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Can A Biopsy Detect Acid Reflux And Gastritis?
Question: Hi - I recently ( end of December) received a " completely normal" upper endoscopy after about 4 months of upper GI issues - nausea, heartburn, indigestion,. The symptoms have been on and off since September with some what I would consider severe bouts. Had similar but less dramatic issues about 4 years ago. Tried Nexium with mixed results , now taking Zegerid. Some moderate improvement with greater improvements the last week .My Doc mentioned other diagnostics outside the what is found with an endoscopy if
symptoms don't completely go away. For now the course is stay on this Zegerid.
Weight , appetite , weight , bowel movements seem fine.
Doc mentioned a small hiatal hernia and gastritis right after exam - but now he said completely normal on biopsies , etc..
Questions...
1) does acid reflux show up in any way on biopsies ?
2) same question for gastritis - is that tested on biopsy ?or is it more of a general condition that now may be slowly disapating
3) what about these other diagnostics outside the stomach / endoscopy area- are we taking the right course of action due to what seems to be an improving condition or are other diagnostics in order since the symptoms are not completely gone
4) what is your analysis
symptoms don't completely go away. For now the course is stay on this Zegerid.
Weight , appetite , weight , bowel movements seem fine.
Doc mentioned a small hiatal hernia and gastritis right after exam - but now he said completely normal on biopsies , etc..
Questions...
1) does acid reflux show up in any way on biopsies ?
2) same question for gastritis - is that tested on biopsy ?or is it more of a general condition that now may be slowly disapating
3) what about these other diagnostics outside the stomach / endoscopy area- are we taking the right course of action due to what seems to be an improving condition or are other diagnostics in order since the symptoms are not completely gone
4) what is your analysis
Brief Answer:
Following answers to your queries...
Detailed Answer:
Hi XXXX,
I have gone through your medical history carefully and understood your concerns.
Please find the following answers to your queries:
1. Tests to diagnose acid reflux include: barium x-rays, upper endoscopy and pH monitoring.
Biopsy will determine whether there is inflammation of esophagus or Barret's esophagitis.
2. Gastritis is determined by upper endoscopy. Biopsy is done to find out if H.pylori is present and if there are malign/ulcer changes in the stomach mucosa.
Other tests include complete blood count, fecal occult blood test to rule out anemia or possible GI hemorrhage.
3. If upper endoscopy concluded normal GI mucosa, then, we should go for other tests in order to determine the right cause:
- barium x-rays and ph monitoring to rule out acid reflux
- abdominal ultrasound to evaluate current changes in your liver/gallbladder/kidney/pancreas
- blood tests: complete blood count; liver/kidney/pancreas function tests
- fecal tests: complete analysis, occult blood tests; examination of stool for ova/parasites; culture of feces
- urine analysis
4. After evaluating the results of these tests, we can run the final conclusions and the best treatment strategy.
For the moment, continue with Zegerid together with antacids after meals. Do not forget to make some changes in your diet and lifestyle habits
- avoid oily/chilly/fried/processed/spicy foods
- increase water intake
- do not skip meals
- do not lay down immediately after eating
- eat often and small portions
Hope it answered to your queries!
Dr.Albana
Following answers to your queries...
Detailed Answer:
Hi XXXX,
I have gone through your medical history carefully and understood your concerns.
Please find the following answers to your queries:
1. Tests to diagnose acid reflux include: barium x-rays, upper endoscopy and pH monitoring.
Biopsy will determine whether there is inflammation of esophagus or Barret's esophagitis.
2. Gastritis is determined by upper endoscopy. Biopsy is done to find out if H.pylori is present and if there are malign/ulcer changes in the stomach mucosa.
Other tests include complete blood count, fecal occult blood test to rule out anemia or possible GI hemorrhage.
3. If upper endoscopy concluded normal GI mucosa, then, we should go for other tests in order to determine the right cause:
- barium x-rays and ph monitoring to rule out acid reflux
- abdominal ultrasound to evaluate current changes in your liver/gallbladder/kidney/pancreas
- blood tests: complete blood count; liver/kidney/pancreas function tests
- fecal tests: complete analysis, occult blood tests; examination of stool for ova/parasites; culture of feces
- urine analysis
4. After evaluating the results of these tests, we can run the final conclusions and the best treatment strategy.
For the moment, continue with Zegerid together with antacids after meals. Do not forget to make some changes in your diet and lifestyle habits
- avoid oily/chilly/fried/processed/spicy foods
- increase water intake
- do not skip meals
- do not lay down immediately after eating
- eat often and small portions
Hope it answered to your queries!
