### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi Doctor,I had a spinal fusion in May 2017 but was readmitted with severe gastric symptoms which was put down to allergy to medication for pain. I have lost 13 kilos and have just had a breath test whicChatDoctore back positive. I have been burping and had flatus all these months. Could the infection have occurred because the gastro nasal tube or mask have been inadequately cleaned?( I used to work in theatre). Should my husband also have a breath test? I also have had candida which has been treated. Many thanks Jan Reid Sydney

### output:

Hi, After reviewing your question I assume you mean a positive breath test for H. pylori? I am sorry to hear the amount of discomfort that you've been through. This is how I would proceed to look at your case:1. Your symptoms are very peculiar for peptic ulcer disease or gastritis. Both are different ways of getting damage done to your stomach. An ulcer is like a crater which may or may not be prone to bleeding. Gastritis is a bit like having multiple pinpoint sore spots, causing pain and discomfort. A positive breath test may mean that you have H. pylori infection. As uncomfortable as this is, it is usually very treatable. Were you on many painkillers because of the spinal fusion? If yes, then they would certainly have contributed. 2. I don't think a mask has anything to do with this. A sterile nasogastric tube taken out of the bag is very unlikely to bring infection to the insides of the stomach. Nasogastric tubes, however, do cause a bit of irritation in the stomach lining. While they could have a very small contribution, I doubt they have had a significant effect. 3. The problem at hand seems to be the H. pylori infection which is a bacterial infection of the stomach lining which causes wear and tear in the stomach. This bug is acquired by the orofacial route. What this means is that someone with H. pylori sheds the bacteria through their stools. Sometimes, because of poor hand hygiene, they may pass it on to others, especially through food. The new victim ingests these bugs and in this way H. pylori finds a new home to infest. I don't think your husband having a breath test will add to anything if he does not have symptoms. 4. An unintentional weight loss may signify a gastric ulcer (in opposition to peptic ulcer)5. You may benefit from a look down into the stomach through gastrostomy. It will give a great deal of information. Your weight loss is also an indication of getting you a CT scan of the abdomen to ensure that there is nothing dangerous in play. 6. Treatment would include amoxicillin, azithromycin and an acid tablet such as omeprazole for a 10 to 14-day course. Since these recommendations include a gastrostomy, you will eventually have to visit a physician or a gastroenterologist to have it done. Gastroenterologists are also excellent at managing h. pylori infections, along with ulcers and gastritis.