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Have Indigestion And Gastric Which Has Led To Dysentery. Was Diagnosed H.pylori Infection. Start Eating Spice?

Posted on Sat, 14 Jul 2012

Question: i have indigestion and gastritics,which lead to desentry many times,last year i have diagonised h.pylori infection for which i did i did 14 days antibiotic course.but yet now i can not take any masala food even if donot take masala food i yet now have indigestion and gastric pain.

Answered by Dr. Neelam Ashish Vanjari (2 hours later)

Hi XXXXXXX

As per your history, you had H. Pylori infection and were treated with antibiotics.
But I would like to ask if you were tested for same infection 4 weeks after treatment or not?
H. Pylori infection usually needs more than 1 round of treatment.
So get one of the following tests done after consulting your gastroenterologist.
1] Blood test for H. Pylori antibodies.
2] Urea breath test.
3] Stool antigen test.
If same infection has recurred get it treated, until it is cured completely.

Get upper gastro-intestinal endoscopy done. [Upper GI scopy]
It will diagnose presence and location of ulcer. i.e. stomach or duodenal or esophageal ulcer.

Consult gastro-enterologist. You can take simple antacids to relieve pain till you get your reports of tests and endoscopy.

At the same time, follow certain lifestyle modifications.
1] Take small and frequent meals.
2] Avoid stress, adopt relaxation techniques.
3] chew your food slowly and thoroughly.
4] Exercise regularly and have regular, timely meals.

I hope I have answered your query. In case if you have doubt, I will be happy to help you.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Neelam Ashish Vanjari (5 hours later)

can h.pylori infection leads to indigestion,desentry.
and i have done whole abdomen ultrasound which shows everything normal.
i did stool test which shows,i did not understand anything can u help me.
the report shows as below::

physical examination=
colour :brown
consistency:soft
chemical examination=
reaction:alkaline
miscellaneous=
strach cell:+
vegetable cell:+
bacteria:seen
orientation tests=
the aerobic culture of the specimen for 24 hrs at 37c shows growth of the following
organism:klebsiella pneumoniae ssp pneumoniae
ATB expert comments=

25-impossible phenotype:please check and correct
25-B-lactams:the resistance must be crossed for
25-these antibiotics,
61-AMINOGLYCOSIDES:THE RESISTANCE TO AMINOGLYCOSIDES IS OFTEN
61-ASSOCIATED WITH esbl
99-IMIPENEM AND MEROPENEM HAVE A SIMMILAR ACTIVITY,
102-aminopenicillins:result valid for ampi.and amoxi.
125-b-lactams:the cephalothin result can be extended to
125-cephapirin,cephradine,cephalexine,cefaclor,cefadroxil
127-b-lactams:MZL ans PIC have a similar activity
129-b-lactams:amoxi-clav. and ampi-sulb.:similar activity
130-cefamandol,cefuroxime,cefonicid:simailar activity.
132-cefotaxime,ceftizomine,cefrriaxone:similar activity.

on the last page it had been written as=
organism:klebsiella pneumoniae ssp pneumoniae
137-activity and resistence crossed between:
137-*ciprofloxacin and levofloxacin.
140-fosfomycin:result only valid for
140-E.coli strains isolated from urine specimens.

Answered by Dr. Neelam Ashish Vanjari (24 hours later)

Hi XXXXXXX

H. Pylori can cause indigestion and peptic ulcers but dysentery is unlikely.

As per your reports of stool examination and culture, cause for dysentery is bacteria- Klebsiella.
It has developed resistance to few antibiotics like aminoglycosides and beta lactamases. It has sensitivity for cephalosporins[as per your above mentioned report].
Klebsiella usually affect in immunodeficient state. Consult your treating doctor about this and bacillary dysentery treated with antibiotic as per mentioned above.

Even after treating bacillary dysentery, if you get similar complaints get endoscopy done. Ultrasound all the time cannot diagnose things correctly.

I hope this information is useful to you. If still you have doubts, revert back; I will be happy to help you.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Neelam Ashish Vanjari (13 hours later)

gestrologist suggest me to do coclonscopy..
but,i am quite afraid to do that,since lat yest due to anal fissure another doctor surgeon do sigmoidoscopy which is very painfull to me.
my gestrologist prescibed tablet :
1)klap
2)gutrex
3)domta-dsr capsules
now ,i am feeling better.
a)should i go for colonscopy and
b)the bacteria- Klebsiella can cause any damage,what it actually cause,what are the foods should i avoid and how to treat the bacteria- Klebsiella
c)E.coli strains isolated from urine specimens.it has been written in stool test as u already seen ,do i have e.coli infection too?plzz suggest.

