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Stomach and chest issues

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Mfernan244
Posts: 6
Joined: Sun Feb 23, 2020 1:08 am

Stomach and chest issues

Post by Mfernan244 »

Hello, I've been reading a lot through the forum and it has been very helpful. I thought I'd join and hopefully get some help myself.

December 24th I started feeling shakey with chest discomfort and vomited end of day. Same thing for December 25th.

I went to ER on December 25th at night after vomiting. Told them I didn't feel well and felt something in throat. They did xray on neck and said I was fine .

December 26th I went to a GI and he said it was likely and abrasion, immediately prescribed 40mg omeprazole (which I began taking immediately) and scheduled endoscopy 2 months out. This was too far out so I went to ER again. They did ECG my heart is fine and chest xray, everything looked fine. Discharged me saying to take PPI prescribed.

I continued to feel bad the next few days so I decided to go to Mexico and get an endoscopy on December 30th. Dr noticed acute gastritis and grade B esophagitis. He took a biopsy that turned out h pylori negative ( keep in mind ive been taking PPI since the 26th). He prescribes pantoprazole 40mg for 8 weeks. I don't take pills, smoke or have any other cause for acute gastritis. So the cause is unknown.

While taking PPI my symptoms got a little better I was able to function but I continue to have indigestion, belching, gas, chest pain burning in stomach. None of my pains are severe but enough to make me feel unwell.

On week 7 of my PPI medication, my girlfriend is h pylori positive. She had been having similar symptoms (except for chest pain).

I immediately stopped taking pantoprazole and 3 days later took urea breath test. Came back negative. I have appointment with dr to redo urea breath test in a few days. A week after stopping PPI I've been starting to feel sick again, have indigestion, chest pain, head ache.

Yesterday a new mild pain started 3 inches under tight armpit. It feels like a pinch whenever I make a sudden movement.

My questions:
-Can the biopsy be false negative due to ppi intake for a few days?
-Is chest pain common or at least a symptom caused? What is it felt like? Mine feels mild and it radiates through whole chest - feels random. I can't recreate feeling.
-Is a urea breath test 3 days after PPI too soon?
-does it sound like what I have is h pylori?
-does PPI suppress h pylori symptoms? After PPI use do h pylori symptoms go back to normal?

I'm sure I may have missed some details, so please let me know.

I know it's a lot but it's been very worrying. I appreciate any help!

Helico_expert
Site Admin
Posts: 3712
Joined: Wed Mar 02, 2011 7:20 am

Re: Stomach and chest issues

Post by Helico_expert »

You will need to wait 2 weeks without PPI or antibiotics before breath/stool test.
You can switch to ranitidine or other H2 blocker while waiting for breath/stool test. Ranitidine will not affect the breath test.
Here is a guideline how to use breath test.
https://helico.com/PYtest_guide_2013.pdf

Since your endoscopy had shown gastritis (inflammation in the stomach), I would presume you have H. pylori.

Sometimes, hurt burn is described as chest pain. So do you feel like the chest is burning hot? this symptom can usually be controlled by PPI.

Mfernan244
Posts: 6
Joined: Sun Feb 23, 2020 1:08 am

Re: Stomach and chest issues

Post by Mfernan244 »

Thank you for the response.

No my chest pain is without burn or acid feeling. I do have what feels like some reflux, but it's not acid. My throat feels a little tight and I have a bad taste in mouth.

The chest pain/discomfort is mild at its worst. Its more of a sensation. I feel it in center ir chest under left and right chest but no actual patterns. I can't reproduce the feeling.

I was on ppi for 7 weeks but I had chest discomfort on and off.

EDIT: in addition to no burning, I think this may be important. I continue to wake up through the night. Have post nasal drip. Need to fix my throat. Not sure if it's possible to have reflux with no acid? But I'm hoping that is what's causing my chest pain/discomfort. In speaking with a friend that works at hospital, he says it could be gas in chest as well

Helico_expert
Site Admin
Posts: 3712
Joined: Wed Mar 02, 2011 7:20 am

Re: Stomach and chest issues

Post by Helico_expert »

perhaps you can switch to ranitidine for two weeks. then go for a breath test. If you are still positive, you can get treated together with your girlfriend.

Mfernan244
Posts: 6
Joined: Sun Feb 23, 2020 1:08 am

Re: Stomach and chest issues

Post by Mfernan244 »

Helico, your response above recommends 2 weeks off PPI, but the pdf says 7 day exclusion period off PPI. Is 2 weeks to be safe for false negatives? Just wondering.

Also, does h pylori have any effects on esophagus? I'm asking as I did have grade b esophagitis.

Helico_expert
Site Admin
Posts: 3712
Joined: Wed Mar 02, 2011 7:20 am

Re: Stomach and chest issues

Post by Helico_expert »

H. pylori does not colonise in the esophagus. However, due to acid reflux, the acid can damage the esophagus that leads to esophagitis.

2 weeks without PPI is minimum to get useful breath test data. The longer you wait without PPI the better accuracy for the UBT.

PPI can lower the acid, which leads to HP turning off the urease enzyme activity, and leads to false negative UBT.

because of the lower acid level, some microbiome can start growing and compete with HP. So, the number of HP can reduce quite significantly.

All test rely on the number of actual H. pylori. So you need to stop PPI for enough time to 1. allow your body to metabolise all PPI and regain acid secretion; 2. allow HP to grow back in big number.

Mfernan244
Posts: 6
Joined: Sun Feb 23, 2020 1:08 am

Re: Stomach and chest issues

Post by Mfernan244 »

I have my dr appointment tomorrow. It will be my 12th day with no ppi.

I'm thinking of asking for a blood test for H pylori. If positive, should I proceed with treatment? Or should I wait until UBT?

What would you recommend?

Helico_expert
Site Admin
Posts: 3712
Joined: Wed Mar 02, 2011 7:20 am

Re: Stomach and chest issues

Post by Helico_expert »

blood test is less reliable compare to breath test.
because your immune system has memory of your infection.
so your blood antibody can stay positive for months or even years.
therefore, a positive blood test means you had been exposed to H. pylori before. not necessary that you have H. pylori now.

a negative blood test is accurate though. it will mean you do not have H. pylori now.

Mfernan244
Posts: 6
Joined: Sun Feb 23, 2020 1:08 am

Re: Stomach and chest issues

Post by Mfernan244 »

I had my doctor visit a few days ago. The doctor I visited said that 12 days off ppi should've been enough. I told him I was told at least 14 days. I went through the test and results came back negative.

Should i accept as negative? Do false negatives change significantly from day 12 to day 14?

I don't know what to do at this point.

I'm having non acidic reflux. Can it be that my acid is lower? Does low acid change how long I should be off of ppi or is it still 14 days? (Not sure if I'm asking this correctly, I'm trying to ask if low stomach acidity can 1. Affect test result and 2. If I should wait longer after ppi for test)

EDIT my acute gastritis was non erosive, we don't know the cause (I don't smoke, drink alcohol, do drugs, take pills) so h pylori was a good culprit

Helico_expert
Site Admin
Posts: 3712
Joined: Wed Mar 02, 2011 7:20 am

Re: Stomach and chest issues

Post by Helico_expert »

that depends on how negative is the negative breath test.
if the cut off value is 50 and you got less than 5, then that's very negative.
if you got 49, then the negative is suspicious.

also what is the positive cut off value?
if it's 200, then 49 is ok
but if it's 180, then that's very suspicious.

since you have reflux symptom. I think you need to take some H2 blockers for another 2 weeks and try the breath test again to be double confirm.

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