If you belch or have burning in your stomach or chest, particularly when your stomach is empty, you probably have either an infection, a tumor, or a condition called GERD (reflux or regurgitation). Infection with bacteria such as helicobacter pylori is by far the most common cause.
Your doctor will probably order an upper GI series X ray to rule out a tumor. That almost always comes back negative to tell you that you do not have tumor. Then you get a blood test for bacteria called 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. Your gastroenterologist will want to put a tube down your mouth and into your stomach, but the biopsy that he will do to find the Helicobacter can often miss the germ even when it is there (11). If your doctor does not offer the antibiotic treatment (see below), you will be stuck with a diagnosis of regurgitation, called GERD, which means you have pain and no one can tell you why. You will need to take medication for the rest of your life.
An article in the medical journal GUT reported that at least 24 different bacteria have been shown to cause stomach ulcers (16). Since doctors do not have any way to check for all 24 different bacteria (10), all people with belching and burning in the stomach should be given a one-week course of antibiotics that are used to treat the most common cause of stomach ulcers, called Helicobacter Pylori.
Twenty years ago, stomach ulcers were treated by drinking cream. Today, almost everyone with belching and burning in the stomach should be treated with antibiotics. 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. He recently received the Nobel Prize for his pioneering work.
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 ulcer symptoms and a negative blood test or biopsy for that germ. They are clearly wrong because literature shows that at least 24 germs cause an irritation in the stomach (9), including H. helmannii (13), H. felis, H. rappini, H. cinaedi, H sp. Strain Mainz (14) H. fennelliae and H. pullorum, H. hepaticus, H. Billis, H. canis, H. Hills (15), cytomegalovirus and mycoplasma (1,2,3,4,5,6,7,), and Helicobacter mesocricetorum sp nov (12).
Helicobacter species have been isolated from the stomachs of dogs, cats, ferrets, pigs, monkeys and cheetahs, birds, mice, chickens. The standard treatment of 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. 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.
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 (1). If you still have symptoms, you may need to have a tube put down your throat by a gastroenterologist. 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.
Helicobacter may also cause liver disease, blood vessel diseases such as clotting and heart attacks, and certain skin conditions such as rosacea.
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