Answer Clarification by
thebookguy-ga
on
03 Jun 2004 18:56 PDT
"I'm sorry I duplicated information in my answer that you already had,
of course I had no way of knowing what you already had!"
Your exclamation indicates I upset you by not accepting your answer
out of hand? That was not my intention.
I realize you have no way of knowing what knowledge I have or don't on
the subject. Your original answer did not address my question of why
the second test was negative.
You may be correct that I was re-infected, I'm certainly no expert.
Personally I don't believe it would have happened that quickly. The
original test was a blood test which of course would not be effective
now. The doctor today said the original test simply said I was at one
time exposed. I would like to have the breath test & may elect to go
elsewhere since this doc does not do it but would rather scope. I may
end up getting scoped but would like to save that pleasure for later.
I am also trying mastic gum & may look at taking an herbal mixture
before electing the traditional allopathic course again. Are you a
physician?
Your follow-up was more to the point of my question. I would
appreciate your further thoughts.
|
Clarification of Answer by
crabcakes-ga
on
03 Jun 2004 21:04 PDT
Gosh no thebookguy, I was not upset at all, and I truly apologise if I
came across that way -- that was not my intention!
I am not a physician. I am an MT(ASCP), Medical Technologist,
certified by the American Society for Clinical Pathologists, with an
interest in medicine and over 25 years of working in hospitals. That's
how I remembered H. pylori used to be called Camplyobacter pylori,
eons ago when I was in college! During my years in health care, I have
also worked as a hospital interpreter, which truly broadened my
knowledge and interests!
According to the following studies, the incidence of reinfection may
be low, unless, as I previously wrote, perhaps a household member were
also positive. Infection of a separate strain is always possible too,
but DNA typing of the organism is expenxive and not commponly
warranted. However, recrudescence (recurrence of same infection) is
highly possible. Both seem to commonly occur within a year of the
first course of therapy.
Regarding re-infection, I found this Italian study that may interest you
"Helicobacter pylori (H. pylori) infection plays an important role in
the cause of duodenal ulcer (DU). Successful cure of the infection
modifies the natural history of the disease, leading to a dramatic
reduction of recurrence.1 In the event of a recurrence, DU can be due
to reinfection or recrudescence by H. pylori, therapy with
nonsteroidal anti-inflammatory drugs (NSAIDs), or rare and less clear
pathogenetic mechanisms. Differences in H. pylori reinfection rates
have been reported in several studies,2-4 and a comparison of strains
obtained prior to and after therapy by fingerprint analysis was rarely
possible. Therefore, it remains speculative whether true reinfection
occurred, or whether it was simply a recrudescence of the previous
bacterial infection.5 The objective of our study was to assess the
incidence of reinfection and new ulceration events after demonstrated
Helicobacter pylori eradication, in a cohort of patients with
recurrent duodenal ulcers.'
http://www.kfshrc.edu.sa/annals/194/98-241.html
and this paper from Vienna, Austria
"Analysis showed that reinfection had been caused by the same H pylori
strain and identified the spouses of these patients as carriers of the
identical strain. Considering the genomic diversity and the
interpatient heterogeneity of H pylori these results suggest a person
to person transmission of H pylori reinfection. By the end of the
observation period reflux oesophagitis had developed in 10 of the 16
patients who had not been reinfected. This surprising finding may be
explained by the changed eating habits of patients after healing of
duodenal ulcer disease."
http://gut.bmjjournals.com/cgi/content/abstract/36/6/831
If you are living in Peru or Japan, watch out!
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14593583&dopt=Abstract
"Reinfection of Helicobacter pylori after eradication is rare in
developed countries but most often occurs within 1 year. In the
present study, we attempted to differentiate between reinfection and
recrudescence of H. pylori strains between 6 months and 6 years after
successful eradication in Japan, a country with a high prevalence of
H. pylori infection."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12752730&dopt=Abstract
By the way, the breath test is the most reliable and sensitive test
available, so you should not need to put yourself through endoscopy!
Sincerely,
crabcakes
|
Request for Answer Clarification by
thebookguy-ga
on
04 Jun 2004 07:56 PDT
I?m really glad you weren?t upset. I appreciate the extra info too.
Can you tell me anymore about the validity of the breath test? For
some reason the docs in my area (small town) don?t do the breath test.