Answered by Dr. Neelam Ashish Vanjari (2 hours later)

Hi XXXXXXX

Thanks again,

I apologize for not addressing the urine reports in our previous discussion. I shall address it this time.
But as you have been given above drugs, one of it being antibiotic will take care of this infection.

1. Klebsiella is associated with dysentry. It can lead to electrolyte imbalance. In an immunodeficient individual this can lead to pneumonia. Presuming you do not have immunodeficiency, the antibiotics prescribed to you should take care of this infection.

2. Colonoscopy allows the doctor to see through the inside of colon. Thus helps doctor to visualize the pathology. I understand the pain associated with it. However when done under an experienced doctor and good anaesthesia you should be experiencing that much pain.

If you are worried about getting colonoscopy, I suggest you to complete the course of medicine as per your treating doctor. We can avoid the procedure if your symptoms resolve with it. Else I encourage you to get the procedure done.

3. Presence of Escherichia coli (E.coli) is insignificant if you do not have any urinary complaints. It is a common contaminant of urine. In the absence of symptoms, I don't think this is concerning. Any way the prescribed antibiotic would take care of this infection too.

Hope this answers all your queries. Close this discussion and rate this answer if all your queries are addressed. Yet, if I have missed out any of your concerns, let me know.

Wish you good health

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Neelam Ashish Vanjari (8 hours later)

thank you mam,
my gestrologist prescibed tablet :
1)klap for 5 days twice daily after food
2)gutrex for 2 months twice daily after food
3)domta-dsr capsules morning empty stomach for 2 months
a)plzz suggest me what are the tablets for
b)is these suffiicent to kill the the infection
also in the last year when doctor surgeon did sigmoidoscopy(due to anal fissure problem)
result finds as:-Grade I haemorrhoid
proctitis
a)is the two names are same,that mean refer to the same disease.
b)is this anal fissure
c)doctor prescribed medicine
i)sucral ano at bed time daily
ii)delgestic before and after passing motion
c)syrap duphalac 20 ml daily at bed tine for control.
for 6 months i took these to get cured and i got relive after that
a) i just want to ask are these medicine sufficent to treat .

Answered by Dr. Neelam Ashish Vanjari (11 hours later)

Hi XXXXXXX

A] Let me explain about your tablets first.

1] Klap: Ofloxacin & Ornidazole -Anti-Infective for klebsiella dysentery.
2] Tab Gutrex: reduces sensitivity of gut.
3] Cap Domta-dsr: antacid with anti- nausea drug.

Five days antibiotic course is usually sufficient to treat infection.
Follow up your treating physician for same.

B] Now coming to your sigmoidoscopy results.

Hemorrhoid and proctitis are two different things.
1] Hemorrhoid grade I is small swellings on the inside lining of the rectum-anus. They cannot be seen or felt from outside the anus.

2] Proctitis is inflammation of the rectum that causes discomfort, bleeding, and occasionally, a discharge of mucus or pus. Hemorrhoid can cause this.

3] Anal Fissure: The anal fissure is a small tear in the lining of the anus. The anal fissure can cause pain, bleeding and/or itching.
Anal fissure co-exists in your case along with hemorrhoid, is not same entity as proctitis or hemorrhoid.

The given medicines are sufficient to treat your condition.
Do not stress yourself for medicines.

Have faith on your treating physician.
Thanks for your query. I hope I have given satisfying answers.

Wish you good health.
Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Neelam Ashish Vanjari (8 days later)

Hello sir/madam,

Doctor,I have gastritis problem form many years,when I went to doctor ,gestroentrologist suggest for ugi endoscopy,he did biopsy it shows I had h.pylori infection.doctor prescribed medicine which i took ,after that it seems to normal someway.but,recently it worst .i again went to another gestroentrologist in our town he suggested ugi endoscopy and colonscopy.i agreed I did ugi endoscopy (without biopsy) ,he told and also write in the report I have duodentitis and without biopsy he told I donot have h.pylori infection.
And also prescribed medicine .in colonscopy ,I throught everywhere it follows same procedure it means ,a mild sedeation given to patient so that patient will not feel the pain.
But,he told here colonscopy is done without sedeation,I request doctor almost 3 times during the visit.he did not agreed by anyway.then I consult with some big hospitals names by hoping that there atleast colonscopy has done with sedeation.but everywhere it’s same.then,I connect with my friend who is living at delhi,he told me here and almost anywhere colonscopy done with mild sedeation which is a standard one.now what can I do.i am 21 years old boy with normal bp.

