Hpylori info please

[sandy]

Hi, I just got a test back on hpylori and the doc. indicated I should go see a G.I.  I wondered if anyone else here had heard that with ANY bacteria (& I think hpylori is a bacteria) that if you have it, it can interfere with minocin…I've read that if you have strep for example it can interfere with minocin…so Im wondering if a GI will know how to treat this as I'm on minocine and Clindy (just got prescribed clindy to add to mino from Dr. F).  I have a call in to Dr. F, but his ph. message said to go see a GI (I'm a new out of town patient for Dr. F).

My fear is that an ordinary GI doc won't know how to balance my need for both both clindy and Mino….any one else had this? (I know hpylori is treatable with antibiotics, so I know I will prob. get a dose of antibiotics prescribed).  Thanks, Sandy

[Susan LymeRA]

Hi Sandy,

How odd your doctor is sending you to another doctor for H.P.

I was first treated by my GP for HP in spring 2004.  I was treated with 10 days Prevpack which is ammoxycillan, biaxin, prevacid.  I felt fabulous afterward.  This was 1 1/2 yrs before RA hit.

April 2007, I recognized the symptoms and was again treated with the same medicine.  May 2007 I was bit by another tick and within 48 hrs I had fever, chills, and all my joints were inflamed.  So I went to a lyme specialist.

She ran bloodwork and saliva test and stool sample.  The stool sample showed I was still heavily infested with H.P.  She gave me the prevpack for months.  Within 30 days all my symptoms were gone and have been doing very well since, though I am still weak positive for RA.

She is doing other things to treat the other stuff she found, but that is my story on the HP.

Any doc can prescribe abx for HP and I don't understand why you are being sent to a GI.  Just tell the GI about your minocycline.  My dr switched my mino to doxy, same dose (100mg MWF) and I kept taking it right along with the Prevpack.

Susan

 

 

 

 

 

[Maz]

Hi Sandy,

You don't mention your dx, but there have been studies that link RA with H Pylori infection. In one study done in Europe, I think it was about 50 or 60% of patients with RA who tested positive for H Pylori and were treated with clarithromycin (brand name biaxin) saw a great decrease in their RA symptoms. I'm not on my usual laptop at the moment as it's not powering up properly, but I have the study bookmarked and will post it here, if I can get it working again. Otherwise you might try looking through PubMed for studies with key words like “clarithromycin”, “RA” and “H Pylori.”

My current Lyme protocol includes both minocin and biaxin, so they can be taken concurrently without any problem. I'm not sure about Clindy IVs. In any case, if you have RA, you may well see a significant reduction in symptoms on biaxin! 😀

Peace, Maz

 

 

 

 

[linda]

I had a peptic ulcer 4 yrs ago caused by H. Pylori. I was given a dose pack of zithromax and felt much better about 3 weeks later. When my stomach problems began to return about a year ago, I asked my doc if he thought it could be another infection, he said that once you get H. pylori and treat it with abx, you can't get it again. More conflictiong info- do these docs know how much they contradict each other? it sure makes life difficult for us. My current problem is supposedly caused by the meds I take, which is likely the case since I've been on prednisone and Mobic for over 10 yrs.

One word of caution, if you treat the H. pylori with abx, make sure it's safe to take with the abx you are already taking. You could completely wipe out the flora of your intestines with certain combos of abx- the result being diarrhea severe enough to cause death. Again, this is from my doctor's mouth, so there is probably another medical opinion that it's perfectly safe! Make sure you keep up with your probiotics, too.

Hope you get this problem resolved soon,

linda

[Susan LymeRA]

Wow Linda.  I never heard that about only getting H. Pylori once.  It doesn't make sense with what I know about H. Pylori.  It is a bacteria you can pick up anywhere.  In my case, none of the 3 doctors who have treated me for H.P. ever did a follow up test (breath test) to be sure it was gone.  Duh?  So, who knows if I was reinfected or if two weeks treatment was not sufficient.

Regardless, the treatment eliminated the remainder of my joint pain.  Now if I could just get the bloodwork to say “negative”.  I'm close, but can't seem to go all the way.

Susan

 

[roserdRA]

Go to Wikipedia and check for Helicobacter pylori. It is very well explained there, including treatment options.

[linda]

It seemed strange to me as well, Susan, after all, we can get strep, pneumonias and other infections more than once. I was always told that we can only get chicken pox once, but my body, always eager to prove prevailing medical opinion wrong, managed to get it 3 times. Apparently the first time I had a mild case, the second time was worse, the third time they thought it was a different strain of the virus. I really don't know what to think. There are infections that we can only get once, otherwise immunizations wouldn't work, but i've never heard anything about a vaccine for H. pylori.  Sometimes it seems like the more we learn, the less we know.

linda

[sandy]

Hi Susan and others, it was odd to be sent to another doc for h pylori, but maybe because Dr, F is out of town and he needed me to go to someone else…I put in a call to dr. F, however, as I am on Minocin MWF, 100mg and he added Clindy every day 300 each tablet. The assistant today said I would have to STOP mino and I asked what about CLINDY and she said she would check….I had high hopes of everything being taken care of with a specialist, but I am back to worrying and having to figure things out myself….so tiring! Where's my magic pill! So I wondered how Dr. F could say I will have to stop mino..how will he know what the GI or the gen. MD will prescribe….I can't get in to the gen. MD for a week…in themeantime, how does HPYLORI impact RA….I heard othrs say it caused the RA symptoms….did brown or scammel discuss this? I haven't read it if they did….

