Effects of antibiotics on the stomach nerves

[Robb S]

First some background info.  I suffer from heart pac's and atrial fibrillation which I believe are triggered by my vagus nerve.  I often feel little pulses or spasms in the region above my naval while the pac's are occurring, which seems to be the stomach-to-heart vagus nerve connection.  These spasms can be started by eating something spicy, drinking something cold, belching, sneezing hard or doing something physical that involves my abdominal muscles. Also the pac's and afib can start without feeling a lot (or any) spasms.  I had an ablation done last fall and so far there is only a slight improvement in the afib.  Now to my question.  Two times now, while taking antibiotics my pac's and afib episodes have disappeared for weeks.  These were during times when I was having symptoms very frequently prior to starting the antibiotics.  The antibiotics were erythromycin and cephalexin, taken about 2 years apart.  It seems that these antibiotics have some positive effect on my vagus nerve endings in my stomach such that they stop getting stimulated or irritated.  It is as if the antibiotics effected the stomach lining, perhaps killing bacteria and healing it such that the vagus nerve endings are better protected.  If that is not what was happening then perhaps the antibiotics were effecting the absorption of essential minerals that my nervous system may be lacking.  I am looking for any explanations that someone in the medical profession has to offer.  My GP just doesn't have a clue.  Are there any tests that make sense to have done?  Should I be seeing a gastroenterologist or would a neurologist be better able to help me?

[Robb S]

Thank you for your comments.  Yes, I do have some reflux, but hardly ever have heartburn.  It is usually manifested by a sour taste and some coughing.  I take Omeprazole as needed, have cut down on coffee and have been sleeping with the head of my bed raised for more than a year.  That all helps, as you suggested, and I would say that my reflux is about a 3 on a scale of 1 to 10, 10 being the worst.  I had the h. pylori blood test in April of 2012 and it came back negative.  Can I be confident in just one blood test for h. pylori or should I be retested?  I also had a food allergy test done last year and the results only showed a problem with cashews and pistachhios.  I have had a diagnosis of non-specific colitus a few years ago.  My GP recommended taking the saccharomyces boulardii pro-biotic, like Primal Defense Ultra contains.  That took care of the discomfort that I was having, but I sometimes still feeling a gnawing in my colon on my left side so I suppose that some colitus may exist.  One other problem that I had in the past that might be worth mentioning is campylobacter.  I had that about 30 years ago and it was rough.  I believe that I fully recovered but I wonder if some residual effects are still at play in my gut.

[Dr. Kokil Mathur]

Hi!
Well, if you also have acidity and gastric reflux (both likely as you have spasms from spicy food), then you could be suffering from H pylori infection of the gut. The fact that symptoms were controlled with antibiotics favors this theory. However, the relief will be short lived without confirmed diagnosis and full fledged treatment.

Diagnosis can be confirmed through blood tests or carbon urea breath test for H pylori infection or through endoscopy. Complete treatment involves life style changes and proton pump inhibitor such as omeprazole, lansoprazole or pantoprazole empty stomach in the morning and an antacid gel after meals or H-2 blocker such as ranitidine for complete relief.

Life style changes that will help include: Drink cold milk at night or take a late night snack. Avoid heavy meals and eat frequent small meals. Avoid too much of caffeine, tea, smoking, fried food and drinks both alcoholic and non alcoholic fuzzy ones. Avoid heavy exercises within 4 hours of a heavy meal. Raise the head end of the bed by pillows to 30 degrees. Avoid lying down for least 2 hours after food. Maybe these tips will help you.

The other possibility is that you are suffering from colitis or an inflammatory bowel disorder. This can be confirmed through specialized tests (like video encapsule endoscopy, tests for celiac disease, endoscopy, colonoscopy etc) by a gastroenterologist and other routine tests like stool examination. Food intolerance is another possibility. All these can cause problems in absorption of vitamin B12, iron, minerals etc. This can in turn cause neurological signs and symptoms and palpitation (especially if you have anemia, low calcium or low magnesium).

So, yes, you should consult a gastroenterologist. Also you must discuss the possibility of an autoimmune neuropathy with your neurologist. A comprehensive investigation is required keeping all the above mentioned points in mind.

Hope you get well soon! Good Luck and take care!