DEAR DR. GOTT: Two months ago I started having stomach cramps. My general practitioner gave me some antibiotics which didn’t work so he suggested I see a gastroenterologist who did biopsies of my stomach, blood tests and a gallbladder ultrasound.
The biopsies of my stomach and upper small small bowel showed evidence of active inflammation called gastritis. There were no signs of H. pylori bacterial infection. The upper small bowel did not show evidence of celiac disease changes.
The blood test showed that my white blood cell count was slightly low at 3.22. My liver and pancreas enzymes were normal. The gallbladder ultrasound was also normal.
My doctor suggested treatment for an H. pylori infection and gave me a prescription for Pylara. I had to take three tablets four times a day for 10 days. I was also told to take omeprazole twice a day for 10 days. I was also told I should have a HIDA scan.
The HIDA scan showed that my gallbladder is not functioning well. The ejection fraction was low at 20% so the doctor suggested it may be chronically inflamed and the cause of my abdominal pain. He suggested surgical removal.
After taking the H. pylori prescription, I was retested for infection by blowing air into an air bag. The breath test was negative and they said the bacteria had successfully been cleared.
I am scared and still have cramping and sometimes a burning sensation. I am not sure what is going on. Can you please help me?
DEAR READER: Perhaps I am missing something. I cannot fathom why you were treated for an H. pylori infection (which was then declared cleared) when your initial testing showed there was no evidence of infection.
That said, I can give you some further information on each condition and some advice about how to proceed from here.
H. pylori is a common bacteria found in the gastrointestinal tract. In some individuals it is responsible for stomach ulcers. In most, signs and symptoms aren’t present and the individual never knows he or she has the condition. For those that do experience symptoms, they can include nausea, vomiting, frequent burping, weight loss, bloating, and an ache or burning sensation in the abdomen.
Treatment typically involves the concomitant use of two different antibiotics and an acid suppression drug. This therapy works by eradicating the bacteria and allowing the stomach lining to heal. Retesting is typically performed several weeks following completion of the regimen. If the infection is still present, another round of antibiotics may be ordered.
Gallbladder inflammation, known as cholecystitis, (which you may or may not have) can have several causes such as infection or gallstones. Symptoms can include nausea, vomiting, sweating, bloating, fever, chills, and severe/steady pain in the upper right portion of the abdomen. The abdomen may be tender to touch. Some individuals may experience pain that radiates to the right shoulder or back.
Treatment typically involves hospitalization for a few days while the inflammation is brought under control. This can be accomplished by fasting which reduces the stress placed on the gallbladder. Intravenous fluids are given to prevent dehydration. Antibiotics may also be given if an infection is present either as the cause or a result of the inflammation. Pain medication may also be prescribed. If symptoms are brought under control, not further treatment may be necessary. For many, however, gallbladder removal may be recommended, especially if the organ is not functioning adequately or if stones are present.
Based on your note, I believe your gastroenterologist is on the right track with the suggestion of gallbladder removal, esepcially since the organ is known to be poorly functioning. Your note also leads me to believe that while you initially sought help, you are not now expressing your concerns, but simply accepting whatever your physician says. If you are frightened and have developed new symptoms such as the burning sensation, you MUST bring these issues to your doctors attention. If he is worth his salt, he’ll take the time to listen to you and help you understand what is going on.
My advice is to simply return to your doctor and talk with him. Make him explain everything about which you are concerned until you are comfortable that you understand the situation. Your health is your responsibility and your physician is there to help you.