[sandy]

hi Maz, I'd be interested in the study (hpylori and RA) if you find it…I mentioned to susan that Dr. F said NOT to take mino since I have hpylori….it's intersting that you stayed on it…..I will try to find out why he thinks that over the phone…I had it once in 99, cannot recall what antibiotic I took, but I may have had this for a while now, undetected, so yes, it can come back…(some doc said it couldn't). I decided to try to see a gen MD, who knows I'm on minocin…maybe will get a little better treatment….Sandy

[Maz]

[user=163]sandy[/user] wrote:

hi Maz, I'd be interested in the study (hpylori and RA) if you find it…I mentioned to susan that Dr. F said NOT to take mino since I have hpylori….it's intersting that you stayed on it…..I will try to find out why he thinks that over the phone…I had it once in 99, cannot recall what antibiotic I took, but I may have had this for a while now, undetected, so yes, it can come back…(some doc said it couldn't). I decided to try to see a gen MD, who knows I'm on minocin…maybe will get a little better treatment….Sandy

Hi Sandy….really sorry, but my laptop is going to be out of action for a while as it has to go for repairs and that's where I have the study bookmarked. If you do a search on the old BB, though, typing in “H Pylori RA Clarithromycin”, it should come up. John McD just posted a link below to access the old BB, but you may have to wade through a lot of porn spam. I think Laura or Susan posted that particular study originally, so they may still have it bookmarked on their pcs.

I just did a quick search online and found these, but there are plenty more if you have time to search more. I just used the same keywords as above:

http://www.druglib.com/abstract/og/ogrendik-m_curr-med-res-opin_20070300.html

http://www.ncbi.nlm.nih.gov/pubmed/12144579

Peace, Maz

[richie]

Hi

Dont think its odd at all –Dr F is a rheumatologist that deals with rheumatic diseases –H. Pylori is a GI disease that is best treated by a GI doctor —I think its a correct and ethical decision for DR F to mention a GI specialist

richie

[Susan LymeRA]

My goodness Richie! You sure are handsome!:P

I saved the H. Pylori study to my Word program so I no longer have the link, but here is the study.

Eradication of Helicobacter pylori may reduce disease severity

in rheumatoid arthritis

P. ZENTILIN*, B. SERIOLO_, P. DULBECCO*, E. CARATTO_, E. IIRITANO*, D. FASCIOLO_,

C. BILARDI*, C. MANSI*, E. TESTA* & V. SAVARINO*

*Dipartimento di Medicina Interna e Specialita` Mediche, Cattedra di Gastroenterologia and _Cattedra di Reumatologia,

Universita` di Genova, Genoa, Italy

Accepted for publication 11 March 2002

SUMMARY

Background: A triggering infectious agent has long been

postulated in rheumatoid arthritis. Data on the possible

role of Helicobacter pylori infection are lacking.

Aim: To assess the effect of H. pylori eradication in

patients with rheumatoid arthritis.

Methods: Fifty-eight adult patients with established

rheumatoid arthritis and dyspeptic symptoms were

recruited ? 28 were H. pylori-positive and 30 were

H. pylori-negative on the basis of invasive tests. All

infected patients were treated successfully. We evaluated

the disease activity using clinical and laboratory

parameters at baseline and every 4 months during

2 years, and compared the variations in the two

subgroups.

Results: H. pylori-eradicated rheumatoid arthritis

patients showed progressive improvement over time

(P < 0.0001) of all clinical indices compared with

baseline, whereas H. pylori-negative rheumatoid arthritis

patients remained substantially unchanged. After

2 years, H. pylori-eradicated rheumatoid arthritis

patients differed significantly (P < 0.04?0.0001) from

patients without H. pylori infection in terms of improvement

of all clinical parameters. At the same time point,

several laboratory indices (erythrocyte sedimentation

rate, fibrinogen, a2-globulins and antinuclear antibody)

showed significantly lower values (P < 0.02?0.0003)

in the H. pylori-eradicated subgroup compared to the

H. pylori-negative subgroup.

Conclusions: Our data suggest that H. pylori infection is

implicated in the pathogenesis of rheumatoid arthritis,

in that its eradication may induce a significant improvement

of disease activity over 24 months. H. pylori

eradication seems to be advantageous in infected

rheumatoid arthritis patients, but controlled studies

are needed.

