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Coeliac disease under investigation,gastritis with H pylori infection - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   Hi My name is XXXXXXXX and I'm 29 yo. I have a few questions for you.
Doctor :   Hi
Doctor :   Iam.Dr....
Doctor :   Please post your query
User :   Hi Dr. Sanju, here i go...I've had heartburn for about 10 years, the doctor prescribed me nexium which i take when i remember to. Aside from that i have been having bloating and constipation, sometimes when i'm able to go, it is in the form of diarrhea. I have been constipated now for about 5 days straight.... there is more...
User :   I had an abdominal MRI last week and it was normal. Yesterday the nurse practitioner told me that I came back positive with H. Pylori, she said they had noticed it back in november, but appararently no one told me, so I've probably had this since then.
User :   She gave me 20mg of omeprazole twice daily, 500mg tetracycline 4x daily, 500mg 3x daily and otc peptobismol tablets 3x daily.
User :   my first questions is if this combination will make me more constipated?
Doctor :   ok
Doctor :   ok
Doctor :   No,the combination is the drug for h pylori
Doctor :   Hpylori infection is assctd with cancer
User :   right , but will this make me more constipated as i read on all of them that the side effects on all could be constipation?
Doctor :   so to get rid of them is very imp
User :   i see
Doctor :   That is mimor
User :   ok
Doctor :   comparing to the benefits of the drug
Doctor :   that is there with almost any drug
Doctor :   you take
User :   i see ..
Doctor :   Are you having proper exercises and good fibre intake
User :   not at all..
User :   ok so h pylori could cause cancer eventually if untreated .. or does it happen when you have cancer already?
Doctor :   H. pylori is a major cause of diseases of the upper gastrointestinal tract. Eradication of the infection in individuals will improve symptoms including dyspepsia, gastritis and peptic ulcers, and may prevent gastric cancer.
Doctor :   yes
Doctor :   An intramuscular vaccine against H. pylori infection is undergoing Phase I clinical trials and has shown an antibody response against the bacterium. Its clinical usefulness requires further study
Doctor :   The standard first-line therapy is a one week "triple therapy" consisting of a proton pump inhibitors such as omeprazole, Lansoprazole and the antibiotics clarithromycin and amoxicillin
User :   ok good.. now can i ask you something else..
Doctor :   H. pylori colonizes the stomach and induces chronic gastritis, a long-lasting inflammation of the stomach. The bacterium persists in the stomach for decades in most people. Most individuals infected by H. pylori will never experience clinical symptoms despite having chronic gastritis.
Doctor :   YES SURE
User :   She mentioned the possiblity that i could have Celiac disease( which really scares me) due to the bloating and borderline anemia, I have a appt on monday with a Gi to see if i could be tested for this
Doctor :   ok
User :   could there be a possibilty that the h. pylori can make the results appear positive for celiac disease?
Doctor :   no,coeliac disease is an auto immune disease
Doctor :   that occurs in genetically predisposed people of all ages from middle infancy onward. Symptoms include chronic diarrhoea, failure to thrive (in children), and fatigue
Doctor :   Coeliac disease is caused by a reaction to gliadin, found in wheat, and similar proteins found in barley and rye).
Doctor :   Do you have weight loss these days?
User :   no i have been pretty steady
Doctor :   Is your diarrhoea voluminous and malodorous
Doctor :   ok
Doctor :   do you have abdominal pain and cramping
User :   it is malodorous but not voluminous abd pain on the right
User :   no cramping
Doctor :   ok
Doctor :   Did you try not using wheat rye etc?
Doctor :   was it advised by ur doctor?
User :   not yet, she mentioned this to me yesterday
User :   no it was a nurse practiotioner
Doctor :   ok
User :   she said she was not sure
Doctor :   Blood tests are the first-line investigation required to make a diagnosis of coeliac disease
Doctor :   IgA antiendomysial antibodies can detect coeliac disease with a sensitivity and specificity of 90% and 99%
User :   my gliadin ab came back equivocal she said
Doctor :   OK
User :   if that makes sense to u
Doctor :   Did you undergo endoscopy and biopsy?
User :   no
Doctor :   ok
Doctor :   A negative serology test may still be followed by a recommendation for endoscopy and duodenal biopsy if clinical suspicion remains high due to the 1 in 100 "false-negative" result.
Doctor :   As such, tissue biopsy is still considered the gold standard in the diagnosis of coeliac disease.
User :   ok
Doctor :   Do you do regular exercises?
User :   unfortunately i dont.. but i will start asap
Doctor :   yes good
Doctor :   That is very important
Doctor :   for digestion related diseases
Doctor :   and good bowel movement
Doctor :   And reduce dietary intake of spicy or non veg foods
User :   Dr...., can i take magnesium citrate to heklp with constipation when taking these meds?
Doctor :   Ok
Doctor :   but some drug interaction do take place
Doctor :   since you are taking acid reducing drugs
Doctor :   which do cause some constipation
Doctor :   and do reduce the effect of stool softeners
User :   ok so It's best not to take it then
Doctor :   Do try exercises and diet modification first
Doctor :   And you will have difference in bowel habits
Doctor :   The routine use of laxatives is discouraged, as having a bowel movement may come to be dependent upon their use.
User :   ok
User :   i am really worried about celiac disease.. and waiting until monday is very hard
Doctor :   Anyway do the test to rule out coeliac disease
User :   yes
Doctor :   because it is assctd with cancer in intestines
User :   i will. well i think that is all i had for now.
User :   if you can think of anything else pls feel free ..
Doctor :   Do you visit toilet immediately after food?
User :   no
Doctor :   yes
Doctor :   ok
Doctor :   some times it can be inflammatory bowel disease
Doctor :   which is very much benign
User :   ok
Doctor :   WWW.WWWW.WW
Doctor :   so be confident
Doctor :   and dont skip the examination by ur gastro
User :   i won't . i Thank you so much for your help and advice
Doctor :   OK
Doctor :   is there anything else i can help you with?
User :   not at the moment i will try to save information , i hope you have a good weekend. :)
Doctor :   Thanks for consulting..Bye for now...
Doctor :   bye, take care..
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