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Confused about what doctor is saying about H.Pylori..Please help

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udaya_kamath
Posts: 4
Joined: Wed Nov 28, 2018 8:49 pm

Confused about what doctor is saying about H.Pylori..Please help

Post by udaya_kamath » Thu Nov 29, 2018 1:52 am

Hello everyone,

I am Uday 48 years old male; lives in Bangalore, India.

8 months back it all started.

All of a sudden one day in April 2018, I started having body pain. Random pains. Bone, muscles everywhere all over the body; pins, needles, side heaviness, random pains near the rib cage near the chest area etc. I WAS FEELING VERY WEIRD. I did not know what had happened to me. After few weeks as the symptoms remained the same - I visited an Ortho doctor. He diagnosed me with Vitamin D deficiency and provided supplements. But at the same when I had body pain symptoms - I also had some kind of gas wandering around my stomach area. But that was some minor issue when compared to body aches that I was experiencing. After some months -after I started having vitamin D3 supplements - body pain started reducing but I noticed my stomach started bloating 24 x 7. This I noticed around June 2018. Strange enough I could not pass gas from anal route. I was experiencing constipation issues. Stool was not passing "full". Then came September 2018 - I started to have stomach distension. As soon as I eat or drink something - my stomach started swelling. It started becoming harder. So I was not able to eat drink anything properly.

Now I ran to a gastroenterologist doctor. He suggested Pantodac (pantoprazole) 40mg ( 1 - 0 - 1 ) (2 tablets daily) for 2 weeks. But sadly it did not help. Symptoms remained the same. Bloated stomach, not able to pass gas, stomach distension, abdominal pain etc. I was not able to sleep in the night. I started having acid reflux (GERD). Now, my gastroenterologist doctor - suggested an Upper GI ENDOSCOPY.

I am writing down my Upper GI ENDOSCOPY lab report picking some important points: (done in october month)
-----------------------------------------------------------------------------------------------------------------------------------------
Oesophagus: Normal Mucosa
OG Junction: LAX LES

Stomach:
Fundus: Normal Mucosa
Body: Normal Mucosa
Antrum: Hyperaemia / Erosions / No Ulcer
Pylorus: Normal

Duodenum:
D1: Hyperaemia / Erosions / No Ulcer
D2: Hyperaemia / Erosions

BIOPSY : Antral Biopsy for H.Pylori by RUT +ve (positive)

Impressions: LAX LES
EROSIVE ANTRAL GASTRITIS
EROSIVE DUODENTIS

==============================================================

When I discussed my lab report with my gastroenterologist doctor - a few days back - he said - instead of starting the H.Pylori Eradication antibiotic treatment immediately - he would put me in the following medication for 2 weeks to see if it helps with my symptoms. The medication he suggested was the following for 2 weeks of time.

i) tab pantodac (pantoprazole) 40 mg ( 1 - 0 - 1)
ii) tab Actapro 100mg (Acotiamide) (for stomach distension)
iii) tab I VORAL FORTE ( 0 - 0 - 1) Just only 1 tablet to kill germs in my intestines if any.

At this time I asked the Doctor that - since I am infected with H.Pylori bacteria- why don't he start with H.Pylori antibiotic treatment straight away?

For this doctor said - as the biopsy is NOT "deep biopsy" - it do not capture the number of H.Pylori bacteria present in my stomach. His theory is that I might have been softly mildly infected with H.Pylori. He told me that only "Deep Biopsy" would tell properly how severely I am affected with H.Pylori. He also said if the above medication do not help me to reduce my symptoms then he will prescribe me H.Pylori Eradication antibiotic treatment after 2 weeks.

I really do not understand the medical term that he was using such as "deep biopsy" and all.

I am in now bigger dilemma than earlier. Please help me with the following doubts that are in my mind.

1) The symptoms that I wrote above could have been caused by H.Pylori bacteria?

2) Whether biopsy R.U.T test do not give a clear picture of H.Pylori infection? I mean is this test is NOT ENOUGH to tell whether i am H.Pylori infected?

3) Should I start with the above medication for 2 weeks ( just as the Doctor suggested) ? Or should I ask him to give me H.Pylori Eradication antibiotic treatment straightaway without wasting any time?

I do not want to waste any further time as this stomach sickness these months long nearly killed me- at least my mind think so...

Please give me a clear picture on the above lab report and next course of steps. That will help me a lot to deal with the stomach sickness I am experiencing since 8 months. Thanks a lot...God Bless All...