INTRODUCTION

Rheumatoid arthritis is an inflammatory chronic disease

with an autoimmune pathogenesis whose aetiology

and progression are multifactorial, including a

range of immune, genetic, neuroendocrine, environmental

and psychosocial factors.1 An infectious aetiology

of rheumatoid arthritis has also been postulated,

but, although many germs have been proposed as the

triggering agent, none has been identified. Several

antibiotics have also been shown to be effective for

patients with mild to moderate rheumatoid arthritis,

although their mechanism of action remains unclear.

2, 3

Recently, Helicobacter pylori infection has been associated

not only with chronic gastritis and peptic ulcer, but

also with many extraintestinal disorders.4?6 Among the

latter, a correlation has been found between this

_ 2002 Blackwell Science Ltd 1291

Correspondence to: Professor V. Savarino, DIMISM, Cattedra di Gastroenterologia,

Universita` degli Studi di Genova, Viale Benedetto XV, n. 6,

16132 Genova, Italy. E-mail: vsavarin@unige.it

Aliment Pharmacol Ther 2002; 16: 1291?1299.

bacterium and various autoimmune diseases.7?9 So far,

the potential role of H. pylori infection in rheumatoid

arthritis has been poorly investigated.

In this study, we evaluated the prevalence of H. pylori

infection in a population of rheumatoid arthritis patients

and the effect of its eradication on various

symptoms and inflammatory indices, in order to

determine whether there is a possible link between the

bacterium and disease severity in these patients.

PATIENTS AND METHODS

This study was conducted in accordance with the

Declaration of Helsinki and its revisions, and the

protocol was approved by the Ethics Committee of

the Department of Internal Medicine of Genoa

University. All patients gave informed consent to

participate in the study.

To be eligible for investigation, patients had to meet the

1987 American Rheumatism Association classification

criteria for rheumatoid arthritis.10 Patients had to be

18 years of age or older. Patients with other systemic

diseases, who had undergone surgery of the gastrointestinal

tract, who had an active peptic ulcer or who had

undergone surgical synovectomy in any large joint were

excluded. Women who were pregnant or not practising

a reliable method of contraception were also excluded.

Fifty-eight consecutive patients with dyspeptic symptoms

and variable rheumatoid arthritis activity were

recruited from September 1992 to March 1995. Their

demographic and clinical characteristics are reported in

Table 1. All patients suffered from upper abdominal

pain, nausea, vomiting, epigastric pyrosis and postprandial

fullness and therefore underwent upper endoscopy.

Twenty-eight were H. pylori-positive and 30 were

H. pylori-negative on the basis of concomitant positive or

negative findings of both CLO test (Delta West Ltd,

Bentley, Western Australia) and histology (modified

Giemsa stain) performed on three antral and two corpus

per-endoscopic biopsies. In two cases, CLO test was

negative, but the presence of H. pylori colonies was

clearly detected on histological preparations. The infected

subgroup was treated with 1-week eradication

therapy consisting of omeprazole, 20 mg b.d., amoxicillin,

1000 mg b.d., and clarithromycin, 250 mg t.d.s.

The bacterium was considered to be eradicated when

both CLO test and histology were negative at least

4 weeks after stopping therapy. In one patient who failed

to respond to the initial therapeutic regimen, a second 1-

week course of omeprazole, 20 mg b.d., amoxicillin,

1000 mg b.d., and metronidazole, 500 mg b.d., was

given and the success of this therapy was assessed as

Table 1. Demographic and clinical characteristics of the two groups of rheumatoid arthritis (RA) patients

H. pylori-positive patients H. pylori-negative patients

Number 28 30

Age (years; mean

[Maz]

Susan – you're terrific!  Thanks for digging that study out. I thought you might have it stored somewhere. 😉

Peace, Maz

[linda]

Once again, I'm disappointed in that AP doc in Scottsdale, you know, the one who wouldn't treat my stomach pain; he is the one who told me that once you have had H. pylori, you can never get it again. Prompted by this thread and the info provided here, I did some research. I found one artcle that stated that once eradicated, <0.5% of patients will redevelop the infection. But, what all the article said was that it is difficult to get rid of and usually takes a triple or even quadruple approach of abx and proton pump inhibitors.

I wanted to put this out before anyone was misled by the info I provided from my doc from my previous post.  I'm just going to quit using any info he gave me, none of it has been borne out by other doctors' studies or anecdotal evidence. So long, Dr. F.

Again, if it weren't for this board, I would be getting negligent treatment. Thanks again to all of you!

P.S. You know, I proof read this post twice and it still had tons of errors. This is getting really annoying!:doh:My brain is turning to mush.

[Maz]

Hi Linda,

Sorry to hear you've had conflicting information that's led you up the garden path. T'was ever thus, every single doctor will have their own opinions about everything under the sun. An example – A friend of mine was suffering from severe post-partum depression…she went to 5 or 6 different doctors of different specialities…every single one had a different opinion of what was wrong with her. The suffering she went through was horrendous in the meantime.

Just scanned the study quickly – looks like these patients were followed for 2 years for their H Pylori and RA improvements…I wonder if that means they received abx for that long or whether they were just followed for reoccurance of infection….hmmm…will have to read through again to figure this out.

Peace, Maz

 

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