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Gastroenterology  (Expert Forum)
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Confused about H. Pylori - Please help!
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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MedHelp Member's Question

Confused about H. Pylori - Please help!

by mia28, Dec 31, 2003 12:00AM
I am a 36 year old female who began to have neurological & stomach problems six months ago. No previous health issues. Neurological problems consist of headaches, numbness, and occasional aches & pains.  Stomach problems consist of chronic stomach aches in upper area and loss of appetite and weight (15 pounds in 4 months).  Tested low positive for H. Pylori (reading of 114) through a blood test.  All other blood tests were fine.



Endoscopy this month indicated mild hiatal hernia and gastritis.  Biopsy revealed no H. Pylori.



Gastro doctor prescribed Nexium, which I started a week ago.  Symptoms still exist.  



Doctor did not prescribe treatment for H. Pylori since biopsy was negative.  I asked him why the blood test was positive if biopsy was negative and he explained that a strong regimen of penicillian I was on back in September (for treatment of a high ASO blood test) most likely destroyed the H. Pylori.  Is this possible?



Also, I have researched H. Pylori on the internet and discovered that long term, untreated H. Pylori can cause neurological problems and possibly a stroke.  Is this also possible?



I was also told that a mild hiatal hernia is common and benign and would not be causing my symptoms and would not require treatment.  Is this true?



Any advice and or information would be very much appreciated.  Thank you so much!
Doctor's Answer

by Kevin Pho, MD, Jan 04, 2004 12:00AM
Erin, GI PA has kindly addressed your question in her comments below and I agree with her assessment.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.
Member Comments (37)

by kevinmd, Dec 31, 2003 12:00AM
I will be away until January 4th. I will answer your question when I return.



Happy holidays,

Kevin, M.D.

by adiavel, Jan 01, 2004 12:00AM
Hi there. I'm a 31 year old male and I am experiencing nearly  the same simptoms like you.

Headaches are not very often but 2 months ago it all started with burning feeling in the upper part of stomach, left and then right side. The burning sensation extended few days later to whole my stomach. I tryied usual medication available in Superdrug shops without any good efect.

After 1 month of struggling with my problem I decided to see a private specialist doctor. I paid a lot of money and he performed an endoscopy. The results are: moderate hiatus hernia with gastritis, and an iflamated stomach. Good duoden and no ulcers. Biopsy test for H.pylori bacteria was NEGATIVE. Also, ultrasound-scanning reavealed NO problems with my GALL BLADDER.

The specialist said he reckons my inflamated stomach may be the result of the stress at my work-place (i cannot accept this explanation!). Hi prescribed me Nexium for 1 month which I have done it... but without any good. My symptoms stil persist. Now I don't have anymore the same acute burning feeling in the upper part of the stomach, it is been replaced by an very uncomfortable feeling in the lower part of my stomach and a lot of gas bulding in stomach and bowels after meals (30mins-1hour or so after meals).

I refuse to believe this is caused by stress, and I'm upset that he never performed any blood tests. I may see him again shortly.

Also he said that my moderate hiatus hernia cannot be treated succesfully. It is an unusually disease for a young person like me and I cannot do anything about that. It will help me if I sleep gradiently (with the head slightly up) to prevent the content of the stomach coming back to my throat while I am asleep, and to lose some weight. He said that the hiatus hernia will get eventually worse with the age, and after years, if the worse comes it exists some medication for that and even a "small" surgery which can be performed in connection with that.

I lost indeed about 12 pounds in the last month, but I don't know if it is the result of my diet or the result of my disease.

I'm desperate to find an answer for my problem and I'll be watching closely this forum. It may help me a lot.

Thanks for listening me and sorry for my bad english.

by GI.PA, Jan 01, 2004 12:00AM
The "blood test" for h-pyrlori will remain positive years after you actually have it.  So, in your case where you were treated with a large dose and duration of antibiotics a few months ago and now your stomach biopsy (the BEST way looking for a h-pylori infection) is negative, I agree with your doctor that treatment of the h-pylori with antibiotics is unneccessary.



If the endoscopy did not show the reason why you are having weight loss and upper abdominal pain, a CT scan of the abdomen (looking at the Pancreas) and perhaps a gallbladder work-up (ultrasound and maybe even a functional test) can be the next steps.  Your doctor may also consider raising your dose of Nexium to twice day dosing for a few weeks to see if this is helpful.



GI.PA

by GI.PA, Jan 01, 2004 12:00AM
"The specialist said he reckons my inflamated stomach may be the result of the stress at my work-place (i cannot accept this explanation!). Hi prescribed me Nexium for 1 month which I have done it... but without any good. My symptoms stil persist. Now I don't have anymore the same acute burning feeling in the upper part of the stomach, it is been replaced by an very uncomfortable feeling in the lower part of my stomach and a lot of gas bulding in stomach and bowels after meals (30mins-1hour or so after meals)."



The Nexium treated what Nexium is suppose to treat (stomach inflammation...in your stomach proper and duodenum, the "acute burning" to quote which has improved).  The gas/pressure sensation in the lower abdomen after eating is most bowel in origin and the Nexium will not treat this.  The discription you give is very consistant with an underlying irritable bowel, but it should be investigated further.  I would stay on the Nexium, and see your specialist again.  Keep an open mind about the fact that there may be more than one thing going on...OR that the symtoms may all be consistant with dypepsia/irritable bowel picture and may need treated along the same lines.



GI.PA