Wheeze and H. Pylori Eradication

[Nes]

I am writing this note and I hope it finds its way to researchers at your reputable Center. I really appreciate if some advice can be offered to me please.

I am a female, 44 years old – in excellent health and complained of no issues earlier. My symptoms started back in May 2020. I observed that I started to feel drained and fatigued. Then around the same time, I started to experience a wheeze when I would wake up in the morning – for the first two or three breaths. This wheezing was something more of a gurgling feeling that goes up to the middle of the chest. It is sensed after laying down for sometime and at the time of waking up – that would disappear for most of the day and only sensed on getting out of bed..

So I looked at these two issues simultaneously ( Feeling tired and the wheezing) I did some tests to find the reason for feeling tired, although am a very active person and found that I had a deficiency in Vitamin D : 7 on a scale of 0-100 (It came as a shock to me as my Vitamin D levels 9 months earlier was 50 out of 100). Also, knowing that am an outdoor person – but I thought that Corona outbreak and staying indoors for two months at the time might have resulted in this situation.

At the same time, I went to get my chest checked for the wheeze – Following normal physical examination, the Dr. said my chest was clear. He diagnosed it as allergy and I was put on Symbicort inhaler ( for almost two months) - but the morning gurgling / wheezing did not subside.

Becoming perplexed, I wanted to be sure, so I got my chest checked through the CT scan – and it was perfect! The issue aroused my curiosity. Then I read by chance about Dr. Marshall’s research, so I thought maybe it is coming from the stomach and the H. pylori and maybe it is acid reflux and it has nothing to do with my chest. I stopped the inhalers and went for the H. Pylori test and to my surprise – I tested positive. This was just last month- after much research and reading. Then I started to experience heartburn but really nothing more than that no pain, vomiting, nausea, chest tightness…really nothing…

To treat the H. Pylori, the Dr. prescribed the protocol of Trio clar ( antibiotics for the h. pylori) and I completed the medication period of two weeks. The gurgling - which could be sensed also in the stomach at the time of the treatment- reduced noticeably - but was not gone. Also, keeping in mind that I was very careful about my diet especially at the time of treatment. Then upon completion of the 14-days treatment protocol, Dr. prescribed Controloc 40, Ganaton and Amipride for one month – and has requested me to go for another h. pylori stool test following two weeks – after the completion of the said medications.

Honestly, this complimentary medication had no effect whatsoever on the wheeze. So I have stopped taking them after two weeks - following the H. pylori treatment. I will be performing the second test of the H. pylori after two weeks. I am worried that this wheeze does not go away.


Now please I have few questions:

1) Please, what is the reason for this wheeze - I am wondering why the wheeze should persist despite the fact that the H. Pylori has been (presumably treated). Of course, I am still waiting to perform the retest. Is it impacting the trachea? How can I get it treated? I am more careful now about my diet - I do not wish to have this gurgling left untreated. I do not complain of anything serious other than this gurgling sensation. Is five months of displaying such symptom considered chronic ? ( keeping in mind that I do not have any other symptoms : pain, chest tightness, vomiting etc... nothing really except that wheeze).

2) Does H. Pylori deprive the body of Vitamin D? I am quite curious to know this point.

13 I have recently gone through research that mentions that H. Pylori deprives the body of Vit. B, Zinc and other minerals...but especially that Zinc helps to heal the Oesophagal and the stomach lining. So I have started taking Stress tab supplements ( which contains Vit B12, Zinc, A, C and E etc..) since one week and am feeling slight improvement in terms of the persistence of the wheeze in the morning. It is too early to decide as I have just started taking this supplement. I am not sure if you can advice me please on this point or shed some light in this regards - per your latest research.

Thank you very much. I really appreciate your advice and sorry for my long email.

Best Regards
Nes

[Helico_expert]

Your problem may or may not be because of H. pylori.

Since you had quite a heavy antibiotic treatment, and the symptoms persist, suggest that it may not be because of a bacteria infection.

But it's good to know that you had done CT and everything came out good.

Nevertheless, if it is indeed because of H. pylori, sometimes it takes a while to recover.

Let's wait and see your follow up stool test. Hopefully your treatment for H. pylori is successful.

[Nes]

Thank you very much for your response and detailed note.

Surely, the retest will give us a concrete result.

Please, when should I go for this retest? I have stopped the complimentary Controloc course about nine days ago - following the trio-clar treatment period of 14 days?

Sincere thanks and will keep you posted.

[Helico_expert]

to get accurate follow up result, you need to stop all medications for at least 14 days.
The longer you wait, the higher the accuracy. This is because we need the survival to build up in numbers. So the more HP, the better the detection.

[Nes]

Hello Helico Expert,

Thank you very much for your earlier response. I wanted to update you that following my last post, I went yesterday for the stool retest and it came out positive again! Honestly I feel depressed.

The evening wheeze still persists with extremely mild chestburn (possibly due to the H. Pylori). I have observed also a bitter taste in the mouth that comes and goes early morning.

On receiving this result, I went for a blood test to identify the HP strain. Will be grateful indeed if you please advise on the suitable antibiotics once the results are out - expected by tomorrow - in view of your great experience in this area.

Thank you very much..I sincerely appreciate your help.

[Helico_expert]

I am sorry that you are still positive of H. pylori.

blood test will only tell if you if had H. pylori previously.
only culture and DNA testing will be able to tell you the strains.
the presence or absence of CagA or VacA antibody from blood test is not very useful.

Now that you know you are still carrier of H. pylori, I think you should focus on what should be the next treatment.

[Nes]

Hello Dr.,

Thank you very much for your response. I do appreciate it. Please, so does identifying the presence of the other strains be useful ? or you mean the test itself is not that useful?

Many thanks

[Nes]

Hello helico_Expert,

Further to my previous question, please can you advise whether a biopsy of the HP - through an endoscope - would be useful at this point - before determining the treatment? I read about this in one of the posts and am interested to go for it - if it will help.

I have an appointment with the Dr. on Wednesday. I hope you can please shed light on these two queries.


Thanks so much..

[Helico_expert]

depending on your age and severity of your gastric disease, endoscopy may or may not be useful.

endoscopy is useful to see if you have other abnormality.
histology can provide more detail assessment of your gastric tissue to see the severity of the inflammation and if there is any pre-cancer marker, eg intestinal metaplasia.

a biopsy can also be processed for H. pylori culture. If the laboratory is able to culture the strain, then they can do antibiotic susceptibility test and find out what is the best antibiotics to use.

So if you had not had one in the past 12 months, you can go and get one done.

otherwise, if you are still young, no family history of gastric cancer, your doctor thinks it is ok to skip endoscopy, then you can proceed to HP treatment.

knowing the type of H. pylori is not useful for you. All you need to know is presence or absence of H. pylori.

sometimes, doctors would recommend skipping endoscopy because the outcome is the same. eg. PPI + antibiotics.

so, just ask for strong PPI, eg. rabeprazole 20mg TID.
also ask for bismuth, eg 240mg QID
and two other antibiotics that you have not tried.
avoid Tetracyline and Amoxicillin combination.

[Nes]

Hello Helio_expert,

Thank you very much for your detailed note and advice. I sincerely appreciate it. I will share with the Dr. your recommendation. Will keep you posted.
Once again, thank you very much.

Best Regards