Have High EOS Count And Deep Ulcer. Having Pain In Neck And Back. Having Weight Loss. Suggested Laproscopy. Chances Of Gastric Lymphoma?
Thank you for the query.
The chances of gastric lymphoma without H.Pylori infection are really low. Moreover, there biopsies which were collected should give positive result (if not year ago than this time). So this really does not sound like a gastric lymphoma.
Such recurring stomach ulcers can be caused by a tumor which secretes gastrin (it is called gastrinoma). With recurring ulcers, also severe diarrhea appears.
Elevated eosynophiles level can be caused by gastrointestinal parasites (I hope you have been tested for that) or by allergies.
Laparoscopy might be a good idea, however in my opinion before this surgery, abdominal CT should be done.
If your ulcer will be recurring again and again, you should consider partial stomach removal and vagotomy (vagal nerve cut, this nerve stimulates stomach acid secretion)
Hope this will help. Feel free to ask further questions.
Regards.
So while I was on protonix this time the ulcer remains maybe kept growing. Also I have no diarreaha. Wouldn't they see parasytic infection on endoscopic biopsies. The pathology came back neg.
Eosynophiles elevated level can be caused by parasites present in the small or large intestine, not in the stomach. There might be a coincidence that you have an ulcer and elevated EOS. That is why you should have stool tests for parasites. Endoscopy wont tell anything about parasites.
You need to know that Pantoprasole (Protonix) can be very effective to some patients and can be completely ineffective for other patients. Very often the dosage prescribed is also not sufficient. You should be taking Protonix 40 mg twice a day for one month to give a chance for your ulcer to heal.
If Pantoprasole does not work for you (it looks like it does not), you should try other medicine. I suggest you to discuss with your doctor about it and try Omeprasole 40 mg twice a day.
You should also avoid coffee (this is very important), fruit juices, fatty foods, alcohol.
After a month, gastroscopy should be repeated. If the ulcer will be still present, surgery and partial stomach removal (with Vagotomy) should be considered.
Hope this will help.
Regards.