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Abdomen pains, black specks in stools. Faecal test negative. Advised for hydrogen breath test. What does it look for?

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Gastroenterologist
Practicing since : 2000
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Dear Dr. XXXXXXX
I recently asked you regarding sharp pains in my abdominal area and unfortunately was busy so not able to follow up on your reply. You mentioned the hydrogen breath test. I thought this test was the same as the H.Pylori test but apparently it is different, what does the test look for? It appears to detect IBS mainly. How accurate is the test because it does seem like it's not totally proven.

I have mentioned to my doctor regarding the pains and the first step is the H.Pylori breath test, is this test able to detect past as well as present infection with the bacteria?

Also, I should mention that I have seen what look like black specks in the stool for a few months but the faecal occult blood test was negative so I assumed it was just food particles. Is it possible for the black specks to be bleeding very early in the gastro-tract that is solidified and hence can't be detected through the occult blood test? What else could cause the black specks?
Posted Tue, 28 May 2013 in IBS(Irritable Bowel Syndrome)
 
 
Answered by Dr. Poorna Chandra K.S 3 hours later
Hi and thanks for the follow up
The breath test indicated was C14 breath test and it specifically looks for active H pylori infection. Past infection is of not much of a relavence as it is not associated with gastroduodenal problems. In an untreated case C14 breath test is a sensitive method to detect H pylori infection.
Stool occult blood is a chemical way of detecting blood as it looks at heam component. It is more specific for upper gastrointestinal tract bleeds than the distal colonic bleeds. Hence if multiple Stool occult blood are negative there is a less chance of any GI bleed. Then the black specks are more likely to represent some food residue
Regards
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Abdomen pains, black specks in stools. Faecal test negative. Advised for hydrogen breath test. What does it look for? 15 hours later
Dear Dr. XXXXXXX

Thanks for the additional information. So, just to confirm, you would not recommend the usual hydrogen breath test in my case, instead the C14 breath test should be indicated. How would past H.Pylori infection be detected if at all? I understand that this type of infection greatly increases the risk of serious issues developing with the stomach or perhaps it's only active infection which increases risk.
Is there any reason why the occult blood tests are better at detecting the upper gastro-bleeds than lower colonic ones, perhaps including ulcers.


Thankyou.
 
 
Answered by Dr. Poorna Chandra K.S 10 hours later
Hi XXXXXXX
As I had written a healed H pylori infection is of not much consequence. However if you have to know both present and past infection go for H pylori serology test
For active infection C14 breath test or gastric biopsy and histopathological examination or a stool antigen tests are recomended. All have similar sensitivities but the breath test is the easiest to do
Regards
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Abdomen pains, black specks in stools. Faecal test negative. Advised for hydrogen breath test. What does it look for? 34 hours later
Hi Dr XXXXXXX

Thanks. I have now found that I will do the C13 breath test soon. I wonder whether it's basically similar in sensitivity to the C14.
Just the past few days, I have experienced a dull pain about 6cms to the right and 10 cms above the navel, just below the rib bone. I am not sure if it's just temporary but would this be the area of the kidneys?
I have mild hydronephrosis of the right kidney.


Thankyou.
 
 
Answered by Dr. Poorna Chandra K.S 20 hours later
Hi
Both are equally good and difference is only in the way that it is measured.
Pain in the (R) upper quadrant can be because of a pathology in -
1) Liver
2) Gall bladder
3) Kidney
4) Stomach/ Duodenum
5) Head of pancreas
and Hepatic flexure of colon rarely
The characteristics of pain and associated symptoms help to make a probable diagnosis
Regards
Dr XXXXXXX
Above answer was peer-reviewed by
 
Follow-up: Abdomen pains, black specks in stools. Faecal test negative. Advised for hydrogen breath test. What does it look for? 9 hours later
Dear Dr. XXXXXXX

Thankyou. I will investigate it further if it continues but I think there is a possibility it was caused by paracetemol intake. I have taken Norgesic, just one tablet for muscle stiffness but it does seem as if paracetemol has a possible effect on the liver or kidney in my case.

On another note, I believe I have asked you concerning GERD in the past, which I've also mentioned to my GP and the breath test is the first step. What is your opinion on Motilium to treat GERD, which was prescribed by an ENT specialist after viewing my throat through a scope together with nexium.

Also, can GERD or conditions of some acid reflux cause a feeling of fullness in the stomach and a sensation at the base of the throat just above the collar bone of wanting to burp but being unable at times. Also, there is an uncomfortable sharp rising sensation near this area after a swallowing motion without anything being swallowed which lasts for about 5 seconds where it rises in intensity before gradually going away. Or would these issues more be strictly to do with the throat?



Thankyou.
 
 
Answered by Dr. Poorna Chandra K.S 6 hours later
Hi and thanks for the query
Paracetamol is the safest NSAID with respect to GI side effects. Hence it is unlikely to c/be the cause of your symptoms
The ENT specialist was right in prescribing Motilium with Neksium. Use of a prokinetic (motilium) along with neksium will increase the response rate by around 15 - 20%.
A bad reflux or GERD and H pylori infection itself will cause the bloating and the throat discomfort. Hence plan and endoscopy and a biopsy for h pylori can be taken during the same procedure.
Regard
Dr XXXXXXX
Above answer was peer-reviewed by
 
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