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Forum Name: Gastroenterology Topics

Question: H.PYLORI & INTESTINAL METAPLASIA AND DYSPLASIA


 Leena - Sat Sep 12, 2009 3:11 am

Dear Doctor:



Since July 2009, my friend Ani has been suffering severe diarrhea with nausea for weeks. Has other symptoms such as drastic weight loss and fatigue. Consulted gastroenterologist who performed endoscopy along with biopsies.



His UGI Endoscopy report findings:

Esophagus: Has 2 erosions at lower end, G. E. Junction at 39 cm, small hiatus hernia.

Stomach: Body, fundus, pylorus and antrum has erythema with congested greater curvature folds

Duodenum: D1 is normal and D2 has normal folds Gastric and D3 BC taken

Impression: GERD LA-B, small hiatus hernia

His Histopathology report results came as follows:



HISTOPATHOLOGY REPORT

A. Duodenal mucosa is patchily eroded and contains moderate diffuse infiltrate of plasma cells, lymphocytes and eosinophils in the lamina propria.Villi and villous crypt ratio are near normal.Part of normal muscularis mucosae present. No Brunner glands, granuloma, collagenosis, or atypia noted.

B. Gastric mucosa is patchily eroded and has moderate diffuse infiltrate of plasma cells, lymphocytes and eosinophils in the oedematous lamina propria. Few glands are crowded showing mild dysplasia, regenerating activity and intestinal metaplasia. Focal distortion of glands present. Part of normal muscularis mucosae seen. No granuloma, collagenosis, increase in IEL or atypia noted. H.Pyloris seen.



A. CHRONIC NON-SPECIFIC DUODENITIS.



B. HELICOBACTOR ASSOCIATED CHRONIC GASTRITIS WITH PATCHY INTESTINAL METAPLASIA AND MILD DYSPLASIA.



1) Where it mentions "HELICOBACTOR ASSOCIATED CHRONIC GASTRITIS WITH PATCHY INTESTINAL METAPLASIA AND MILD DYSPLASIA," is there something to be extremely concerned about? Is this pre-cancerous or has it already progressed to cancer?



2) What type of treatment is recommended?

Currently having breathing difficulty and doctor said due to his stomach ailment. Currently taking Amoxicllin, Clarithromycin and Rabeprazole.

Need your esteemed opinion and advise, please



Thank you



Leena
 Dr.M.Aroon kamath - Tue Nov 03, 2009 2:31 am

User avatar Hi,
H.pylori can result in two types of gastritis..
- Antral predominant gastritis (may lead to peptic ulceration) or
- Multifocal atrophic gastritis (this may lead to a chronic atrophic gastritis - with areas of 'intestinal mataplasia'- increases the risk for gastric carcinomas).
H.pylori infection also increases the risk for gastric MALT lymphomas.

It does not mean however,that everyone who has Multifocal atrophic gastritis will develop a cancer.
In most people, it remains as atrophic gastritis. Only a small minority may develop a gastric cancer if they happen to have additional risk factors.
People living in areas where gastric cancer incidence is high are believed to be at a higher risk.
Best wishes!

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