From the Guidelines
You should contact your doctor to discuss your persistent symptoms of nausea, stomach ache, bloating, and gas, as they may need to evaluate you for other potential causes or provide additional guidance on managing your symptoms, as suggested by the British Society of Gastroenterology guidelines on the management of functional dyspepsia 1. Given that you finished H. pylori treatment 2 weeks ago, it's possible that your symptoms are related to the treatment or the infection itself. The guidelines recommend that patients with functional dyspepsia, which includes symptoms like nausea, stomach ache, bloating, and gas, should be offered a stool test or breath test to look for a stomach infection called H. pylori 1. Some key points to consider:
- Your symptoms could be due to your digestive system still healing from the infection and antibiotics, which can disrupt gut bacteria.
- To manage symptoms, try eating smaller, more frequent meals, avoiding spicy or fatty foods, limiting caffeine and alcohol, and staying hydrated.
- Probiotics (such as Lactobacillus or Saccharomyces boulardii) may help restore gut flora balance - consider taking them for 2-4 weeks, as there is some evidence to suggest that psychological or behavioural therapies may be beneficial for treating symptoms in functional dyspepsia 1.
- Over-the-counter remedies like simethicone for gas, antacids for stomach pain, or bismuth subsalicylate for nausea might provide temporary relief.
- If symptoms worsen, include severe pain, persistent vomiting, or blood in stool, seek immediate medical attention as these could indicate complications requiring prompt evaluation. Additionally, the AGA clinical practice update on evaluation and management of belching, abdominal bloating, and distention suggests that dietary restrictions, such as avoiding fructans, may lead to symptoms of bloating, and that breath testing can be a useful diagnostic tool for suspected lactose, fructose, or sucrose intolerances 1.
From the Research
Symptoms after H. pylori Treatment
- Nausea, stomach ache, bloating, and gas are common symptoms that may occur after finishing H. pylori treatment 2.
- These symptoms can be associated with a variety of conditions, but are most commonly caused by functional gastrointestinal disorders 2.
- Functional dyspepsia, irritable bowel syndrome, and chronic idiopathic constipation are the most common causes of these disorders 2.
H. pylori Eradication Therapy
- The combined treatment with acid-lowering drugs and antibiotics is widely accepted for H. pylori eradication therapy 3.
- Proton pump inhibitors and H2-receptor antagonists are two types of acid-lowering drugs that can be used in combination with antibiotics for H. pylori eradication therapy 3, 4.
- Studies have shown that proton pump inhibitors and H2-receptor antagonists have similar effectiveness in eradicating H. pylori when used in combination with antibiotics 3, 4.
Management of Symptoms
- Empiric therapy is a reasonable initial approach to functional gastrointestinal disorders, including acid suppression with proton pump inhibitors for functional dyspepsia, antispasmodics for irritable bowel syndrome, and osmotic laxatives and increased fiber for chronic idiopathic constipation 2.
- Noninvasive testing for H. pylori and eradication of confirmed infection (i.e., test and treat) are more cost-effective than endoscopy for presumed functional dyspepsia 2.
- Patients with symptoms of irritable bowel syndrome should be tested for celiac disease, and patients with chronic constipation should have a rectal examination to evaluate for dyssynergic defecation 2.