LPR problems after finishing antibiotics. Coincedence????

Hello, my name is Maria and I am 30 years old. Sorry for any english mistakes but I live in a European country and english is not my mother tongue.

Last May, I had a sudden surgery because of ovarian cyst rupture. I stayed in the hospital for 2 days. I returned to my home and I was feeling very good.
The doctor had prescribed me an antibiotic ( Ceclor 1500mg for approximately 10 days) and xeforapid for post surgery pains. During all this time I had diarreah every day but I didn't worry. I was trying to eat a yogurt sometimes.

Within a week after finishing the antibiotics, my nightmare started and until now I am not healthy as I was before.
3 days after finising the antibiotics I experienced in the morning cough and a sensation of lump in throat after waking up. I worried but I didn't pay much attention because these first symptoms subdided during the day. But unfortunately within 2 days after, in the end of the same week, suddenly after my dinner I felt heartburn in stomach area, sternum up to my throat. Constant sensation lump in throat, extremely amount of belching etc
I did an endoscopy and doctor found mild gastrtitis in antrum and a tiny hiatal hernia. He prescribed omeprazole for one month. The heartburn disappeared immediately but not the other symptoms.
Apart from that, during treatment period I had o lot of PPI side effects headaches, bone pains, shortness of breath. I also developed rhinitis for first time in my whole life, occasional ear pains and rarely sharp chest pains like heart attack.
I did additional tests, manometry, phmetry and impedance test and barium swallow. I also checked for scleroderma( normal results so we rule out this)

The results of my phmetry are normal demeester score, one episode of longest reflux period. Number of reflux periods 15,9 < 50. total reflux time 2,3< 4,2 .

Unfortunately my impedance test showed multiple events of weakly acid and less weakly alkaline reflux, elevated liquid and mixed results, bolus exposure elevated above the normal, normal proximal extent.
All of them in upright position, which verified the fact that I suffer during the day and not the night.

My manometry results are the following :
mean LES resting pressure 10mmHg ( 6-25 normal)
i had 2 swallows.
First one with resting pressure 7mmHg and duration 3,8 sec and the other one 12 mmHg and duration 8,5 sec

% complete LES relaxations 100%

but i am extremely worried and confused because on the paper results is writing something else

Average of LES relaxations
Percentage LES relaxations mean 86% ( normal 90-100)
Residual pressure mean 1mmHg
Duration mean 0,8 ( normal 5-10sec)
pre relaxation pressure mean 2,6 mmHg
post relaxation pressure mean 2,9mm Hg

Esophageal motility
Peak amplitute mean 43 mmHg and contraction duration mean 3,4 sc
% peristaltic contractions 88% ( 80-100 normal)
% simultaneous contractions 12% ( 0-20 normal)

The barium swallow didn't show neither reflux nor hiatal hernia.

The most worrying thing in my case is why the duration of LES relaxations is extremely short. I asked if I have achalasia but the doctor refused it.
I am currently taking riopan gel and asked for probiotics for my flora.

My symptoms are varying. The lump is still there but not so intense. Hoarsness specialy after eating sth, I also have a NEW symptom foamy saliva in mouth ( pepsin???) and before a few days again rhinitis and phagyngitis ( sore throat)
I am still burping even after drinking water or empty stomach, first thing in the morning.

I am crying at work, i have no social life, no quality of life.
What is happening to me?
all my problems started after antibiotics. Is it a coincedence?
I a thinking of suicide, because i don't feel normal and healthy as before. Seems to be a permanent condition
sorry for my long post, I would like to hear your opinions.

Maria



testing....

Post Edited (Maraki) : 10/31/2016 8:04:50 AM (GMT-6)

Hi Maria,

Antibiotics had triggered your GERD or had create damaged on your gut flora. Also those Advil i was taking. I have same experience last June 2015. You might have silent GERD already but when you took the antibiotics it made it worst.

I was rushed to ER last June 2015 not knowing it was due to the antibiotic. All test/check up was normal. It's always good to be checked too. With my case I was diagnosed with GERD and took PPI (Pantoprazole) for six weeks. This was per doctor's advice not knowing this had made me worst. My doctor did not believe me, that it's the antibiotic. I was prescribed with PPI, not knowing my stomach was already on a low acid situation due to the antibiotics, then taking PPI made it worst. I wean myself from PPI meds. and H2 blocker. Have battled with acid rebound, anxiety and not sleeping at night. Not an easy situation but God is my healer.

Took some B6/B12/D3, Magnesium supplements. Probitoics helped me too. I went to a strict diet and healed naturally.

