HELICOBACTER-PYLORI-INDUCED DIARRHEA POST-ILEOGASTROSTOMY

A retrospective study of all ileogastrostomy procedures (n = 26) perfo rmed in 1993 by one surgeon (IGMC) was carried out to investigate the hypothesis that Helicobacter pylori may be implicated in certain sever e cases of post-operation nausea and diarrhea. Ten of 26 persons (38.5 %) displayed nausea and notable diarrhea (greater than or equal to ten bowel movements per day), seven of which warranted upper GI investiga tion. One hundred per cent (seven of seven) of these persons were foun d to possess H. pylori upon C-14 breath test. In four of six cases era dication therapy (1 g amoxicillin b.i.d./20 mg omeprazole b.i.d. for 2 weeks) corresponded with a resolution of severe nausea and diarrhea ( one additional case involved omeprazole use only), suggesting that H. pylori should be considered as a possible cause of these symptoms post -ileogastrostomy. Additionally, in four of seven cases persons were re -tested (C-14 breath analysis) at least 1 month post-therapy and in th is group three persons were found to be free of the organism. All thre e cases of notable diarrhea and nausea resolved with treatment, provid ing the strongest evidence for a possible association between infectio n and these symptoms.