Stomach Bugs 2

Mr. Bugged is still worried about the bugs that have been bugging his stomach. As you may remember, the last column was bugged with H. pylori bacterium in response to a question from Mr. Bugged. But Mr. Bugged feels that the column did not completely answer his question. He is not sure if the debugging process was medically indicated in his case and whether it has worked.

Mr. Bugged is having sleepless nights worrying about these bugs. He thinks that the bugs, in the middle of the night, crawl up his oesophagus and have a late night party in his mouth. Well, Mr Bugged, let me assure you that nothing like that has been reported in the scientific literature.

Mr. Bugged says that his stomach rumbles every time he has a meal. He wonders if the bugs are eating away his food. Starving him of essential nutrients. Again, this is not true.

The last column said that H. pylori should be treated if only a person is proven to have an ulcer in the stomach or duodenum. But Mr. Bugged did not have an ulcer. Mr. Bugged is upset with his doctor. The doctor had given him two antibiotics and an acid suppressing expensive drug. Mr. Bugged’s diagnosis? Non-ulcer dyspepsia with H. pylori infection.

Was Mr. Bugged’s doctor wrong? Not really. Mr. Bugged, your doctor must have carefully assessed your symptoms and findings before prescribing the medications. Let me explain the term non-ulcer dyspepsia and the controversy surrounding the treatment of this condition when associated with H. pylori infection.

The term “dyspepsia” is derived from the Greek word dys (bad) and pepsis (digestion). Symptoms of dyspepsia include upper abdominal pain, discomfort, early satiety, bloating, nausea and vomiting. About 30 percent of the population suffers from this but only 20 percent of them seek medical help.

The question is – is H. pylori the cause of dyspepsia? No, the jury is still out on that. Then why treat H. pylori in patients who have no ulcer? This is controversial.

A review article, published in the New England Journal of Medicine, November 1988, says that in 8 of 16 studies, the eradication of H. pylori significantly improved symptoms in patients with non-ulcer dyspepsia. And a recent review article (September 16) in the British Medical Journal says that H. pylori eradication treatment was significantly superior to placebo in treating non-ulcer dyspepsia, one case of dyspepsia being cured for every 15 people treated. Is this a good reason to prescribe medications to get rid of H. pylori in patients with no ulcer? Depends on individual cases.

So, Mr. Bugged, if your symptoms have disappeared after the treatment then your doctor was right. If not, then atleast he tried as long as he explained to you his reasons.
So have a good sleep and enjoy your meals. One day, hopefully, we will have an answer for you.

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