Pancreas

I had same things , pain sometimes on left and sometimes on right side . I did all tests and everything came back clear. I had H pylori bacteria which caused all that pain , loose stools and bloading.

Yep I know what you mean. It's amazing how a little bacteria can affect your health so badly!

H pylori stool tests are pretty accurate, however if you were on ppi when you did it this can reduce the accuracy some what.

I would be requesting an endoscopy as it sounds like you have gastritis if you have burning in your stomach.

I don't wish to sound harsh...but my experience of doctors wasn't particularly good. After numerous tests I was told that I was fine and probably had IBS, but I knew something was wrong with my stomach. I suffered for months and lost 3 stone altogether and felt really ill.

Finally, after I kept pushing, they found I had bad gastritis and h pylori. I had the triple therapy and it killed it but it took me 6 months of strict diet and ppi to heal. I'm ok now and back to normal but it took me a while to heal.

You may not have h pylori but gastritis can be caused by other things.

Get checked out to be on safe side. I had the same symptoms as you.

And in the meantime eat clean, it will greatly help your symptoms.

Sorry to weigh in here, but the stool h.pylori test is not influenced by PPI.

(The stool h.pylori looks for the antigen, the -dead- bacteria, bacteria parts, itself - h.pylori does not live anymore when passed through guts, sensitive to bile acid-, whereas a breath test or biopsy looks for a metabolism activity -urease- or bacteria itself in the histology)

That's the beauty of the stool test and yes, it is quite sensitive, rarely has false neg results.

Since it was 12 months ago, I would ask if it could be retested by it stool or breath, but for breath test you need to be off PPI for weeks please.

(Blood and urine look for antibody, hence not good to decide on if present infection or passed)

Good luck.

Sanya I personally spoke to a doctor who owned his own testing clinic. He stated that ppi does affect the result, it makes it 70% accurate rather than the usual 96%. He advised come off it for 14 days.

H2 blockers don't affect the result.

Shaun if you get an endoscopy they can test for h pylori then as well. But again it's best if you're off ppi for 14 days when you have this

Wow

I have never ever seen a study of a stool test h.pyl statistic

sensitivity and/or specifity dropping from 96% to 70% (but in breath tests).

Only slight drops, not significant enough to sound the alarm.

He should publish this data then if stool tests were as effected in sensitivity (specifity is mostly not) as breath tests.

Really!

It's not out there. I am a med scientist and have not come accross such a dramatic statistic re stool test and PPI.

But be aware few false negative results happen even without PPI anyway.

(The sensitivity is not 100% for any of those tests even without PPI.)

PPI have a bacteriostatic effect (not completely killing otherwise this would be treating the infection, which it doesn't obviously),

numbers are smaller;

I would anyway recommend a repeat....12 months is a long time.

Especially if symptoms persist.

And a cheer for docs, that are playing it on the save side.

That's good.

We had biopsies taken and 'neg' result under PPI and I had a real struggle to tell them, that the chances of being false negative are quite significant given the circumstances of being under PPI for biopsy urease testing and overlooking the small number of bacteria in the microscopy slide.

THAT I call really frustrating.

I will speak with my GP when he returns from holiday and ask to be tested again for HPylori infection. From reading the comments posted the stool sample test is the most reliable test, so I will go down that road.

Just curious Sanya with you being a med scientist why omperazole stop the acid reflux by taking one a day yet they don't seem to touch the pain discomfort in my upper abdomen?.

I agree, there is still a lot of confusion out there around whether you can or not take ppi before certain h pylori testing procedures.

My own personal view was I'd rather not risk it so I came off ppi for 2 weeks prior to tests (stool / endoscopy). Then went back on after. Just used Gaviscon and strict diet for the 14 days whilst off meds.

One thing that not many docs know is that ppi can cause h pylori to spread from the Antrum up to the Corpus of the stomach (happened to me!). It made my symptoms much much worse. Once the infection was eradicated I could tolerate PPIs much better.