For your convinence I uploading the report and medicine prescription.

Doctor prescribed medicine as follows :
1)nizonide-o twice daily for 5 days
2)rekool D once in the morning for two months
3)cibis tablet twice daily for two months.

Answered by Dr. Neelam Ashish Vanjari (3 hours later)

Hi XXXXXXX
Thanks for writing back.
Colonoscopy is done with mild sedation and also pain relievers are given to ease the procedure.
I would recommend you to get it done at the hospital where it is done with sedation. You might search it in nearby town.
H.pylori infection status can not be ruled out by just looking at it, as biopsy or blood/breath test is required. But as you have already taken medicines for it, it looks like it may not be present as duodenitis is diagnosed.
Continue above mentioned medication.
I would suggest, get only colonoscopy done. Do not repeat upper GI endoscopy.
Once colonoscopy is done, if it comes normal; no need to worry. With above medication, symptoms will come down.
I hope I have answered your query.
Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Neelam Ashish Vanjari (3 days later)

mam can u tell me what the medicine for
Doctor prescribed medicine as follows :
1)nizonide-o twice daily for 5 days
2)rekool D once in the morning for two months
3)cibis tablet twice daily for two months.
and in this condition can i take spice and oil foods.geera,lime .halidi powder,garam masala,garlic,onion etc can i take to cook vegetables with oil.now,i am taking only boil foods with boil vegetables.taking fruits which are XXXXXXX in fibre like XXXXXXX banana,papaya others will hurt.can i take sweets and egg,meat,fish.plzz suggest some diet.

Answered by Dr. Neelam Ashish Vanjari (17 minutes later)

Hi XXXXXXX

Thanks for writing in.
Nizonide-o is anti infective. Rekool-D is for acidity which has proton pump inhibitor and antiemetic contents.
Cibis is antispasmodic given in irritable bowel disease.

I would like to ask you, have you done Ultrasound abdomen/CT abdomen?
Sometimes in case of acidity/indigestion; culprit can be either in liver or gallbladder or pancreas.
If Not, get at least ultrasound abdomen done.

Regarding diet, you can take cooked vegetables with oil but let oil be in fewer amounts.
Do not only eat boiled vegetables, it will make you weak. Eat all sorts of fruits and leafy vegetables. But spices like jeera, garam masala should be less. You can use haldi, lime, and no issues with that.
Even you can have egg, meat, fish but keep it least possible spicy.

Hope I have cleared your doubt. In case of other doubts, you can revert back.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Neelam Ashish Vanjari (3 hours later)

mam i did ultrasound,it was writtten in the impression as:
ORGANS IMAGE ARE WITHIN NORMAL LIMITS.(DATED 8 MAY,2012)
mam,i love sweets ,not choclate,but like rosogola,any other that type of sweets.
can i have those?

Answered by Dr. Neelam Ashish Vanjari (24 hours later)

Hi XXXXXXX

It is good that your ultrasound is normal.

You can have sweets like rasgola, no problem.

If colonoscopy is available with sedation, then only go ahead and get it done.

Upper GI endoscopy has already detected duodenitis.

So continue prescribed medication.

No need to worry.

Wish you good health.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Neelam Ashish Vanjari (41 hours later)

Mam,
I am trying hard to get a name of any hospital,where colonscopy done with mild sedeation in our city ,if not,then I will go to any other town.

You told me that cibis tablet used for bowel movement.but,I take enough fiber and used to use toilet 2 or 3 times in day.
But since last 3 /4 days my stool becomes harder and I have to give lot of strain to pass.
Finally after using duphalc for two days.yesterday I dring peglec solution to clean bowel.
No option was present near me.
Mam,is it harm me and I also stop taking cibis tablet.
a)Is this (cibis tablet) responsible for harder my stool.
b)For what diseases it has been prescribed to me.

Mam,
As I told u before I had anal fissure and I took 6 months medicine I was getting relief .
But with medicine,then I start habit for doing bowel after dinner,in the morning when I use bowel it becomes soft and I do not give any pressure to pass it.i left medicine form that day and since from last 1 year I uses this habit.but one of my uncle told me it is bad and will harm u.
a)     is it bad ,and will this habit goes to any harmfull diseases.
b)     My grandfather told me it it good to clear you bowel 3 /4 times in a days,so that you will not suffer from any anorectal diseases,since then I am using 3/4 toilet in a day.
c)     Mam,will it hurt me.

