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Suggest Treatment For Gastritis After Gastroscopy And Colonoscopy

Posted on Fri, 26 Jun 2015

Question: Hi,
I've recently done a gastroscopy and colonoscopy and have attached the reports and images. While there was nothing specifically found wrong apart from gastritis, I wonder if the pictures show the stomach hernia getting worse. I am not sure if the first image on the top left shows a hernia in the new set of images for 2015. Also, I noticed the red marks in the third picture from the top on the left. Where would the red marks be found and is there any significance?

Thankyou.

Answered by Dr. Dr. Klerida Shehu (7 hours later)

Brief Answer:
Gerd/ gastritis, nothing else...

Detailed Answer:
Hi
I read carefully all your reports and I can say as follow:
1. The first figure of upper endoscopy report shows small hiatal hernia associated with inflamation of oesophagus ( oesophagitis).
Both of them indicate Gerd( acid refluxs)

2. The third fig shows antral gastritis.
Red miliary spots are typical findings of inflamation and stomach mucosa damage.

So, If I were your treating doctor I would suggest :
_ start PPI like pantoprazol
_ start domperidon treatment
_ use two pillow when you lay down
_ eat three hours before go to bed
_ avoid cofee, carbonated drinks, alcohol,smoking
_ increase your physical activity

Hope it is helpfull.
Dr.Klerida

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Klerida Shehu (37 hours later)

Thanks Dr. Klerida,

My doctor did not recommend any special treatment so I am assuming the gastritis is not that serious. However, do the red miliary spots indicate that the inflammation is quite serious? Is it usual for area of the hernia to have a different colour to the surroundings? For the images attached for the 2015 gastroscopy (set of 8 images) is it possible to see if the hernia has become worse compared to the 2013 gastroscopy? (4 images).

Thankyou.

Answered by Dr. Dr. Klerida Shehu (17 hours later)

Brief Answer:
Following advice.

Detailed Answer:
Hi back,

The mucosal layer of the hiatal hernia is not different (are the same layer) from stomach mucosal layer. Hiatal hernia is the part of stomach that has passed through (has herniated) diaphragm from abdominal cavity into the mediastinum. Hiatal hernia mucosal layer is different from esophageal mucosal layer.

With regards to miliary red spots they are typical findings for gastritis but in your case this isn't indicative for severe gastritis.

Although the hiatal hernia is smaller in the gastrostopy done in 2015 there is still a mild gastritis that need to be treated for 4 weeks.

Wish you health!
Dr. Shehu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Klerida Shehu (44 hours later)

Thanks Dr. Klerida,

To me the hernia now appears larger than in 2013 and it also has a different colour so I am wondering why my doctor did not recommend any special treatment. I have seen a different specialist this time and it may be that he is more conservative.

In any case, it is mild gastritis so not too serious.

Thankyou.

Answered by Dr. Dr. Klerida Shehu (17 hours later)

Brief Answer:
Suggestions below

Detailed Answer:
Hi back XXXXXXX
Thank you for follow up.

With regards to hiatal hernia size it is difficult to judge only from a picture. I can’t say it is bigger and has changed color since the endoscopic view depends on:
-video endoscopy resolution,
- