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Would you treat ​H. pylori​ regardless of age and treat patients with pancreatic insufficiency?

Chris Kresser: “Would you treat ​H. pylori​ regardless of age and treat patients with pancreatic insufficiency?”

No. I think the research now is suggesting that ​H. pylori​ doesn’t always need to be treated. It’s a function of how much is there and how virulent it is, which is why I like the Diagnostic Solutions test that gives you both of those characteristics. I recently had a patient that [was] hospitalized with severe gastrointestinal [GI] bleeding, and they tested them for ​H. pylori.​ They just used the breath test, ​so it’s [25:20]​ positive and negative. He was severely anemic. He was really, really bad off, really sick, like, probably the worst ​H. pylori​ infection I’d seen. He came to see us, and we did the Diagnostic Solutions test. He had super high levels and he had 7/8 of the risk factors that they test for that were positive, which I’d never seen before. I think there is a correlation there, and that test is useful because with that kind of presentation on the test results, we’re going to be way more aggressive than if the patient just has, like, the ​H. pylori levels that were detected below the threshold or cutoff and no virulence factors. In fact, we might often not treat in that situation.

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