They would rather scope. It seems to me that should be the last
option. However, allopathic medicine doesn?t always make sense to me.
I can probably get my pcp to send me to a gastro doc who may do the
breath, don?t know. The only info I have available about all this is
what I find on the ?net & I?m limited in being able to read through it
because of my health. I have had CFS for a long time & I suspect the
Helicobacter too. Just going to the doctor yesterday took so much out
of me it sent me to bed all day & today will be slow. If you have
access to more info & are so inclined I would love to have it. Your
sifting through for the most pertinent is very helpful. Either way I
will rate your answer top. Thanks a lot!
|
Clarification of Answer by
crabcakes-ga
on
04 Jun 2004 08:08 PDT
Hello thebookguy,
I have seen your clarification, and I will be glad to outline the
breath test, along with more info. I will be away most of the day, but
I will post this evening.
Regards,
crabcakes
|
Request for Answer Clarification by
thebookguy-ga
on
04 Jun 2004 20:09 PDT
Looking forward to it, crabcakes.
Thanks,
Ed
|
Clarification of Answer by
crabcakes-ga
on
04 Jun 2004 22:36 PDT
Hi again thebookguy,
You were interested in more information on the breath test for H.
pylori. In fact, this test is the most accurate, and considered the
Gold Standard in H.pylori testing. Without meaning to sound *too*
cynical, an endoscopic procedure does return a larger return for the
doctor than a lab test, which you have done elsewhere. In fairness,
many family doctors may not be very familiar with the breath test. I
have more information on the breath test at the end of this
clarification.
I?m also sorry to hear that you are suffering from CFS, and I hope you
have a sympathetic doctor! CFS and fibromyalgia affect many people and
it seems many patients are not taken seriously. I do want to warn you
about trusting medical information from reliable sites only, however.
Sites published by universities, medical institutions and the
government are considered reliable. Information published by vitamin
and/or supplement sellers may be questionable.
I found these articles, about CFS and homeopathic treatment, a bit off
topic, but they may interest you.
http://experts.about.com/q/974/650715.htm
http://www.cfs-recovery.org/gastroin.htm
While trying to find some research that may link CFS and H.pylori
infection, all I could find were alternative medicine sites or sites
that were selling supplements. Personally, I don?t put much stock in
medical advice sites that are also selling a product. Since I was
unable to locate reliable medical information linking the two, I will
have to venture a guess that conventional medicine does not consider
one condition affecting the other. There is always a possibility
though!
A bit more general information:
?An estimated two-thirds of the world?s population is currently
infected with the H. pylori bacterium. The annual incidence of
symptomatic peptic ulcer disease in the United States is now
approaching two percent of the population, with 500,000 to 800,000 new
cases diagnosed each year.?
http://www.ameripath.com/patients/gi/peptic.htm
?However, a small group of patients will need to be treated again with
a different combination of drugs because some strains of H. pylori
have developed resistance to some of the drugs.? And ?Once an H.
pylori infection is cured, reinfection is not common, probably
occurring less than 5 percent of the time. There has not been a great
deal of research done in this area. The few studies that have been
done show that reinfection tends to occur from close contacts, such as
family members?
http://www.ivillagehealth.com/experts/digestive/qas/0,,287884_174383-2,00.html
Urea Breath Test for H.pylori
With the availablity and ease of this test, why get 'scoped?
?The UBT is considered to be a gold standard for both diagnosis and
assessment of eradication after therapy, and the test has been well
accepted since its introduction.?
http://www.mdsdx.com/MDS_Metro_Laboratories/Health_Care/newsletters/MDS_Metro_Physicians_Newsletter_Volume_3_Number_1.asp
Medicine Net describes the UBT (Urea Breath Test): ?For the test,
patients swallow a capsule containing urea made from an isotope of
carbon. (Isotopes of carbon occur in miniscule amounts in nature, and
can be measured with special testing machines.) If H. pylori is
present in the stomach, the urea is broken up into nitrogen and carbon
(as carbon dioxide). The carbon dioxide is absorbed across the lining
of the stomach and into the blood. It then is excreted from the lungs
in the breath. Samples of exhaled breath are collected, and the
isotopic carbon in the exhaled carbon dioxide is measured?