We all are different, with me prayers had healed me thru those tough times. All the best.

SD93 said...
Hi Maria first let me say don't loose hope, not yet! You seem to have very good doctors there for you and that's awesome! You also seem to google things a lot because you know so much about your condition, pepsin, gut flora, etc and that is also good.

Now to answer your question: Coincidence? No, I experienced the same thing and if you google for "lpr/gerd after antibiotics" you will find many people with the same experience. See, the gut contains many different types of bacteria and they must maintain a balance between them. If the balance is broken then things go bad. Antibiotics kill a lot of good bacterias not just the bad ones which can break the balance. For example H pylori bacteria is present in most people but it causes no problem usually because it's kept in check by other bacterias. Burping from drinking water or on an empty stomach is a good sign of H pylori going out of control: https://www.healingwell.com/community/default.aspx?f=45&m=2283377 . It can also cause gastritis, gerd and ulcers if it gets really bad.

So, here's my opinion: You already know about gut flora (bacterias) and probiotics but there are many different strands of probiotics out there and taking the wrong kind wont help. If I were you I would ask the doctors to check you for H Pylori !!!overgrowth!!! (no antacid for 48 hours before the test I think). If it comes back positive then I'd google the best probiotics for that. If the doctor give you antibiotics for H pylori personally I wouldn't take them. Because 1) if the bacterias that keep Pylori in check aren't there it will just come back stronger 2) those antibiotics might kill more good bacteria making the problem worse. If the test come back negative then I would shop around for the different strands of probiotics and try each of them 1 at a time for 2 weeks. If it gets worst after 1 week stop it, wait 1 week and try a new one. If it gets better continue on it for 2 weeks. If you're better but not 100% keep taking it and add a new one. If probiotics are too expensive or you can't find many in store google for a gut flora restoration diet.

Also in my opinion tests for lpr/gerd can only confirm it and not find the problem behind it. I also wouldn't worry about your test results if there was a serious problem the doctor would've told you. A healthy stomach producing the right amount of acid with no unbalanced gut flora will cause you only very minor problems if you have minor abnormal test results. You're the proof because of your hernia! 0 problems before and now boom lots of reflux from antibiotics and they don't cause hernias.

PS. Because you have good doctors ask them to check your levels of B6, B12 and D also google them. A deficiency in those can cause muscles to become weak or not properly contract. I doubt it's the cause but if you're deficient supplementing in those might give you a bit of relief while you figure out the real cause.

PPS. I found this recently https://proteinpower.com/drmike/2013/09/23/gerd-treat-low-high-carb-diet/ I don't know how valid or accurate it is but it's worth a read and personally I will be trying a low carb diet to see if it helps, you might wanna try it too before investing in the probiotics and such.

Thank you a lot for your time.
I am currently taking probiotics and a prokinetic dryg imebutine. My belching has dimished a lot but I am feeling my throat hot.
I strongly believe that the antibiotics also made a nerve damage in my digestive system nto only imbalalnce of bacteria. I am completely lost at this moment.

Hi Maraki,

With my experience, i wean off all meds. Are you taking any PPI. I tried healing naturally from the antibiotic damage. It took me within 4 to 6 months to see the difference. It's been a year and 2 months since after I wean off all meds. I am also taking good probiotics. Later part I am drinking pure organic Aloe juice. I was able to drink Boost food supplements during my healing process, then some vitamins like magnesium, B12/D3. In the morning take 1 tsp manuka Honey. I went in to strict diet for almost a year. On top of all, prayers and faith in God had helped me to make it. This have healed me.

I hope this information will give you hope. I also go to my doctor for check up. So far so good. Amen.

All the best. God bless.

Hi Maraki,
Yes everything started after antibiotic meds. I did not even realize that after it was too late. But God is good, now I am healed.

I wean off PPI [Omneprazole] after 6 weeks. Then took some Zantac after for almost 2 months. It was horrible. I thought those meds were helping me but it damaged the gut flora or made the situation worst. But I cannot just stop cold turkey once you are on PPI. So I have to wean from it slowly. The acid rebound was tough. Good Probiotics had helped me. If you are ok, take a drink of Yakult after each meal. After a month of weaning my meds I was able to drink organic aloe(no sugar added). I mix it with a little apple juice for taste. I mix a tsp Apple cider vinegar on my food, coz it's too strong for me to drink. Remember because of the antibiotics and taking the PPI, you might have low acid instead of high acid. The normal acid in your stomach is needed to digest your food. But the antibiotic had missed it up. So try drinking water, no ice with a little slice of lemon 30 mins before your food. If youre ok, or feel a bit relief then you might have low acid stomach. You can also have your GI doctor test your stomach acidity. Just stick to basic food, avoid triggered food. Remember even the oil you use to cook your food can upset your stomach. No pepper or spicy stuff. I always eat at home. Most restaurant foods are too oily and some engridients used can trigger your gut.