Dr.Albana
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So - even though the biopsies were normal- gastritis and acid reflux can exist?
It just seems that the recent meds are working better now - when I was taking the Nexium - I was taking them and then immediately eating . I later found out that it was important to wait 30 minutes to an hour before eating . I am wondering if that was a factor with persistent heartburn and indigestion
I am definitely following up with my Dr. - but at this point we are seeing if the symptoms continue to subside with the current MEDS.
I understand about the need to determine cause but I am wondering about the strategy of holding off on the battery of testing that you refer to ?
Could the diagnosis be acid reflux and gastritis or are those conditions somehow ruled out by biopsies ?
It just seems that the recent meds are working better now - when I was taking the Nexium - I was taking them and then immediately eating . I later found out that it was important to wait 30 minutes to an hour before eating . I am wondering if that was a factor with persistent heartburn and indigestion
I am definitely following up with my Dr. - but at this point we are seeing if the symptoms continue to subside with the current MEDS.
I understand about the need to determine cause but I am wondering about the strategy of holding off on the battery of testing that you refer to ?
Could the diagnosis be acid reflux and gastritis or are those conditions somehow ruled out by biopsies ?
Brief Answer:
Please provide the upper endoscopy/biopsy results....
Detailed Answer:
Hi back XXXX,
1. You can provide the biopsy results to confirm that if it is normal, it means that no worries for abnormality. However, inflammation can be present in cases of gastritis/acid reflux, but nothing else.
2. When taking PPIs (e.g. Nexium or Zegerid); we do recommend to take early in the morning with a glass of water and at least 30 minutes before meal (I personally recommend at least 1 hours before meal).
3. Yes, I do advise the same. Wait for a few more days to see if the symptoms will get better and then consult further with your doctor.
4. If no betterment with current therapy, can go for further analysis as advised earlier.
5. To my opinion, it could be acid reflux. Once again, can send your upper endoscopy/biopsy reports for further evaluations.
All the best!
Dr.Albana
Please provide the upper endoscopy/biopsy results....
Detailed Answer:
Hi back XXXX,
1. You can provide the biopsy results to confirm that if it is normal, it means that no worries for abnormality. However, inflammation can be present in cases of gastritis/acid reflux, but nothing else.
2. When taking PPIs (e.g. Nexium or Zegerid); we do recommend to take early in the morning with a glass of water and at least 30 minutes before meal (I personally recommend at least 1 hours before meal).
3. Yes, I do advise the same. Wait for a few more days to see if the symptoms will get better and then consult further with your doctor.
4. If no betterment with current therapy, can go for further analysis as advised earlier.
5. To my opinion, it could be acid reflux. Once again, can send your upper endoscopy/biopsy reports for further evaluations.
All the best!
Dr.Albana
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I talked to my Doctor today and they scheduled abdominal CAT scan for next WED.
I am slightly reluctant on this step because of the radiation.
My symptoms are better , but not completely gone - still get occasional cramping, slight occasional nausea that goes away quickly , heartburn I can barely feel, some slight indigestion - - on scale of 1 to 10 ( 10 being most uncomfortable) - I would say I was a 7 in the beginning of December right before the endoscopy - now a 2 . ( Endoscopy was normal)
I am wondering if I have NERD
Would you wait for the symptoms to change or proceed with test. I know about being cautious , but I am weighing the radiation exposure.
I am slightly reluctant on this step because of the radiation.
My symptoms are better , but not completely gone - still get occasional cramping, slight occasional nausea that goes away quickly , heartburn I can barely feel, some slight indigestion - - on scale of 1 to 10 ( 10 being most uncomfortable) - I would say I was a 7 in the beginning of December right before the endoscopy - now a 2 . ( Endoscopy was normal)
I am wondering if I have NERD
Would you wait for the symptoms to change or proceed with test. I know about being cautious , but I am weighing the radiation exposure.
Brief Answer:
tests necessary to determine the final diagnosis
Detailed Answer:
Hi back XXXX,
Ct-scan is ok after evaluating your current health situation. It is time to give an end to all your problems. However, I still think you should consider the other tests I advised earlier. Can discuss this further with your doctor.
With regards to radiation exposure, it is minimal if you run ct-scan for first time and not repetitive in a short time period.
Take care!
Dr.Albana
tests necessary to determine the final diagnosis
Detailed Answer:
Hi back XXXX,
Ct-scan is ok after evaluating your current health situation. It is time to give an end to all your problems. However, I still think you should consider the other tests I advised earlier. Can discuss this further with your doctor.
With regards to radiation exposure, it is minimal if you run ct-scan for first time and not repetitive in a short time period.
Take care!
Dr.Albana
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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