SynesthAsia
Posts: 5
Joined: Tue Nov 20, 2018 10:06 am

Re: Confused about what doctor is saying about H.Pylori..Please help

Post by SynesthAsia » Thu Nov 29, 2018 7:11 am

I am not a doctor, just a fellow sufferer....
You might consider getting a second opinion.
By the looks of it your doctor is not aiming for eradication but reduction to the point that you won t have any symptoms. I ve read around that it is believed by some that h pylori in low concentrations is useful for the stomach. It might be the case that your doctor is from this "school". it s true that antibiotics are very heavy and trying for the stomach and he may think that you can avoid them, however I don t understand why he didn t perform the "deep biopsy" right away" to save you a second unpleasant procedure if need be. I also know that the most accurate tests to measure the concentration of the bacteria are breath or stool tests. I again don t know why he didn't do them straight away. If you have some options where you live, I d say go to another doctor and request to have a stool or breath test. Don t start with the medicine he gave you though before you get the above tests as they can affect the results.
I hope it helps somewhat.

Helico_expert
Site Admin
Posts: 2826
Joined: Wed Mar 02, 2011 7:20 am

Re: Confused about what doctor is saying about H.Pylori..Please help

Post by Helico_expert » Thu Nov 29, 2018 8:26 am

You might consider getting a second opinion.
By the looks of it your doctor is not aiming for eradication but reduction to the point that you won t have any symptoms. I ve read around that it is believed by some that h pylori in low concentrations is useful for the stomach. It might be the case that your doctor is from this "school". it s true that antibiotics are very heavy and trying for the stomach and he may think that you can avoid them, however I don t understand why he didn t perform the "deep biopsy" right away" to save you a second unpleasant procedure if need be. I also know that the most accurate tests to measure the concentration of the bacteria are breath or stool tests. I again don t know why he didn't do them straight away. If you have some options where you live, I d say go to another doctor and request to have a stool or breath test. Don t start with the medicine he gave you though before you get the above tests as they can affect the results.
I hope it helps somewhat.
Where is the "Like" button?
Totally agree.

RUT is good enough to show that you have HP.
Erosion is good enough evidence that you need HP eradication therapy.
I would go ahead with antibiotic treatment, why wait till the symptom get worse.

udaya_kamath
Posts: 4
Joined: Wed Nov 28, 2018 8:49 pm

Re: Confused about what doctor is saying about H.Pylori..Please help

Post by udaya_kamath » Thu Nov 29, 2018 10:27 pm

Thank you very much SynesthAsia and Helico_expert for your quickest expert advise. That helped me a lot clearing the doubts I had on Doctor's thinking and my next course of action. Yes, you have guessed it right!!! My gastroenterologist doctor is of the age around 65 years and takes only one step at a time as far as I understand him..

Meanwhile I have read an interesting medical article about R.U.T. A part of the article reads like below:

"
A positive RUT requires approximately 10 (5) ( i.e., 10 raise to the power of 5 ) H. pylori in the biopsy sample to change the color using an agar-based test such as the CLO test. This is generally not a problem as the concentration of H. pylori typically exceeds that minimum. The sensitivity of various RUT tests as primary diagnostic tests is high and has been reported to vary between approximately 80% and 100% and specificity between 97% and 99%.

"

Now, while referring the above article; for a R.U.T biopsy test to be positive for H.Pylori - it requires 1 lakh ( hundred thousand) bacteria concentration ( 10 raise to the power of 5 ). In this case how my doctor thought - I might be mildly affected with H.Pylori ?

Apparently I do not have stomach ulcers which is common with H.Pylori presence. One last question would be - can H.Pylori cause the symptoms that I am experiencing such as - body pain, bloated stomach, not able to pass gas from anal route, stomach distension, weird feeling, depression dis-interest and fatigue? Is H.Pylori bacteria that much troublesome apart from causing stomach ulcers that it is synonym with?

Thanks for all your help...

Helico_expert
Site Admin
Posts: 2826
Joined: Wed Mar 02, 2011 7:20 am

Re: Confused about what doctor is saying about H.Pylori..Please help

Post by Helico_expert » Fri Nov 30, 2018 1:23 pm

H. pylori can cause lots of different symptoms. everyone experience it differently. However, all H. pylori causes inflammation in the stomach. The inflammation may or may not cause symptoms. It's a very chronic infection. When you are young and healthy, the damage heal quickly. As you aged, the repair ability decreased, and you are more likely to experience symptom. What we dont want to see is damage that is irreversible when you are in older age.

your current symptoms may or may not be caused by H. pylori. But eradicating it prevent you from further damage. As we all know, prevention is better than cure.

udaya_kamath
Posts: 4
Joined: Wed Nov 28, 2018 8:49 pm

Re: Confused about what doctor is saying about H.Pylori..Please help

Post by udaya_kamath » Fri Nov 30, 2018 4:00 pm

Thank you Helico-expert for your guidance on eradicating H.Pylori bacteria.

My mind is now more clear and I will go for eradication therapy straightaway and will let you know in this forum about the proceedings after a few weeks. Thank you once again for extraordinary help...


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