I got healed, so are you. It takes time but you will get there. God bless.

Hi Maraki,

Yes, the antibiotics damaged a lot. Few years back when I was given antibiotics and pain meds, couple of times I felt horrible got rushed to emergency few times but the doctors always point on a different direction, thought it was the BiCodaine or the pain medications, but it was the antibiotic. Then last June I was the one who figured it out because I did not take anything (pain meds) except the antibiotic and Advil. Then few people on this site was saying the same thing. Healing from it will take sometime. But it will heal. It just that you will have to eat differently after. The gut will be more sensitive to any fatty foods and spicy foods. Even onions and tomatoes still gives me discomfort after a year and 2 months.

Just start with the non trigger foods and eat frequently (every 2 to 3 hrs). Warm food is always better. Never eat ice cold food.

All the best. God bless.

Hi SD93,

That's way to go. Knowing your body which ones makes you feel better. With my experience it was tough not to eat. I have to have food 2 to 3 hrs.(small portion at a time). I was repeating same food for almost 6 months. Then I introduce one dish at a time just to make sure it is ok for me.

I had low acid in my stomach because of the antibiotic and PPI. I only was eating small portion at a time as it was tough to digest any food. Food that were easy to digest for me were salmon mix with ACV (apple cider vinegar), white rice and soft boiled egg. I was able to drink Boost supplements at least 2 bottles per day. I learn each day what to eat and what time to eat. It's a long repeated process. I got so bored eating same thing but I'd rather do that and feel better. Later I was able to eat Japanese food. I think because it was less greasy and Miso soup which is fermented helped my gut flora. Fermented food is good too. I never liked Kimchi, but I was eating it from time to time just to fix my gut.

SD93, That's good to know that gut and stomach have different function. That make sense.

It is a long journey but you will get better naturally. I am so happy to share that information to you all.
Continue on praying and trusting God. With my personal experience, It was a miracle.

God bless.

By the way,I would like to ask sth else...

I have seen many reflux sufferers writing the phrase that after a round of antibiotics.....
How many days lasts a round? What does this mean? One box of anitbiotics? 3-4 days?

Thank u

Maria

SD93 said...
I swear I checked the "Email me when a reply is posted" box, oh well. I don't want to interject but I'd like to propose an experiment. See this part here "I am currently taking probiotics and a prokinetic dryg imebutine. My belching has dimished a lot but I am feeling my throat hot." is interesting to me because I was reading that we digest in 2 different ways. The first one is simply your stomach but the other one is through the gut flora. The stomach handles fat, meat, that kind of stuff but it can't handle things like carbs, that's the flora's job. I think it'd be worth experimenting for a few days (at least 3, apparently it takes up to 48 hours to completely "empty" yourself of what you've previously eaten) by eating only vegetables. This is what I think the experiment would show starting from day 2-3:

Feeling better -> Gut flora is restored but your stomach has trouble with fat, meat, etc (digestive enzymes should help until it restores itself (or again as I said before get tested for H Pylori)).
Feeling worst -> Gut flora is still damaged (continue on probiotics like Tu Wang said it takes time).

This isn't the best test in the world, if there's no difference then it can either mean both the stomach AND gut flora is damaged OR the problem is something else entirely. But it's easy to test, pretty fast and can give you clues to where exactly the problem is.

I did the experiment myself but it showed no difference. I think for myself that means the problem is something else, meaning my stomach and gut flora are probably OK. I also tried fasting (not eating for 3 days) and there was no difference again. The funny thing is during the fast I still continued to burp quite a bit and apparently that means either I'm swallowing air without noticing or again the infamous H Pylori. I don't recommend fasting to test it out I'm just sharing what I did to gain more information, sadly my doctor ignored them and refused to send for the H Pylori test.

Btw @Wang thanks for replying to my thread I guess I didn't check the "email me" box again lol. I'm feeling better I think I had a flare up or such it lasted about a day then it calmed down. It's still lingering around but a lot less bad, just some throat tightness that comes and goes now + my regular symptoms :).

I think that I digest meat better than other kinds of food.
Did your problem start from antibiotics?

Maraki said...
Did your problem start from antibiotics?

No my problems started years ago in 2010 out of nowhere (no antibiotics, nothing) but at the time my only symptom was feeling small pieces of food stuck in my throat after eating (for hours). doctors looked at my throat with a camera and saw a lot of irritation but they blamed it on smoking. It slowly went away in about 6 months just by being more active (started a new job where i was walking a lot).