Either way the road to gastritis / ulcer recovery is DIET. Some people think they can take PPI and then eat / drink what they want, wrong!

Strict diet for 3 months and ppi cured me finally, but it requires discipline and patience.

Diet mistakes can irritate the stomach lining and cause pain and discomfort.

Acid is the worst offender (it ultimately causes ulcers!) but fat and alcohol and strong spices can also irritate.

if you're on ppi your acid is much reduced so likely diet errors are what are giving you pain. Keep a food diary and eliminate what irritates you.

It does sound like

You have gastritis. Just need to find out why

Thanks Paul, my diet isn't the best nor the worst either. I don't drink or smoke so I can rule that out. I will see how the food diary goes

Alcohol is a major irritant so it's good you've cut that out.

Give me a typical days eating and il try see what could irritate you.

My diet yesterday was shreddies with semi skimmed milk for breakfast. No lunch, for evening meal chicken on wholemeal bread and 2 x chocolate bars afterwards. My diets been only 2 meals a day and not 3 set meals. Today's diet was much the same. The problem is there is no let up from the discomfort. The last 2 days have seen zero spice and fat.

Hate to say this but chocolate is a no no for gastritis sufferers. Cut it out. Also try almond milk instead of milk. Rest of what you ate is fine. Eat the same as yesterday and leave out choc and see how you feel. If after couple days you feel better then you know you're on right path.

Choc made my symptoms much worse

I eat chocolate every day, never even considered chocolate being a culprit. Will stay away from it and see how I get on.

Thanks for the info Paul.

If you have gastritis chocolate is a food to avoid. It's high in fat, sugar and caffeine. All the things you need to avoid. If you weren't on ppi and eating it you would have bad acid problems.

Avoid it for some time and eat healthy whole foods (eggs / whole grain bread and cereals / well cooked veg / lean meats / non acidic fruit like melon and pear). Keep a food diary and if you feel symptoms 1-4 hours after eating something in what you ate is irritating you.

When you eat right you can go a whole

Day with no symptoms.

Good luck

I am trained to understand testing methods (mainly chemistry), avoid false results produced in labs, or screen microscopically PAP, blood smears etc.

I am unfortunately not trained to understand physiology/pharmacology and symptoms.

BUT from experience I just 'know',

that first of all, each PPI works a bit different in every person regarding the acid influence and side effects.

Pantoprazole 2x20mg was not doing as much as 1x20mg esomeprazole for me. My husband had no success with esomeprazole (and got headaches), but is very happy with omeprazole once a day......

There is a lot of trial involved in which kind of PPI and which dose is right for you, if you need PPI....pain in the patella, I know.

I was also told, that gastritis took a long time to heal,

(the acid reflux, that you feel creeping up your oesophagus (and burns) is quite instantly influenced, but the damage - gastritis or ulcers- to the stomach lining seems to take many months (anyone an experience here how long?) to heal, is not an instant effect and not quite sure, if PPI do the trick for it since a stomach (in contrary to oesophagus) should have a protection layer production of bicarbonate in place.

Also people on PPI still need to take care what they eat. It is not a bulletproof therapy and you can do what you want. Not at all.

It's just an aid for oesophageal acid reflux, for ulcers, for problems, where further acid could do more damage to the tissue.

Of course your problems could also be due to other issues.

Also bile reflux from duodenum into stomach irritates the lining, but is not tackled by PPI. (we have that problem, too)

on the other hand bile acid kills h.pylori, so I see it on the bright side. ;-)

There is a lot of controversy out there, if actually lowering the acid's acitidy is doing more harm than good for the organ stomach itself also concerning h.pylori. 

One thing agreeing: IF you had h.pylori AND typical symptoms (from upper abdominal pain, nausea, bloating), then treat it first.

But from there, the healing is a different (more diet based) step.

I wish there were more real objective (not book selling) statistics and studies out there, I wish each medical doc had to write a thesus, then those questions would be tackled, studied and concluded.