Answered by Dr. Neelam Ashish Vanjari (9 hours later)

Hi XXXXXXX

You have mistaken Cibis tablet. It has anti-spasmodic effect so you will not get discomfort.
Cibis tablet will not cause constipation or will not harden stool.
Inflammed duodenum in duodenitis causes pain due to contractions, so it has been prescribed to you.
Do not stop in between, continue tablet for 2 months.

Regarding anal fissure or bowel habits, people will give different opinion, do not follow each and everything they advice.
Take lots of water as and when you need.
Include good amount fiber in the form of fruits and leafy vegetables.
Bowel habits even if is done for once is enough, it does not affect or cause any disease.
Just take care that it will not lead to constipation or passing motion in 3-4 days.

Most important thing what I have observed is you take too much stress for small things.
I strongly suggest jogging / brisk walking for 40 minutes. Also quick run for 2 minutes when you are stressed out or your thoughts taking away your peace of mind.

Wish you good health.
Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Neelam Ashish Vanjari (12 hours later)

thank you,mam,i start taking the tablet from today.
mam,my bowel do not clear in one time,can you suggest me anything that i have in the morning or at night so that my bowel gets clear in the morning in once time.
i heard colon cleaning helps in improving digestion.i met a yoga therapist he suggest colon cleaning program,he told to add the liquids of a lime into he 2 liter water and have it in the morning just like peglec solution.since i can not have lime in the empty stomach.can you give anything else just like peglec solution to clean colon and how many times i can do in a month and what is the procedure?

Answered by Dr. Neelam Ashish Vanjari (1 hour later)

Hi XXXXXXX

Good to know you have started your tablets.

Regarding colon cleaning, it is not lime which helps; but it's the "2 litres of water" which removes toxins from body and does colon cleaning. So do not use lime, have only water.

Do not get any other colon cleaning procedures done. You do not need that.

Just having lots of water and fibre in diet is enough to take care of your bowels.

There is no need to follow it as monthly procedure; just inculcate habit of having enough water.

Hope this helps.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Neelam Ashish Vanjari (4 days later)

Mam,I have a few queries left in my mind
a)you did not tell me having bowel movement after dinner will effect anyways to me.it means it may leads to any crohn’s diseases?
b) I am thinking about to start morning walk and some exercise like yoga(abdomen related),should I start in this condition?

Answered by Dr. Neelam Ashish Vanjari (1 hour later)

Hi XXXXXXX

Let me assure you first that your condition is not so bad that you cannot start exercise.
Rather you are just 22 yrs old. You need to do this kind of exercise which helps in digestion and maintaining person's well-being.

Do yoga not only abdomen related but also full including Suryanamaskara.

You are having only duodenitis which will get cured with prescribed medicines.

Bowel movements early in the morning and after dinner i.e. before going to bed are good habits. It will not cause any disease.

So do not worry and practice healthy living with balanced diet and exercise.

Thanks again.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Neelam Ashish Vanjari (2 days later)

mam,once u mentioned the statement
1)Klebsiella is associated with dysentry. It can lead to electrolyte imbalance. In an immunodeficient individual this can lead to pneumonia. Presuming you do not have immunodeficiency, the antibiotics prescribed to you should take care of this infection.
actually i want to ask:-
a)what is immunodeficiency,and how to detect a person have immunodeficiency disease that means any test that shows.
b)what is the best time to do morning walk?
c)should i go on empty stomach or drink 2/3 glasses of water and then proceed.

Answered by Dr. Neelam Ashish Vanjari (1 hour later)

Hi XXXXXXX

Let me explain immunity first. Immunity is made up of cells which fight against the infection. These cells kill the micro-organisms or inactivate the toxins produced by pathogenic bacteria.
1] The person who lacks those cells will be immunodeficient. Those people will be susceptible to more infection.
Blood test like T cell count, neutrophil count, phagocyte and immunoglobulin levels are used to find out whether person is immunodeficient or not. If you have been fit and healthy so far, it is unlikely that you have any immunodeficiency.

2] Morning walk is best when there is no pollution. Usually morning 6 o clock is fine but as such there is no strict rule.

