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H.pylori causing excessive belching & stomach bloating?
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H.pylori causing excessive belching & stomach bloating?

After taking Celebrex about 6 years ago, I gradually started developing heartburn & reflux.  It got so bad that I couldn't eat anything but saltine crackers and I lost 20 pounds over about a 2 month period.  To go along with this, I would have episodes of tachycardia (heart rate 130 - 140) & difficulty breathing.  The episodes of tachycardia & dyspnea seemed to be associated with stomach bloating & nausea.  I was put on Zantac & had an upper GI that showed nothing but mild reflux.  EKGs,  two echocardiograms, 24 hr & 30 day cardiac monitoring showed nothing but intermittent episodes of sinus tachycardia.  The zantac did not work & I was put on Nexium for about 8 weeks.  The symptoms improved dramatically after the Nexium and I was able to switch back to OTC zantac (150 mg twice a day).  I still had symptoms but they were very manageable and I was able to cut back on the zantac to 75 mg before bedtime, even while pregnant.

About 2 months after I gave birth to my son, my GI issues really started back in full force.  I would be fine during the day but my nights would be miserable.  I was awake most nights with nausea, reflux, stomach bloating and excessive belching.  The problems would usually start around 7 pm & would continue thru the nite.  After 6 months of misery, I went to a doctor that diagnosed me w/H.pylori.  I was given a prev pack in Sept '07, switched to Nexium in Oct '07 since prevacid wasn't controlling my symptoms and have been on it since.  

My symptoms have never completely gone away since.  I attributed a lot of it at first to stress from my mom's terminal illness, helping care for her and dealing with her death.  However, the symptoms have gotten worse over the last few months.  I never eat past 5 pm, sleep on a wedge pillow, lay on my left side,  and avoid caffeine & spicy foods.  I avoid milk products & fatty foods after lunch time.  The reflux is not as bad as it was before I was treated for H. pylori (due to the nexium), but otherwise the symptoms are exactly the same.  I have terrible stomach bloating with very excessive belching (particularly after milk products, peanut butter & fatty foods), nausea, increased HR (not as high as previously), chest tightness and occasional difficulty breathing.  The problem is so bad again that I wake up multiple times during the night and am often awake for hours because of the bloating & belching which seem to be the principle problem.  I haven't slept more than 3 hours a night so far this week. The symptoms will improve after taking my nexium in the middle of the night but don't always completely go away. My instincts, both as a patient and as a nurse, are that the prev pack did not cure the H.pylori infection and I think I should be tested again.  However, my gastroenterologist (that I like very much), refuses to test me again for H.pylori.  Instead he wants me to have an endoscopy & biopsy done, which would confirm or rule out H.pylori.

I'm really dragging my heels on having the endoscopy & biopsy, because I don't want to have it done for reasons I won't go into here.  But also since my symptoms are exactly the same and the prev pack treatment is not 100% effective in all cases, it makes sense to me to start out with a less invasive  procedure (lab tests for H.pylori) instead of going straight to an invasive procedure.   A fellow nurse that was diagnosed at the same time I was had little improvement in symptoms after initial treatment but a stool test showed she still had H. pylori.  She had another round of meds and now has no problems whatsoever.  Unfortunately, seeing her GI doc isn't an option for me.

If another lab test ruled out H.pylori, I would be much more agreeable to having the EGD. However, I also realize that as a neonatal nurse, I know very little about adult GI issues. Is it possible that the H.pylori infection is causing all the stomach bloating and excessive belching?  Since it hasn't been quite 2 years since I completed the prev pack, how long do I need to wait for a blood test?  At this point would the stool test or breath test be better?

From a GI standpoint, is it the usual medical standard of care to not test symptomatic patients again for H. pylori after being treated and jump right into invasive testing?  I'm considering seeing another gastroenterologist but I don't want to waste my time and money if they all are going to recommend doing an EGD and biopsy right off the bat.  Thanks!

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