Feeling like a guinea pig in this field, honestly.

Also some info said, like we know, under PPI, lower adicity, it seems to do something bacteriostatic to h.pylori, chemical (urea in breath and biopsies/microscopy) tests produce more false neg results (even stool sample antigen test it seems?),

but on the other hand, stomach (and bile) acid seems to kill h.pylori and others say, the lower the acidity, the more it could grow??

This is so contradictive info.

If PPI reduced stomach acidity helped h.pylori to grow, then wouldn't number be higher, the biopsy bac number and urea tests be not influenced? But they are, so... there is some knot in the whole story.

If anyone knows the answer, please let me know.

That one taking PPI, lower acidity is more prone to bacterial GI infections, is known too and makes sense, since the acid is helping to kill bad bacteria.

H.pylori though is made to live in the stomach....

Diet is for sure something to look into.

Any reflux of any acid into the oesophagus is a problem

(if keeping the reflux stuff acidity low or trying to keep the reflux at bay is the solution, has to be trialed individually since a hiatus hernia for example will not be influenced by the shpincter and high acidity to close it. It depends really on each one's situation physically, if PPI are a solution even they do not tackle the root cause for GERD, just the acidity and effect of reflux. There is no shoe that fits all.)

But gastritis itself (not talking GERD) is a huge field as how to tackle, it seems.

I guess your discomfort could be gastritis, which for mentioned reasons might not be healed by PPI alone or take long, but also maybe are digestion problems.

Have you trialed digestive enzymes when eating?

(your pancreas enzymes were measured, so that is a relief)

 

PS: I only was involved in mamma and colorectal cancer treatment studies at a point, no gastritis/h.pylori, sorry.

Yes, chocolate....

my daughter eats one piece (she could eat a whole bar in former times)

and vomits instantly with stomach pain - she has chronic gastritis in all stomach parts, no h.pylori found in any tests, but bile reflux into stomach.

I still can eat a whole bar and have no symptoms whatsoever...

Life isn't fair, or is it. In the long run might be better being told off chocolate by body ;-)

I had h pylori caused chronic gastritis for roughly 2 years...it took me about 6 months to fully heal. And this required strict diet which is the most important factor. Even to this day I can't go daft with bad foods and drinks. On the plus side I am a much healthier person now !

Ppi / H2 blockers help reduce the symptoms but it is the diet that ultimately allows you to heal. Stress doesn't help either and needs reducing.

I actually found I felt better when on Zantac rather than ppi. I felt bloated on ppi, but that's maybe just me.

I know some people that healed from gastritis with diet and supplements alone and didn't bother with acid blockers...each to their own.

The road to recovery from gastritis is a long one and doesn't happen in a few weeks. But after 2/3 weeks of eating well you should be symptom free and be able to have a day without Pain. But this doesn't mean you have fully healed, you have to keep on with diet and only introduce new foods gradually and as a treat. So a bit of chocolate once a week is ok...but not everyday!

I don't know if the ppi causes h Pylori to grow as such, more just move from the Antrum to the corpus. The theory is that h pylori usually resides in the Antrum as there are no parietal (acid making) cells there. The parietal cells are in the corpus. But because ppi effectively shuts down acid production massively the h pylori can move up the stomach as the acid concentrations are much lower than normal.

I found this happened to me when I went on ppi before a h pylori infection diagnosis. After diagnosis and antibiotic treatment my symptoms massively reduced as the bacteria was no longer living in the corpus of my stomach.

There is still a lot of confusion and mixed messages out there. I found many doctors (including specialists) had very little knowledge of how strict a gastritis diet has to be. They just said 'eat carefully', but the truth is that to heal it requires a big lifestyle and diet change.

They just throw ppi at you and tell you to go away.

I found I had to trial and error my diet and keep a food diary, and speak to other sufferers who had healed themselves. They knew much more than a medical professional.

Very interesting read Sanya, thank you for the information. 😀

Thanks Paul, very interesting read also. 😀