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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes difficulty in breathing?

I was diagnosed with chronic idiopathic angioedema about 2 years ago. It has been well controlled with antihistamines but it is back! I am VERY frustrated and scared. It has started to affect my breathing at times and I am terrified to leave the house without my epipen. I just ran across some info on h pylori and angioedema. Do any of you have any experience with angioedema and h pylori?
Wed, 31 Jan 2018
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Oncologist 's  Response
Hi

After hearing your history, I feel Helicobacter pylori infection is considered among the causative factors of urticaria and angioedema. Chronic idiopathic angioedema may decrease substantially following the eradication of H. pylori infection.
H. pylori is eradicated by triple therapy.

Some of the drugs that are used in a triple therapy treatment include:
Clarithromycin.
Proton-pump inhibitors (PPI) such as Lansoprazole (Prevacid), Esomeprazole (Nexium), Pantoprazole (Protonix), or Rabeprazole (AcipHex), Metronidazole (for 7 to 14 days) and Amoxicillin (for 7 to 14 days).

Treatment may vary depending on your past medical history and if you have allergies to any of these medications. Allergic and idiopathic angioedema are usually treated with antihistamines or occasionally with the help of steroid medication to reduce the swelling. As you are having breathing difficulty you can take tablet Asthalin 4 mg twice daily after food for 5 days.


Regards,
Dr. Monish De,
Oncologist.
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Oncologist Dr. Monish De's  Response
Hi

Yes H pylorii is related to angioedema and it is one of the causes to development of angioedema.

So you must test yourself for H pylori by

Blood test. Analysis of a blood sample may reveal evidence of an active or previous H. pylori infection in your body. However, breath and stool tests are better at detecting active H. pylori infections than is a blood test.

Breath test. During a breath test, you swallow a pill, liquid or pudding that contains tagged carbon molecules. If you have an H. pylori infection, carbon is released when the solution is broken down in your stomach.

Stool test. A laboratory test called a stool antigen test looks for foreign proteins (antigens) associated with H. pylori infection in your stool. As with the breath test, PPIs and bismuth subsalicylate can affect the results of this test, so your doctor will ask you to stop taking them for two weeks before the test.

If H plylori is found then it has to be treated by
At least two different antibiotics at once, to help prevent the bacteria from developing a resistance to one particular antibiotic. Your doctor also will prescribe or recommend an acid-suppressing drug, to help your stomach lining heal.

Drugs that can suppress acid include:

Proton pump inhibitors (PPIs). These drugs stop acid from being produced in the stomach. Some examples of PPIs are omeprazole (Prilosec, others), esomeprazole (Nexium, others), lansoprazole (Prevacid, others) and pantoprazole (Protonix, others).

Histamine (H-2) blockers. These medications block a substance called histamine, which triggers acid production. Examples include cimetidine (Tagamet) and ranitidine (Zantac).

Bismuth subsalicylate. More commonly known as Pepto-Bismol, this drug works by coating the ulcer and protecting it from stomach acid.

Your doctor may recommend that you undergo testing for H. pylori at least four weeks after your treatment. If the tests show the treatment was unsuccessful, you may undergo another round of treatment with a different combination of antibiotic medications.

Regarding your breathing problem you must do a chest x ray PA view.

You can also take tablet Asthalin 4 mg twice daily after food for 5 days.

Regards

DR DE
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