Diagnosed and treated for H Pylori

[pylorihater]

I hope some of you can assist me. In March 2013 I started having a stabbing pain in my stomach and went to the ER a week or so later. They did an ultrasound, bloodwork, urinanalysis, and based upon my symptoms the doctor said I had gastritis/ulcer (I suppose unclear on which). I was put on Nexium 40 mg once per day. I had a follow-up visit and they bumped it up to twice a day. I'm in my 30s and they have not done an endoscopy as they are treating the symptoms first. A month later I felt even worse and finally found a doctor that would test me for H Pylori. Surprise, surprise I was positive. (Even my dog's vet was convinced I had it based on my symptoms.) Anyway, I was put on Flagyl and Amoxicillin for 14 days and Protonix (a PPI).

It's now been two weeks since I completed the antibiotics. I have had a few days here and there where I didn't really have any pain, but for the most part I still have pain (not as bad as it was). Food doesn't seem to change it, meaning it doesn't seem to be lactose intolerance or a food allergy. Sometimes I have the pain in my stomach and sometimes it is a little above my navel.

My biggest concern is that my stool seems to be reverting back to what it looked like prior to taking the antibiotics. It had been somewhat light colored, not quite a yellow color, and foul-smelling, which my doctor said is probably indicative of infection. Anyway, that is all coming back again. It's weird because I had a few days at the end of the antibiotics where it started looking more normal and was brown and now it is lightening up again and smells bad. I am having a re-check for H Pylori soon (not the breath because I am still on a PPI) and was wondering if it sounds like I still have H Pylori based upon these symptoms with the pain and abnormal stool. Any ideas?

[Helico_scientist]

It is difficult to say if you still have H. pylori based on the symptoms as it will take some time for the symptoms to disappear after eradication. Some antibiotics make the stools go darker so I wouldn't worry too much about that. It is important to check the eradication after treatment with a test like stool test or breath test ( not blood test). If it is still positive then you will need a new treatment with different antibiotics. If the symptoms persists I would suggest an endoscopy.
Good luck

[Helico_expert]

i wonder how are you going to recheck your H. pylori status if you are on PPI.

You'll have to stop PPI for at least 2 weeks before doing breath or stool test.

Blood test cannot tell your current infection status.

[pylorihater]

I know the breath test requires you to be off the PPI, but I didn't know you needed to be for the stool test. What happens if you're not? Will it be a false negative or false positive?

Does H Pylori change your stool? (I mean it being associated with gastritis or ulcers?)

[Helico_expert]

According to the guidelines, you should stop PPI before retesting for H. pylori. Reason is because PPI may reduce the H. pylori load and hence not enough to be detected by stool antigen test. hence a false negative result.

Similar to the UBT, the sensitivity of the FAT is affected by the recent use of bismuth compounds, antibiotics, and PPIs (108, 109).

from article: American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection

Nevertheless, a few studies did suggest that it will not be affected.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3251804/


The bottom line, if your stool test is positive. Then you know you still have it. If your stool test is negative, then you wonder, if it is because of stool test being affected by PPI, then you probably want to re-do another one 1 month later. Then again, the specialist and pathology lab are both very important. an experienced specialist and skillful laboratory may produce more accurate result. If your specialist is confident, then go for it.

[pylorihater]

It'll be a few weeks before I am retested. In the meantime, I have been taking probiotics and continuing on Protonix 40mg twice daily. I have symptoms that I would describe as flare-ups. I can go close to a week without being in pain and then I will have two or three days where I do experience an achy-type pain in my stomach and then it disppears again and will eventually come back. Based on your experience, does that sound typical of folks who are still infected or is it more likely that my system is beginning to recover?

[Helico_expert]

it's hard to predict anything at the moment. let's wait till you have your test redone. hopefully your "flare-up" will slowly sub-side and gone in a few weeks time.

[pylorihater]

I had the stool test done and it came back negative, so the first round of antibiotics apparently worked. I have stopped taking a PPI and am on no medications at present. I still have pain at times and what I would consider "flare-ups." Sometimes I will feel full for many hours after I eat and I can sometimes feel a "lump" around my sternum area. My doctor thinks it's possible it might be a hiatal hernia but I don't have heartburn or really any indigestion problems. It also wasn't noted on an ultrasound. My next step would be to have an endoscopy, but I'd rather not... at least not quite yet.

I know it varies person to person, but at what point should an "average" person feel back to normal after having been treated successfully for H Pylori? It's been nearly two months for me and the infection-type symptoms are gone, but I'm still dealing with pain in my stomach. Help!

[Helico_expert]

your problem may or may not be H. pylori. some people does waited a while for it's recovery. at least you know you are clear from H. pylori now. meanwhile, you probably want to visit a specialist to explore other possible cause. eg parasite

[pylorihater]

I did have many symptoms from H Pylori which are all gone, but what I was originally diagnosed with was an ulcer and/or gastritis. I had an ultrasound done and bloodwork, but they diagnosed me primarily on my symptoms. Because most ulcers and gastritis is often times caused by H Pylori, that's why I had the doctor test me for it and of course, came back positive. Now that the infection is gone (supposedly), I am still dealing with the other problem(s), which are not official because I haven't had an endoscopy. They tested my stool and found no bacteria or any "bugs," so I don't know what it is. Could it be diet related?