So, if the isotopic carbon is detected in your breath, it means that
H. pylori is present in the stomach. This test *will* turn negative if
you have completely wiped out the growth of H.pylori is stopped with
effective antibiotics. The test cost about $120 .
http://www.medicinenet.com/urea_breath_test/article.htm
?The H. pylori breath test is non-invasive and is as accurate as
endoscopy with biopsy
(1). It is superior to serology, since it detects only active
infection. Therefore, this is an excellent test for diagnosis of
current infection, as well as confirmation of successful eradication
by therapy. It is also a safe test. Carbon-13 is stable, naturally
occurring, and non-radioactive. About 1% of the carbon dioxide and
urea normally found in the body is in the carbon-13 form.
Patients should be fasting for at least one hour prior to testing. To
minimize false
negatives, at least 4 weeks should elapse after treatment before
re-testing to confirm
eradication.?
http://depts.washington.edu/labweb/test/wn/hpylori.pdf
You can see a simple illustration of the test here:
http://www.dianon.com/advbod.htm
Your doctor?s office can administer the UBT. This ?send off test? was
new to me, and rather interesting!
?The BreathTek? Urea Breath Test (UBT) provides a simple, safe,
non-invasive and cost-effective solution to diagnose and monitor
treatment of ACTIVE H. pylori infection. The test can be administered
in the doctor's office, clinic or patient service center in about 15
minutes. No special in-office licenses or equipment are required.
Everything needed is contained in the BreathTek? UBT Collection Kits.
Simply administer the test and send breath samples in the return
packaging to our testing laboratory.
·Diagnose & monitor treatment - FDA approved to identify H. pylori infection
·Simple to perform - Now takes about 15 minutes to complete the
administration procedure
·Cost effective - covered by most major insurance carriers, including Medicare
·Non-invasive - as accurate as endoscopy with biopsy
·Superior to serology tests - Specifically detects ACTIVE infection?
http://www.metsol.com/ubt_home.htm
This UBT by Oridion (From Israel) provides immediate results, without
the need for waiting!
?The test preparation and administration is simple and when completed
the BreathID® system automatically stops the test and prints a hard
copy of the results. Total test time is less than 10 minutes for the
average patient.
There is no need to send the sample to a laboratory for analysis; the
analysis is performed immediately in the physician-patient
environment.?
For questions and/or tech support:
Technical Support Contact
Technical Service Manager
P.O. Box 45025
Jerusalem 91450
Israel
Tel: +972 2 5899211
Fax: +972 2 5828868
email: bidsupport@oridion.com
http://www.oridion.com/english/products/breath_testing/breath_test_applications/h_pylori/
If your doctor is not willing to use the above mentioned tests, she/he
will have access to information about local performing labs, and can
arrange for you to have the UBT.
I certainly hope you can get this cleared up. Maybe your CFS *will*
improve if the nasty Helicobacter pylori is completely eradicated from
your gastric lining!
Sincerely,
crabcakes
|
Request for Answer Clarification by
thebookguy-ga
on
05 Jun 2004 06:07 PDT
Thanks very much, crabcakes. I wish I knew someone in the medical
field who would communicate with me via email to answer my questions.
I found out long ago I would have to educate myself since the largest
part of the medical community doesn?t understand CFS. I have tried to
obtain knowledge but having CFS makes that hard. Again, much thanks
for all your work. My best to you and yours. May good health stay
with you:~ )
Ed West
|
Clarification of Answer by
crabcakes-ga
on
05 Jun 2004 09:30 PDT
Thank you thebookguy,
Here are a few sites with reliable information on CFS:
CDC
http://www.cdc.gov/ncidod/diseases/cfs/
Chronic Fatigue and Immune Dysfunction Syndromw Assoc. of America
http://www.cfids.org/
NAtional Institutes of Allergy and Infectious Disease
http://www.niaid.nih.gov/factsheets/cfs.htm
Reliable Health Sites in General
Medline Plus
http://www.nlm.nih.gov/medlineplus/tutorial.html
Mayo Clinic
http://www.mayoclinic.com/index.cfm?
Healthfinder
http://www.healthfinder.gov/
And, of course, you can always fill out the form to ask another Google
Answers question!
Good Health to you,
Regards,
crabcakes
|
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