Helicobacter Forums

Hello all,

I'm new to the forum. Some background about my case: I'm a 34 year old man in Washington DC. I've suffered from acid reflux once or twice a year for about the last 8 years, but it always cleared up quickly with Nexium products. I have in the past also had bouts of what I presumed was IBS, with poop just like saliva. But when I moved to the US from the UK 6 years ago, this largely stopped.

Anyway, in October I noticed that some fairly persistent acid reflux symptoms and weird stools were happening together. My symptoms had never really seemed "food triggered." But one day I drank a big pint of tomato juice. Within 2/3 hours I was in a lot of pain. Severe heartburn and indigestion like symptoms. Cramping stomach with pain if I bent over. I began a Nexium course, drank some Mylanta. The next day I woke up and my stomach sounded like a dishwasher - audibly very loud gushing. I had explosive green diarrhea.

But the anti acids seemed to work for a few days. I went to a wedding. After about 5 days though, I realised that my acid reflux symptoms were now persistent. I developed a constant low full ache through sometimes burning stomach. What's more, my stools remained extremely loose, and a dark green color. My stomach felt way worse 2/3 hours after food or on an empty stomach, and at night. After two weeks of this, I decided to try to get a Gastro appointment, but none were available until next year. I saw my primary care doctor. She did a breath test & blood tests, including for H Pylori. The breath test came back negative (likely a false negative given all the anti acids) but the blood test had antibodies suggesting a recent infection. She prescribed me a 14 day three treatment course of amoxicillin, clarithomycin, and pantoprazole.

I did the treatment. And things definitely improved a lot with the stomach. No more diarrhea, although stools still dark green. The acid reflux was better controlled, although it always felt like the tablets were merely holding back the tide. In fact, one day I underdosed on pantoprazole and was in a lot of pain. After two weeks my symptoms felt almost gone. My doctor advised continuing to take the panto for a couple more weeks as my stomach normalized.

However, 3/4 days after antibiotics were complete, some very mild stomach discomfort began reoccurring. This has now led to stomach gurgling, and the same dull and burning aches in the stomach again. My stool is still a very dark green. I went to a GI yesterday, and because I'm supposed to be off travelling for Xmas, he's arranged an endoscopy for today to try to identify what is going on.

I am posting this story to see if others have had similar tales, to ask whether anyone has had this return of symptoms after H pylori has cleared up or whether this sounds like the bacteria wasn't fully defeated? And to elicit any other tips an advice for eliminating symptoms. As an FYI: since the antibiotic, I've pretty much been on a diet of steamed vegetables, summer berries, and occasionally very light meats such as chicken.

Update: the doctor seemed relatively pleased with the endoscopy, but he did identify some furrowing in the esophagus and some nodules in the stomach, which he took biopsies of. My acid is definitely getting worse despite the continued pantoprazole. I have had acid and heartburn all day today, including a horrible mouth taste.

Some good news! My biopsy only found evidence of mild inactive chronic gastritis, but no active H Pylori or gastritis. So it seems as if the antiobiotic treatment was successful.

I would be really really grateful if anyone here had a good experience for a stomach normalisation post-H Pylori eradication? Right now I still get quite a bit of reflux and so still on prescription dose PPI. How to ease off of this? And any recommendations for a diet/general health plan to help repair my stomach more quickly?

Thanks

Ryan

sorry for the late respond. looks like you had successful treatment without much side effect.
There is no official guideline to recovery. Everyone is slightly different depending on the damage accumulated. Some people try herbs, probiotics, or green tea to ease the symptoms. You can try any as long as you dont overdose yourself.
Stay positive and eat healthy is always the key to good recovery.

Hi Helico Expert

My endoscopy in Sep 22 showed mild chronic gastritis associated with occasional helicobacter organism on the surface. I was put on 14 days treatment of Amoxicillin, Levoflaxin and Dexilant all twice a day. I complete the triple therapy treatment on 23 October but continued on Dexilant x2 day for another 5 weeks. As I felt the symptoms were under control i reduced to one Dexilant in the morning only. For the last week or so I am finding my symptoms have worsen - heartburn and pain in the epigastric.

I know if (and it is a big if) the helicobacter has gone then it would take time for mild chronic gastritis to heal but why would things get better and then get worse? Is this part of the healing process? Did I reduce the PPI too soon? Can I take H2 blocker like Cimetidine 400mg in between morning and evening dose of Dexilant 30mg?

Since i had the bug in Oct 2020 and after initial 7 day treatment had multiple stool and breath tests all negative but the histology in sept 22 still found the bacteria my gastro has suggested another endoscopy in Feb to confirm eradication.

Thanks Helico Expert

One thing I would pass on to everyone is if you have Helico stomach irritation, AVOID TOMATOES!!

The discomfort for me with them is INSTANT. I just accidentally had a bit of a sauce that had tomato as an ingredient and it aggravated my stomach, which had been getting better for days. In fact, it was a glass of tomato juice that gave me a terrible stomach that made me initially notice the infection.

So I went to a wedding in Guatemala last week and since then my acid reflux is back with a vengeance. Pretty constant. And today I have had a thick mucus stool. I don't know whether this is a new stomach complaint or some sort of H Pylori revival, but it feels like before - which is strange, because my endoscopy biopsy showed no sign of infection. I'm still on 2 Nexium per day and have had the occasional reflux.

I'm so over feeling like this. I've started getting stomach pains today too...

assuming you are truly H. pylori negative. Some patients can experience episodes of symptoms. Perhaps due to particular food that triggers the symptoms.
The aim is to have the episodes come less and less frequent and ultimately never comes back.

So most importantly is to make sure you are free of H. pylori.
make sure you do a follow up breath test when you are not taking PPI.
make sure everyone living under the same roof is free of H. pylori.

Hi Helico Expert

Under what scenarios could a breath test and/or stool test be NEGATIVE (with NO PPI for at least 14 days before these tests) but the histology of the biopsy taken returns a H Pylori POSTIVE. Have you come across such cases?

This was in my case and the histology also found mild chronic gastritis in the antral region. Took the 3 round of triple therapy in Oct 22 and since then symptoms got much better but then came back with vengeance but now has again subsided. Thinking of another endoscopy in March to check eradication as I can no longer trust breath or stool tests.

One gastro said to me that if H Pylori is dormant it will not produce enough chemicals (urea) for the breath test or if the quantity of H Pylori is low it will can be missed in the stool test but under biopsy since it is sample based the histology will detect the bacteria regardless of whether it is dormant or active. Is this theory correct?

When your stomach doesnt produce enough acid, then HP can turn off the urease pathway and produce false negative.

also, how negative is your negative result?
if 50 dpm is the cut off and your result is 49 dpm, then it's low confident negative.
if your result is 1 dpm, that would mean it's almost true negative.

Of course, it could be technical error where the breath test machine is not calibrated, or the test is not correctly operated by the technician, that could lead to false negative too.

Nevertheless, histology is the gold standard.