How do I manage gastric issues after stopping antibiotics?

Question

Hello doctor,

About two months ago, I was diagnosed with typhoid and an ulcer. I received IV fluids and injections, followed by Amoxicillin and Omeprazole for five days. My symptoms improved.

A few weeks later, I developed severe stomach pain and was prescribed Rifabutin (Rifabon), Amoxicillin, and Nexium for 10 days. After that, I was given Rabeprazole for three months, but I stopped it after a few weeks when I started feeling better.

For the past four weeks, I have been experiencing:

Mild stomach cramps (not severe).
An “unbalanced” feeling in the abdomen.
Intestinal rumbling sounds.
A sensation of needing to pass stool (but bowel movements are normal).

I have no fever, no weight loss, no vomiting, and no blood in the stool. I sleep well.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your current symptoms are most consistent with post-infectious gut dysfunction and residual gastritis, rather than an active infection or a serious disease.

After typhoid and ulcer treatment, the stomach and intestines often remain inflamed and hypersensitive for weeks to months. Multiple antibiotics (Amoxicillin, Rifabutin) and stopping the PPI (proton-pump inhibitors) early can also disrupt the gut microbiome, leading to:

Mild cramps.
Rumbling sounds (borborygmi).
A sensation of incomplete evacuation.
An “unbalanced” abdominal feeling.

These symptoms occur due to altered motility and increased gut nerve sensitivity, not structural damage.

Reassuring features in your case include:

No weight loss.
No bleeding.
No vomiting.
Normal bowel frequency.
No fever.

This strongly favors a functional, reversible condition such as post-infectious IBS (irritable bowel syndrome) or the gastritis recovery phase.

Recommended management includes:

Restart a PPI (Rabeprazole or Esomeprazole) for four to six weeks.
Add a probiotic (Saccharomyces boulardii or a multi-strain probiotic).
Eat regular meals and avoid prolonged fasting.
Avoid spicy, acidic, and junk foods temporarily.
Reduce anxiety and stress (the gut–brain axis plays a role).
Recovery timeline: Most patients gradually improve over six to twelve weeks.

Further testing is only needed if alarm symptoms develop, such as weight loss, bleeding, persistent vomiting, or severe pain.

This condition is common after typhoid and antibiotic therapy and usually resolves completely with supportive care.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.

Thank you.