Chronic indigestion problems

[robertin75]

Dear Dr. Meador:

I have been suffering from several digestive problems, includying abdominal distention since 1997 and no one has found the cause.

I can even feel my stomach bloated when I haven't eat or drink anything like when I wake up.

I have had several tests includying endoscopies, abdominal CT scans, barium upper GI series, stomach biopsies, etc and everything has became normal (liver, pancreas, kidneys, spleen, gallbladder, adrenal glands, intestines, thyroid).

The only time that I have been in complete remission of all my digestive problems (bloating, gas, flatulence, etc.) was in the year 2001, when I was given clarithromycin for a throat infection, so this makes me suspect that my digestive problems are due to some infection. Unfortunately, as soon as I discontinued the antibiotic, all of my symptoms returned.

I really couldn't believe the immediate relief I got from this antibiotic since the very first day. I could drink and eat anything without getting all my digestive problems.

Does this sounds like helicobacter pylori infection that has not been properly diagnosed and treated?

Unfortunately, when my gastroenterologist tried to give me the full HP treatment (2 antibiotics + PPI) which included clarithromycin, I got terrible diarrea and didn't feel any improvement like in the year 2001, so makes me think if the stomach infection (helicobacter pylory?) has already developed resistance to clarithromycin.

Thanks and your help is greatly appreciated.

Sincerely,
Roberto

[lmroswell]

His stomach showed mild gastritis on last exam. They did a test for HP at the time his exam was done, and it was negative. This last September, he had a severe bout with irritated stomach and colon.  His doctor put him on two antibiotics, as we were to go on a cruise, and almost cancelled due to his feeling bad, and he improved within 24 hours.  I don't recall the antibiotics used, but can get the names.  He was good for a few months, and now he is slowly returning back to his feeling lousy.  When this bothers him, I can tell, he is not himself.  But, some testing (not sure what) will be done soon.  Hopefully, that will yield some answers.  Thanks for the info.

[Forum-M.D.-CM]

cm doctor
seems to me that if heliobacte was the problem that they would have seen gastritis on biopsy whether or not they found the bacteria. i would not put all bets on heliobacter but would start to experiment with selective food omissions and observe what helps and what makes it worse. Actually you biggest clues will come from what makes you worse. There are endless substances you take in that could be doing this. I would go on the simplest diet possible and then add foods to see if you can find a trigger. Wheat products are famous for causing spru , peanuts are frequent as are many nuts, shell fish do all sorts of GI tricks, You need to become your own detective. Good luck. if you find out please let us all know ,

[lmroswell]

You sound a lot like my husband who has suffered bouts with this on and off for years.  I am no expert, but I have heard that the HP breath test is the most accurate.  I could be wrong.  DH just saw his gastro doc, and they plan on doing more tests in 2 weeks, but not sure which ones.  He has tested positive for delayed gastric emptying.  His doctor was also interested in the fact that he has traveled out of the country several times, China and parts of the Carribean, so I think the doc might be thinking it could be parasitic.  He is currently on Reglan and the Purple Pill Nexium, which provides him with some relief but just doesn't get rid of it.  It gets better and then can get worse, and stress is not it for him.  I hope you get some answers and feel better soon.

[robertin75]

Dear Dr. Meador:

This is the full HP treatment that I took about 3 months after I took clarithromycin alone (February 2002, took it for 7 days) for a throat infection, which did nothing for my digestive problems. In fact, it made me feel worse (more bloated and with diarrea):

In May 2002 I was prescribed the following treatment for 14 days but had to stop it because the problems that I previously described:

Lansoprazole 30 mg
Clarithromycin 500 mg
Amoxicillin 500 mg

I guess it is similar to PREVPAC but has another name (PYLOPAC).

I don't remember exactly how I took them, but the instructions came in the box which were the same as my doctor told me.

How soon did your symptoms return after you stopped it?

After I stopped the clarithromycin treatment alone for my throat infection in February 2002, the digestive symptoms returned almost immediately (1 or 2 days later).

As you observe your feelings, what things make it worse, what things make it better, even slightly? When it is worse AM, afternoon, evening or night?

As I said before, my bloated stomach (as well as the other symptoms) are always present, but they are worse when I wake up and haven't had any food. It improves a little when I eat food.

Between breakfast (about 8:00 AM) and lunch (about 1:30 PM), I feel the slight improvement, but I don't eat again until about 7:30 PM (dinner).

Seems like the longer I don't eat anything, the worse the symptoms get.

There is really not a specific set of foods or drinks that make me feel worse. As I said in my previous post, in my February 2002 remission, I could eat and drink anything without any problems. I really couldn't believe how well my stomach felt with just that antibiotic !

Right now, I can even get bloated with a glass of water (this was also present between 1997 and February 2002), and this situation went away in my February 2002 remission with the clarithromycin alone.

Now, at present, a couple of months ago when one doctor tried to give me clarithromycin for a bacterial infection that could be used for, I got the same symptoms as in May 2002 (specially the more bloated stomach problem).

Of course, after these experiences, I try to avoid clarithromycin  by telling the doctors about the bad reactions that I've had.

Stomach antrum biopsies from endoscopies have been tested for HP infection with the CLOTEST method and have always became negative.

I read that HP can be missed a lot of times in biopsies as this bacteria can be in several parts of the stomach.

I sometimes feel really frustrated as doctors think it is just stress because stomach biopsies haven't show anything, but the February 2002 event really puzzles me.

Hope I was clear enough, and if not please let me know.

Thanks a a lot for your help and guidance,
Roberto