Dear Dr. Roach: My friend was diagnosed with H. pylori. He was treated,then later given a stool-sample test. The test was negative, and he was told he does not have the H. pylori bacteria anymore. No more medication was given to him, and no special or restricted diet was advised. Unfortunately, he continues to burp all day and night, no matter what he eats. He is always suffering from built-up gas. Can you advise on what could be the cause? D.J.Y.
Helicobacter pylori is a bacteria species that can infect the lining of the stomach. It may cause symptoms of abdominal discomfort, but it also causes stomach ulcers in some people. It increases the risk of a rare cancer of the stomach.
Burping or belching is not typically caused by H. pylori but by excessive intake of gas through eating or chewing gum and from dissolved gas in carbonated beverages. Your friend should avoid gum and fizzy drinks; he should eat slowly and in a relaxed fashion. Above all, knowing that burping does not indicate serious problems in the stomach should help your friend.
Dear Dr. Roach: I’m a woman with recurring urinary tract infections over the years. In my past two episodes, although the urine tested positive in the doctor’s office, when the results came back from the lab, there was no reported infection. In both these cases, I had the usual UTI symptoms of intense burning and urgency to void. In addition to my internist, I’ve seen a urologist, and neither could explain these test results. Anon.
The urine dipstick in the doctor’s office looks for an enzyme made by white blood cells in the urine, whereas the lab looks for the bacteria themselves. Your situation is not uncommon, and there are several possible reasons why this might happen.
Given your symptoms, one likely possibility is that you have an infection in the bladder or urethra (the short tube that drains the bladder), an area that is very sensitive to the inflammation caused by bacteria and white blood cells.
However, the level of infection shown on the culture results may be so low that the lab reports it as negative. There are a few infections, such as chlamydia and tuberculosis, that don’t show up on a standard culture. Treatment with appropriate antibiotics in this situation resolves the symptoms. If it doesn’t, then looking for another cause is indicated.
There are non-infectious causes of the burning sensation. Post-menopausal women can get atrophy, which usually is treated with topical estrogen. Interstitial cystitis is a possibility, and the symptoms in IC usually are temporarily relieved by voiding. Concentrated urine, small stones and trauma also can cause a burning sensation. However, I think infection, interstitial cystitis and stones are the most likely possibilities.
