Symptoms back after treatment

The cure of Hp usually requires antibiotics. Other things have been tried and have a weaker effect.

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rdwl
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Symptoms back after treatment

Post by rdwl » Mon Jul 10, 2017 5:36 am

Hello everyone,

8 years ago I suddenly started burping and belching excessively 24/7. Along with this my digestion slowed down a lot too, and my diet has been reduced to just a couple of foods that I can digest with more ease, in small quantities. No matter what I eat or drink the lower part of my abdomen becomes very distended, even if it's water. The only way to make it go back to normal is to not ingest nothing at all.
I went through an endoscopy that returned positive for h pylori and my doctor at the time told me to do the 2 antibiotics + PPI treatment for 10 days (specifically, amoxicillin and cephalexin + lansoprazole.) During that time I was doing very well, the only symptom remaining was the endless burps but because I could finally eat whatever I wanted in a proper quantity without feeling like my bowels were going to implode I was happy. However as soon as I finished the treatment all my symptoms came back.
My doctor didn't tell me to do a breath test or anything to check if the h pylori was still there, so I spent like a year that way until I found out about breath tests. I did it twice in different hospitals and both came back negative.
I've also taken several meds for SIBO and gastroparesis but they didn't change the situation in the slightest. Same with diet changes. The only thing that brought me relief was the h pylori treatment, but the tests came negative and my doctors don't think of giving me a second h pylori treatment.

Does anyone know what this can be and/or how I can proceed?

Helico_expert
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Re: Symptoms back after treatment

Post by Helico_expert » Mon Jul 10, 2017 9:10 am

sounds like you have done several tests after 1 year post treatment and they all came back negative. In that case, there is no reason for the doctor to give you anymore antibiotics.

However, it is possible to give you some PPI or domperidone (or both) to ease your burping symptoms.

some patients do develop post treatment reflux symptoms. and some does gradually recover over time. Nobody knows exactly why and how it happens. Perhaps it is because the stomach is trying to adjust itself to the state where it has no H. pylori. after all, the stomach had most probably been infected for decades and had evolved to adapt with the infection. Now that the bacteria is gone, it'll take some time for the stomach to adjust.

anyway, if you are young and healthy, the chance of your recovery is high.

rdwl
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Re: Symptoms back after treatment

Post by rdwl » Mon Jul 10, 2017 9:20 pm

Thanks for replying.
However, it is possible to give you some PPI or domperidone (or both) to ease your burping symptoms.
I've taken domperidone and several PPIs (omeprazole, pantoprazole, Nexium, lansoprazole) already, but the burping, belching and stayed the same in all cases.
some patients do develop post treatment reflux symptoms. and some does gradually recover over time.
I've always had reflux, it's not something that appeared after the treatment. I manage it with pantoprazole, and while not having reflux makes my digestion better, nothing else changes, as I mentioned above. Nothing new appeared after I finished the h pylori treatment, the symptoms are the same as they were before taking the antibiotics. It's been 3 years since I finished it and I'm not feeling any better. I know I can't take antibiotics for life but it's very strange for me that it was the only thing that gave me some relief. Could it be that the h pylori was eradicated but there's something else in my small intestine? I've asked this to each of the dozens of doctors I've visited but no one gave me an answer.

Helico_expert
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Re: Symptoms back after treatment

Post by Helico_expert » Tue Jul 11, 2017 2:06 am

just in case, let me remind you that PPI can affect the breath test result. I assume your doctor did the right thing: asked you to stop PPI for at least 3 weeks before the breath test.

also, you can consider doing a follow up endoscopy check, to make sure your stomach has nothing abnormal. A histology of the biopsy can also be helpful to see if your inflammation decreased. sometimes, the histology can be used as a hint, to see if H. pylori still exist.

rdwl
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Re: Symptoms back after treatment

Post by rdwl » Tue Jul 11, 2017 3:04 am

just in case, let me remind you that PPI can affect the breath test result. I assume your doctor did the right thing: asked you to stop PPI for at least 3 weeks before the breath test.
Yes, that's what they did.
also, you can consider doing a follow up endoscopy check, to make sure your stomach has nothing abnormal. A histology of the biopsy can also be helpful to see if your inflammation decreased. sometimes, the histology can be used as a hint, to see if H. pylori still exist.
I've considered that, but I haven't gone through a second endoscopy because I wanted to leave invasive checks as a last resource. I don't know what else I can test though, so I guess I've run out of other options. Would the pill camera check be as effective for diagnosis?

Helico_expert
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Re: Symptoms back after treatment

Post by Helico_expert » Tue Jul 11, 2017 5:32 am

i think a histology check on your biopsy will be more useful than the camera pill.

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