Fwd: Acid reflux, GERD, almost always an infection

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Heartburn: Don't Blame Stress; It's Usually an Infection

By Gabe Mirkin, M.D.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you belch or have burning in your stomach or chest, particularly when your

stomach is empty, you have either an infection, a tumor, or a condition called

GERD in which you belch and have pain and don't have the foggiest idea why. Your

gastroenterologist probably will want to put a tube down your mouth and into

your stomach, but the biopsy that he will do to find the germ can often miss the

germ when it is there.

At least 24 different bacteria have been shown to cause stomach ulcers. Since

doctors do not have any way to check for all 24 different bacteria, all people

with belching and burning in the stomach should be given the one-week course of

antibiotics that is used to treat the most common cause of stomach ulcers,

called Helicobacter Pylori.

I recommend that you get an upper GI series X ray to rule out a tumor, which

almost always comes back negative. Then you get a blood test for Helicobacter

Pylori and you should be treated with antibiotics, even if the blood test is

negative, because there are at least 23 other species of bacteria that this test

does not detect. Otherwise, you will be stuck with a diagnosis of regurgitation,

called GERD, and you will take medication for the rest of your life.

Twenty years ago, everyone believed that stomach problems were caused by

stress. In 1983 they laughed at Dr. Barry Marshall when he reported that stomach

ulcers were caused by infection with helicobacter pylori and could be cured with

antibiotics. Fellow physicians were so mean to him that he responded by

swallowing a vial of helicobacter and almost died. This year he won the Nobel

Prize for his discovery and his courage.

Now almost every reasonable physician agrees that all people who have belching

and burning in the stomach and a positive blood test for helicobacter pylori can

be cured with antibiotics, but many gastroenterologists stubbornly refuse to

treat patients with a negative blood test or biopsy for that germ. They are

clearly wrong because many other bacteria can cause the same symptoms, including

including H. helmannii, H. felis, H. rappini, H. cinaedi, H sp. Strain Mainz, H.

fennelliae , H. pullorum, H. hepaticus, H. Billis, H. canis, H. Hills, H.

mesocricetorum sp nov, cytomegalovirus and mycoplasma.

These germs also grow in saliva, so they can be transmitted between family

members and pets. So some doctors prescribe antibiotics to all people with

belching and stomach burning, and check the other members of the household for

symptoms. The standard treatment, one week of clarithromycin 500 mg twice a day,

metronidazole 500 mg twice a day and omeperazole 20 mg once a day, is safe and

effective.

At least 12 weeks later, you need a follow up blood test for helicobacter. If

your symptoms are gone and the titre drops, you are probably cured. If your

helicobacter titre is still high, your helicobacter is probably resistant to

metronidazole and you need to be treated for at least ten days with amoxacillin

500 mg four times a day, tetracycline 500 mg three times a day and omeperazole

20 mg once a day. If you have regurgitation of stomach acid into your esophagus

(reflux, hiatal hernia), you may need to be treated with 20 mg omeperazole once

a day. Some people who are not infected with helicobacter may benefit from

taking clarithromycin or other antibiotic for a longer period of time. Check

with your doctor.

Helicobacter may also cause liver disease, blood vessel diseases such as

clotting and heart attacks, and certain skin conditions such as rosacea.

For journal references on this article see

http://www.drmirkin.com/morehealth/G123.htm

Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing

physician for more than 40 years; he is board certified in four specialties,

including sports medicine. Read or listen to hundreds of his fitness and health

reports at http://www.DrMirkin.com

 

 

 

 

 

 

 

 

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