
Had Gastroscopy Done Which Revealed Hiatus Hernia With Grade A Reflux Esophagitis And H. Pylori. Suggestions?

I recently had gastroscopy done which revealed a Hiatus Hernia with Grade A Reflux Esophagitis and H. pylori negative Gastritis affecting the antrum of the stomach.
The histopathology report showed features suggesting gastro-oesophageal reflux disease without oesophagitis.
The gastric biopsy showed chemical/reactive gastritis, suggestive of bile reflux or drugs (NSAIDS).
I am wondering why the histopathology report is not entirely consistent with the gastroscopy report itself (one suggests oesophagitis and the pathology report does not).
Also, how is bile reflux detected?
Do these conditions have a high likelihood of bleeding?
Lastly, how is the level of liver toxicity detected and does my fatty liver condition cause greater liver toxicity?
Ans 1: Grade A reflux esophagitis on gastroscopy suggest there were few small erosion at lower end of esophagus. Histopathology report did not show esophagitis but showed gastroesophageal disease!? I am also wondering how the histology showed gastroesophageal reflux? without showing esophagitis. Here I want to put one query from where this biopsy was taken? However if it is taken from esophagus and did not show esophagitis is not very strange because the tissue taken during biopsy is very small and sometimes it may not be taken from the diseased site.
Ans 2:Bile reflux is detected during gastroscopy itself when bile (fluid) which is golden yellow in colour is seen in stomach or may be esophagus
Ans 3: Bleeding may occur in reflux esophagitis if persist for a long time due to formation of ulcer in esophagus but not so common
Ans 4: liver is seen as fatty on imaging like ultrasound etc.Toxicity is detected by liver function tests especially transaminase levels (SGOT and SGPT)
I hope I have answered your query and this will help you. Remain in touch and get-well soon.


I am not sure where the biopsy was taken but will include the reports. Somehow the bile reflux was suspected on the pathology but it is not confirmed.
Does the picture of the hernia look serious in the report?
Thankyou.
Findings on histopathology report in specimen B suggest inflammation which may be due to many causes so they have suspected bile reflux or drug induced.
Sorry, there is no picture or report of Gastroscopy


Sorry as the file was a little too large and it was never accepted. I have re-uploaded it.
It appears to be a small Hiatus hernia only. Most of the time it is asymptomatic and remain so throughout life
For hiatus hernia what all you have to do is:
1.Avoid fatty meals
2. Don't lie down soon after meals for at least half hour
3.Take small and frequent meals, instead of full meals at a time
4. wear loose clothes
5. If you are overweight or obese do weight reduction with dieting and exercise
6. Avoid straining while defecation, lifting heavy weight, coughing, sneezing and smoking if you do
Among the medications:
1. take domperidone it don't simply act as a prokinetic agent but it also increase the tone of lower esophageal sphincter
2. Baclofen also helps in increasing tone of lower esophageal sphincter
3.May be proton pump inhibitor like rabeprazole
I hope I have answered your query and this will help you. Remain in touch and get-well soon.



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