Q: My mother is 48 years old and has been suffering from H.. pylori for over six months. She went to a lot of specialists but no one was able to diagnose her for this infection so she started her own research online. She told the doctor to test her for it and found that she tested positive. She was given a combination therapy course for a week. The antibiotics had lots of side effects and she was taken to the emergency room a few times. It’s now been over a month since she finished, however she is still suffering from abdominal pain, indigestion, nausea and insomnia. Her diet has been healthy, lots of probiotics, fresh fruits and vegetables. Some days are good, others aren’t. Should she get another test done to see if she has some infection left? The doctor told her it is a bit too soon, as she might still be positive. She also has an endoscopy appointment but wants to know what to do meanwhile. Please advise the recovery time for H- pylori and what she should do now, as no one else knows what should be done.
A: H. pylori is a germ, a type of bacteria known medically as Helicobacter pylori that infects the stomach. It commonly begins during childhood; it is much less common during adulthood. The condition can be passed from person to person through direct contact with vomit, saliva, fecal matter, and through contaminated food or water. It is quite common and is present in almost half the people in the world. Most individuals are completely unaware they have the condition because they don’t have any symptoms. When symptoms are present, they include weight loss, vomiting, nausea, boating, and abdominal pain anywhere between the breastbone and the navel. The pain may be present when the stomach is empty, may be relieved by eating or taking an antacid, may last briefly or for hours, and may wax and wane.
Complications of the disorder include inflammation of the stomach lining — a condition known as gastritis, ulcers of the small intestine and stomach lining, and stomach cancer. Factors that increase an individual’s risk for H. pylori include living in undeveloped countries, living with someone who already has the infection, living with numerous other people in substandard conditions, not washing or cooking foods properly, drinking water from a source that may contain bacteria, and not having sufficient hot water that will keep the home clean.
Because symptoms can be attributed to countless other conditions, H. pylori is not likely a first consideration for physicians unless the individual has reason to test for it. Laboratory testing might include drawing blood to determine if it is present or has been present in the past; endoscopy that utilizes a flexible tube inserted into the throat, esophagus and into the stomach. A small camera attached to the tubing will allow a physician to view irregularities of the upper digestive tract and, if he or she determines the necessity, a tissue biopsy can be obtained; stool testing that looks for antigens; and lastly, a breath test that contains radioactive carbon molecules.
Treatment is commonly provided with two or even three antibiotics taken simultaneously to help the bacteria present from developing a resistance to one or the other. The doctor may also recommend an acid suppression drug that will allow the lining of the stomach to heal. As you have discovered, therapy may cause nausea, headache, diarrhea, stomach upset, a metallic taste in the mouth, sun sensitivity, and still more. After about four weeks, the doctor will likely order testing once again to determine if the drugs were successful or if a different combination is necessary for control. Blood tests will not be ordered immediately following treatment because a patient’s blood can test positive for H. pylori even following the elimination of the bacteria. And, more than one course of antibiotics may be necessary, since between 80 and 90% of the bacteria can be eradicated, but not 100%. Because you indicate a month has already passed, my guess is that it is time for retesting; however, her doctor may have specific reasons for waiting. Of importance is that the H. pylori blood test is not a good indicator of disease. A large number of patients will test positive for the bacteria and have no disease. Therefore, if symptoms persist, I recommend you touch base with a gastroenterologist for evaluation and possible endoscopy.
Prevention includes washing hands with soap and water frequently, washing and cooking foods properly, and drinking water from a clean source.