It came back out of nowhere again (like the first time) in december 2014 but with different symptoms; hoarseness, voice changes, burning tongue, inflamed taste buds and shortness of breath. i saw a new ENT who diagnosed me just by symptoms (no camera) with LPR. it was manageable (no meds - just being even more active). during winter it was worst (less exercise) and during summer it was much better (gone for 2-3 weeks with only 1-2 bad days then gone again).

in june 2016 i took antibiotics, 10 days of ciprofloxin 500mg 1x per day. since the antitbiotics my symptoms happen everyday, being more active doesn't help anymore. i also developed new symptoms (lump in throat, neck pressure, dizziness and chest pressure) so antibiotics was not how it started BUT it definitely made it much much worse.

Maraki said...
I think that I digest meat better than other kinds of food.

then the low carb diet should help the symptoms :).

Maraki said...
I am too scared and depressed. I want to wean off the meds but I am afraid the rebound

try to go slow, very slow so it's not too bad. try not to worry too much, i know it's hard but stress/anxiety makes reflux much worst! try to be positive, you're taking probiotic and trying a diet to reduce the symptoms this is the good path. when you feel stressed try to change your mind, take a walk or something it helps stress and digestion!

Maraki said...
How many days lasts a round? What does this mean? One box of anitbiotics? 3-4 days?

usually 1 round is 10 days, but it can be 1 or 2 pills a day for 10 days.

SD93 said...

Maraki said...
Did your problem start from antibiotics?

No my problems started years ago in 2010 out of nowhere (no antibiotics, nothing) but at the time my only symptom was feeling small pieces of food stuck in my throat after eating (for hours). doctors looked at my throat with a camera and saw a lot of irritation but they blamed it on smoking. It slowly went away in about 6 months just by being more active (started a new job where i was walking a lot).

It came back out of nowhere again (like the first time) in december 2014 but with different symptoms; hoarseness, voice changes, burning tongue, inflamed taste buds and shortness of breath. i saw a new ENT who diagnosed me just by symptoms (no camera) with LPR. it was manageable (no meds - just being even more active). during winter it was worst (less exercise) and during summer it was much better (gone for 2-3 weeks with only 1-2 bad days then gone again).

in june 2016 i took antibiotics, 10 days of ciprofloxin 500mg 1x per day. since the antitbiotics my symptoms happen everyday, being more active doesn't help anymore. i also developed new symptoms (lump in throat, neck pressure, dizziness and chest pressure) so antibiotics was not how it started BUT it definitely made it much much worse.

Maraki said...
I think that I digest meat better than other kinds of food.

then the low carb diet should help the symptoms :).

Maraki said...
I am too scared and depressed. I want to wean off the meds but I am afraid the rebound

try to go slow, very slow so it's not too bad. try not to worry too much, i know it's hard but stress/anxiety makes reflux much worst! try to be positive, you're taking probiotic and trying a diet to reduce the symptoms this is the good path. when you feel stressed try to change your mind, take a walk or something it helps stress and digestion!

Maraki said...
How many days lasts a round? What does this mean? One box of anitbiotics? 3-4 days?

usually 1 round is 10 days, but it can be 1 or 2 pills a day for 10 days.

Hello, you were very unlucky that your reflux worsened by antibiotics.

Do you believe that I had reflux prior to antibiotics and the antibiotic came into the forefront or my reflux is caused by bacteria imbalance?
Is it sth permanent?
I drink water and I want to burp...It is very annoying and socially embarassing!

Maybe in 1 month i will be cured or maybe it will take 1 year, just don't loose hope and don't be afraid to try different options/treatment!

Thank you a lot for your supporting words and your advice.

I hope God help all of us and recover soon!

It's sth that prevent sb from leaving a normal life. Currently my symptoms are execessive amount of saliva more than normal and some burpings regardless if I have eaten or not.

I am taking my riopan gel two times a day after meal and a prokinetic drug to reinforce my digestive system but I am afraid of the side effects. I am also taking probiotics on a daily basis.

Jukke said...
Maria, what manometry says about your UES?
You can have normal LES but issue with UES (hypo or hyper).
Ask your GI.

The doctor said that UES and LES has normal pressure. My manometry is cosnidered normal according to the doctors.

All my problems started after finishing the antibiotics. I took 1500 mg / day for 8 days plus 3 days during my accomodation in hospital. Before that I was completely healthy and normal

I am very depressed and sometimes very angry with doctor's irresponsibility