Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
|mike1486 - Sun Jun 20, 2010 3:54 am|
Dear Doctor and other users of this forum,
I am currently living and working in China. In March of this year, I had an endoscopy performed following complaints of what I thought were breathing problems. Turns out I have Chronic Erosive Gastritis. I have been to see many doctors here, all giving me different medicines, ranging from the Nexium (that I am currently on - 20mg daily), various antibitoics and other Chinese medicines. So much intake of so many different meds really screwed up my entire system. I have been solely on the nexium for about 2 months (4 months total, now). I recently went and visited a 'western clinic' in Guangzhou and had many tests carried out there, more to eliminate other problems. The doctor there sent me this message:
1. You are a little anemic
2. The urine test showed some microscopic blood. This combined with an enlarged prostate with calcification would require a referral to the Urology specialist. I will arrange for it if you give me the days that you are available.
3. One of your stool tests has some blood. There are no parasites seen. I recommend that you have the stool test for blood repeated 3 times. If all positive, you will need to undergo a colonoscopy. (UPADTE: I HAD STOOL TESTED, PER ABOVE - NO BLOOD WAS FOUND.)
With the anemia, the enlarged prostate with calcification, the blood in the stool and the weight loss, we have to figure out that there is no serious stuff going on in those two organs.
4. HAV IgG Positive, indicates that you have been exposed to Hepatitis A in the past. No new action needed.
5. The Amylase is slightly elevated (116 instead of <110). The Amylase comes from the pancreas mainly. However, you have already had an abdominal CT scan done which there was no abnormality seen in the pancreas. Will repeat lab in 2-3 weeks.
6. Anti-HBs Negative which means you do not have immunity against Hepatitis B. I strongly recommend that you receive the Hepatitis B vaccinations. You can have it done at our clinic.
7. The PSA is normal 0.39 (0 to 4)
8. The Vitamin B12 level is in the low normal range. Vit B12 279 (187 to 1059)
You should take the Vit B12 by injection or sub-lingual, not by mouth. This will help with absorption.
9. The other cancer markers CEA (colon cancer) and AFP (liver and testicular cancers) are within normal range.
After reviewing all your lab results, I still recommend you to repeat the stool test for blood for 3 days in a roll. If the repeat test is positive, I strongly suggest you have a colonoscopy. I also recommend that you follow up with a urologist to assess the prostate. Please let me know how you want me to arrange for all of the above.
Both HIV and Syphilis are negative
OK - sorry for the length of this piost, but I wanted you to have all the available information.
Currently, I feel constantly tight in the stomach and often the chest, too. I often feel it is hard to get a full breath and this increases my anxiety, still further. And, of course, that makes the Gastritis worse. I always find that I sleep OK, if not too much; the problems only resurface as my body wakes up and realises it has to face another day of Gastritis! Getting depressed, as I don't know what esle to do; tried following most tips on healthy eating, and yes, I still smoke but at a greatly reduced amount and with filter. Other doctors suggested an increase in the nexium to 40mg; tried this, breathing felt a little better, but other side effects were highly unpleasant. Tried coming off nexium, altogether; felt OK (ish) for 1 day, then highly uncomfortable the next day, so I had to take again. I am worried that this could be something else, something the docotors have missed, since most Gastritis sufferers report burning pains and fullness, but, me, I don't have any real (big) pain, just highly unpleasant tightness and uneasiness that I cannot properly describe. I sometimes would prefer a 'real' pain, something definite; don't why I say that, but I often feel I would be less anxious.
I have had CT Scans, Ultrasounds, Chest X Ray and exstensive blood tests. So, what else could be going on?
This site could be a Godsend to me, as I know it is for many others. Particulalry as I am in China and lack a good doctor to follow instructions from.
What can I do? Any suggestions?