3] There is no need to go for walk on empty stomach. After having 1 glass of water you can start and have remaining water later. But you should keep yourself well hydrated throughout.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Neelam Ashish Vanjari (9 hours later)

mam,i am thinking about to show to any gestroentrologist outside our town ,can u suggest me any good names,who actually treat patient with care but not hunger for money making.recently i heard about dr XXXXXXX XXXXXXX and and dr.a.k.kriplani form delhi appolo and about their negligence towards treating a old lady and misleading in the hospital XXXXXXX sorry to use such words,but there are doctors in the private hospitals actually doing such things,i know there are good doctors are too who charged money but also give same respond towards the patient while treating.thank you

Answered by Dr. Neelam Ashish Vanjari (12 hours later)

Hi XXXXXXX
Thanks for writing in.
You can consult gastroenterologist out side of your town and get colonoscopy done under sedation.
Inquire well - in advance about sedation. You can consult Dr XXXXXXX XXXXXXX in XXXXXXX XXXXXXX Hospital, Delhi. He is quite good. If you do not have faith in private hospitals, you can consult someone in AIIMS or GB Pant hospital as well.
Wish you good health.
Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Neelam Ashish Vanjari (8 hours later)

but,mam in aiims they donot have time to see the patient.do u know any XXXXXXX gestroentrologist(professor) of aiims who visit any clinic or private hospital in delhi.
about dr XXXXXXX XXXXXXX i heard about him,last year when i diagonised with h.pylori infection it was at delhi appolo by dr.amitab dutta.do u know any doctor in calcutta,
i also heard about dr.a.t.mohan(gestroentrologist) chennai appolo,i only heard,do u know anything about him.

Answered by Dr. Neelam Ashish Vanjari (18 hours later)

Hi XXXXXXX

Thanks for writing in.

You can consult Gastroenterologist in Bangalore at Baptist hospital, Hebbal.

Dr. XXXXXXX is very good. You can inquire in advance for it.

I have no idea regarding doctor at Chennai Apollo or Delhi Apollo. I am sorry on this.

Wish you good health.

Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Neelam Ashish Vanjari (2 days later)

mam,for what purpose whole abdomen ultrasound done for?
a)are small instestine,large intestine(colon) not revealed using ultrasound?if any abnormality found.
b)what are the organs actually revealed using whole abdomen ultrasound?
c)mam,i heard about ct colonography,is it equivalent to colonscopy?

Answered by Dr. Neelam Ashish Vanjari (14 hours later)

Hi XXXXXXX

Small and large intestine can be seen with ultrasound.

Whole ultrasound is done to reveal organs in abdomen which include- stomach, small intestine, large intestine, spleen, liver , gall bladder, pancreas, lymph nodes, kidneys, ureter, prostate, urinary bladder.

Yes, CT colonography is equivalent to colonoscopy. It is more comfortable than conventional colonoscopy for some people because it does not use a colonoscope. As a result, no sedation is needed, and the patient can return to his/her usual activities or go home after the procedure without the aid of another person. It also takes less time than either a conventional colonoscopy or a lower GI series.
It provides a secondary benefit of revealing diseases or abnormalities outside the colon.

Only disadvantage is that it can diagnose problems but as possible with colonoscopy, we can not remove or treat abnormalities at that point.

Hope I have cleared your doubt.
Best regards,
Dr. Neelam.

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Neelam Ashish Vanjari (7 hours later)

mam,if whole abdomen ultrasound reveals so many things,then
a)why colonscopy required?
b)whole abdomen ultrasound also reveals large and small bowel and other organs?
c)mam,what is capsule endoscopy,and why actually it is done?

Answered by Dr. Neelam Ashish Vanjari (3 hours later)

Hi XXXXXXX

a) Ultrasound though can see all abdominal organs, one can not reach inside of the organs. Rather colonoscopy can reach inside of organs, can diagnose conditions as well treats them like removing polyps.

b) Whole abdomen ultrasound reveals organs as mentioned in our prior discussion.

c) Capsule endoscopy is endoscopy done using capsule like our medicine pill. Camera is attached to it's front side. Capsule needs to be swallowed with water.
Once swallowed the camera moves naturally through the digestive tract while patients carry out their normal activities. Approximately eight hours after ingesting the camera, patients return the recording device to their doctor or nurse so the images can be downloaded to a computer and evaluated. The Capsule endoscope is disposable and will be excreted naturally in your bowel movement.

I hope I have cleared your doubt.
Best regards,
Dr. Neelam.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar