First, blood testing is not a reliable indicator for the verification of successful eradication of the H. pylori bacteria, post-treatment. Secondly, relief of symptoms such as abdominal pain is also an unreliable marker for verifying H. pylori eradication.Nearly all studies have found that successful treatment is associated with a 40 to 50% decrease in IgG levels by 6 months post-treatment. However, only about 25% of successfully treated patients show a complete disappearance of IgG antibodies, even when measured 3.5 years after treatment.
Abdominal pain and GI symptoms even after Prevpac or Pylera. What’s my next step?
The only reliable post-treatment blood testing is A combination IgG, IgM, and IgA PLUS a Western blot for antibodies recognizing specific H. Pylori proteins, including cytotoxin-associated gene A (CagA) protein and vacuolating cytotoxin A (VacA) protein.
The preferred follow-up procedure: The best follow-up test is still an H. pylori, stool, antigen assay, which detects H. pylori protein present in one’s bowel movement (stool). Unlike antibody assays, this test is positive only in association with active infection. All testing has a margin of error.
If your abdominal pain, gas, bloating, constipation, diarrhea.. still exist even after you have completed antibiotic treatment for SIBO or triple (Prevpac), quadruple therapy (Pylera) for the H. pylori bacteria, continue reading below.
H. pylori – If symptoms, such as abdominal pain, are still present after H. pylori treatment and you have not done an H. pylori stool antigen test or stomach tissue biopsy (most accurate), wait at least one month and get one of the two tests performed. If negative it’s most likely one of the 9 causes below, but can be #10 as well. Give me a call so we can work you up and find out what’s truly going on.
SIBO – If you tested negative for SIBO using a follow-up, 3-hour lactulose challenge, which measures both hydrogen and methane gas, give me a call so we can work you up and find out what’s truly going on. If negative it’s most likely one of the 9 causes below, but can be #10 as well.
- Excess histamine production in the stomach or an inability to enzymatically break down histamine – lack of the enzyme, diamine oxidase (DAO).
- Leaky gut (erosion of the microvilli of the small intestine). There can be multiple causes for this and there may be more than one cause active at a time.
- Lack of HCl and/or pancreatic enzymes production – multiple causes.
- Eating foods, not for your blood type (A, B, O, AB), causing inflammation. We need to find out your blood type.
- Inability to break down simple sugars, especially fructose.
- A deficiency of the enzyme alpha-galactosidase. This deficiency can cause an inability to break down certain complex carbohydrates found in many foods such as beans, vegetables, and whole grains.
- Blastocystis hominis, Clostridium difficile, E. coli or other pathogenic bacteria
- Parasites
- Excessive Candida albicans overgrowth.
- Many other causes