Thanks so much for your time.
|Faye Lang, RN, MSW - Thu Jul 08, 2010 12:53 pm|
I'm sorry to hear of your difficulties. Gastritis is inflammation of the lining of the stomach. If irritating substances are not discontinued or eliminated, the inflammation can become erosive, or cause breaks or ulcers in the lining. Symptoms of gastritis include upper abdominal pain/discomfort which is increased by eating, indigestion, loss of appetite, nausea, vomiting, dark stools, or vomiting blood or coffee-ground appearing substance. Some people have few or no symptoms present while having gastritis. Diagnosis is made by physical evaluation, which then may lead to tests such as CBC (complete blood count), stool guaiac test (usually 3 days in a row), or evaluation by scope with biopsy (esophagogastroduodenoscopy). There are various possible causes, such as chronic use of NSAIDS (non-steroidal anti-inflammatory drugs), overuse of aspirin, a bacteria known as Helicobacter pylori, degeneration of stomach lining due to aging, chronic bile reflux, or pernicious anemia (an autoimmune condition). The focus of treatment is to reduce stomach acid or to neutralize stomach acid, through dietary adjustments and medication, as well as B-12 for anemia, or antibiotics for Helicobacter pylori. If symptoms are not improved or relieved by treatment, further evaluation is warranted, particulary the above mentioned scope with biopsy. Since you have had a pretty extensive evaluation, it would be wise to proceed with the guaiac test and to schedule the scope and biopsy that your doctor recommends. Erosive gastritis can lead to stomach cancer, so ruling that out with the scope would be encouraged. I hope this is helpful to you. Good luck to you.
|mike1486 - Tue Jul 13, 2010 12:18 pm|
Thank you so much, Faye, for taking the time and trouble to reply to my rather lengthy message! I really appreciate it!
I'm just back from the second doctor's appointment; seems he's pleased with my progress, in that I have regained weight and seem in a better mood. I certainly feel it! All this appears to have happened since I stopped taking the dreaded PPI, nexium. I have no been off that terrible drug for nearly two weeks, and my breathing feels easier, my chest is no longer tight and constricted. I no longer feel nervous or anxious. How on Earth can one pill (20mg) of this stuff make one SO ill? Indeed, it was 6 months of Hell! I know a lot of that 'Hell' would have been the actual illness, but a lot of pain was almost certainly down to the Nexium. I used to wonder why many doctors thought Nexium was counterproducitve for most Gastritis cases - one even described it as 'the most ridiculous drug in the field of medicine'! Faye, I am not sure what your opinions are, but I have to say now, I tend to side with that opinion. I have since adopted harmless Chinese medicine into my regime and have also started using Apple Cider Vinegar. The ACV seems to work wonders!
The docotor, after seeing me, agreed that I seemed to be on the right course, though he has suggested I follow through with the Urologist as there is still microscopic blood in my urine. Indeed, the pain in my stomach seems to be lower down these days; more a dull ache which extends to the lower back and hips on occasions. I get confused as to whether the pain is still linked to the Gastiris / Erosion, or whether it is now stemming from the prostate; no trouble or pain urinating, though the sttream is slow and stops and starts.
Doc didn't think an endoscopy was warranted on this occasion, but has stated this may be necessary, with biopsy, further down the line if I still feel aches in the stomach after Prostate pains have been investigated and ruled out. In the meantime, I should try to stick to a good, healthy diet and engage in some regular exercise.
Faye, I wonder whether you have assisited in the treatment of erosive Gastritis? Is it possible the Gastritis is finally healing? Or, perhaps I just feel that it is because I no longer get side effects from the nexium? Am I putting my stomach and espohagus at risk? I do SOMETIMES, and only BRIEFLY, feel heartburn, usually in the small hours of the morning. But they seem to be gone before I can reach for an antacid! :)
Again, Faye, I really appreciate your reply. I take my hat off to people like you, who dedicate a lot of their free time to help and advice others! You're a star!
Best Wishes to you from a VERY HOT and humid Guangdong Province, China!
|Faye Lang, RN, MSW - Tue Aug 10, 2010 8:35 pm|
I'm sorry I didn't see your return post sooner. I'm very pleased for you that your symptoms are abating and that you're on the road to recovery.
You can be having the benefits of both discontinuing the nexium, and starting the healing process. If the person is able to commit to following treatment and diet guidelines, as well as complying with medications - whether Chinese, American, homeopathic or others - the outcome is generally positive. Sometimes consistency is the key, and healing can occur. I do not recommend this since I am neither a physician or dietician, but in regard to your question about healing, I've known of several people who achieved healing through drinking fresh goat's milk (pasteurized) for approximately a month. With usual treatment, some people are able to heal, and some are not able to achieve complete healing, but do have significant periods of remission.
I hope you continue on your path to recovery!
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