Helicobacter Forums

Hello,
I'm a 42 year old female from the west of Ireland. I was diagnosed with h. pylori in 2010 via a stool test. My symptoms were nausea, burping, regurgitation of food, pain while eating, chest pain, loss of appetite, weight loss, fatigue etc. I was treated with triple therapy, rechecked a month later via stool test and endoscopy a few months later. H. pylori was successfully eradicated. I feel like I had it for many years previously. I always suffered from bad breath which immediately cleared up when h. pylori was eliminated.

However, over the last 2-3 months I've had bloating, fatigue, loose stools sometimes. I don't drink much alcohol at all but overindulged on a night out and suffered severe heartburn and burping that night. My stomach hadn't been right leading up to that night as mentioned. I went to my dr. 3 weeks later as my symptoms had not improved - burping a lot, even after sips of water and chest pain/burning pain after eating. My dr. said I'd alcohol-induced gastritis and I may have been stressed at the time also as work was v. busy. She gave me a PPI (Zoton fasttabs) for a month. I sent in a stool sample for h.pylori the next day before starting PPI. Results came back negative. (I think some urine may have got into my stool sample but would that have adversely affected the results?)

Now, despite nearly finishing a 4 week course of PPI, I'm not feeling much better. I'm still quite gassy, burp a lot (especially after eating) and I generally feel pain after eating (especially in chest/ribs area) often a burning pain. I also feel food is slow going down, feel mucousy in my throat and that something is stuck there sometimes. I read that h. pylori can affect motility and can alter the host's mood too. Is this correct? I get v. tired and anxious sometimes also.

I am also a coeliac (diagnosed at 32 yrs.) and I have a hormone imbalance (PCOS) so I have a sensitive stomach anyways and I'm prone to inflammation due to my endocrine disorder. I follow a strict gluten-free diet and gastro consultant says my endoscopy results are fine, coeliac antibody blood test results good etc.

I also have low iron stores and my cholesterol went down this year from 5 to 4.5. (I read that h. pylori feeds on iron and can lower cholesterol!)

I went back to my GP again. As my pain is related to eating (incl. burning pain in ribs) I've an abdominal ultrasound this week to check my gallbladder, stomach, spleen etc. Dr. advised me if ultrasound results are negative to start 7-day triple therapy for h. pylori afterwards. She said my stool test may have been a false negative and that because I had the infection before this is what is often done as h. pylori may be embedded in the lining. If I still have symptoms after triple therapy she will refer me for an endoscopy.

However, the prescription she gave me now: Clarithromycin, Amoxicillin and Losec is the same treatment I was given in 2010 for h. pylori. She was going to give me Flagyl but I was very sick after I was given it following surgery for removal of a twisted ovary in 2002 so I think I'm allergic to it.

What should I do now? I can wait until the ultrasound scan but I'd be most grateful for any advice re above and my queries below please.

1. Is it possible I have h. pylori again in spite of a negative stool test? They don't seem to do breath tests at my GP practice. (As I've had good results from 2 endoscopies in the last few years, I think my dr. is reluctant to send me for one now without trying triple therapy first).

2. Should I take the triple therapy as a test to see if my symptoms improve? If so, should I ask for different antibiotics and what combination would be best?

3. Does having coeliac disease/PCOS make me more vulnerable to re-infection of h. pylori?

4. I share a house with a friend (not a partner) - should they get tested? They are reluctant to take the treatment if positive. I am v. hygienic as are they but I've read confusing info. as to whether or not people you live with should be tested also.

5. Could my issues be related to SIBO/leaky gut instead?

6. I have fair Celtic skin but it gets very red/inflamed and it's been worse recently. Is there a link with inflamed skin/rosacea and h. pylori? I read rosacea is closely linked with SIBO also and the antibiotic rifaximin works well but my dr. was reluctant to give me this.

7. Over the last 2 weeks or so I've also noticed some white bits in my stool (like small pieces of cotton wool). I'm not sure if they are mucus/parasite etc.
Should I get tested for parasites? Should I get tested for candida also? My stool tests have only ever been checked for h. pylori. I've had endoscopies & colonoscopies in recent years but I don't think they check for parasites/candida?

Many thanks for your help!

first of all, if endoscopy comes back ok, meaning no abnormality, no ulcer, and no cancer, I agree with your Dr. that there is really no need for another check up.

So, the question is, do you still have H. pylori after 2010? if you do, does it mean that your previous treatment failed? or you are recently reinfected from your housemates? if it is the formal, that means you cannot take the same treatment again. If it is the later, then you can take the same treatment.

In regards to stool test, it is quite sensitive. The only reason for a false negative will be because you have low bacteria load. PPI and antibiotics can reduce the bacteria load and give false negative. So, perhaps you should repeat this test. What about your previous endoscopy? did the doctor get a histology report? perhaps the pathologist kept your slide and can review it to see if there is any H. pylori.

i wouldnt recommend antibiotics without testing positive for H. pylori. the antibiotics will kill off all your good bacteria or in very rare case, induce resistance to other bacteria.

if you are truly negative for H. pylori, perhaps you want to see a dietitian or immunologist to find out if you are allergic to other food?

People said H. pylori is associated with rosacea. But H. pylori only stays in the stomach and no other place. So i think it is other pathogen that give you the rosacea and the triple therapy may be helpful in killing off this unknown pathogen.

you may ask your GP for parasite test.

Thanks for your reply. My abdominal ultrasound came back fine, no gallstones etc.

Regarding my recent stool test which was negative for h. pylori, I wasn't on any medication/antibiotics etc. when the sample was taken. I started a 1-month PPI the day after the stool sample was submitted. Does this mean that I am truly negative for h. pylori?? Please advise.

My dr. said this may be a false negative and that as I had it once before, it would be worth doing triple therapy again. If I'm still symptomatic I will be referred for an endoscopy. I'll check with my GP again re histology report and whether h. pylori was successfully eliminated in 2010. I suspect it was though as I recall having a follow-up stool test & endoscopies.

I agree with your advice that antibiotics should not be taken unless I test positive for h. pylori.

A dietitian/immunologist is a very good suggestion, which I would be willing to explore but I'm keen to clarify whether or not I have h. pylori first.

Thanks for your assistance.

Do you know if your doctor have access to breath test? perhaps that's the test you need to find out if you are truly H. pylori positive.

I think, you probably have a special strain that the stool antigen doesnt recognise. but that's just a hypothesis.

Clean up your diet is pretty much all I can say. Forget the antibiotic route it was negative from the stool. If you really want to know than do another upper endoscope to make sure its negative..Stay away from another route of antibiotics unless you get a positive for H. plyori. Like said clean up your diet cut out the crappy processed foods and sugar. See a dietician. I prefer keto style diet at like 80%, little bit of carbs at times.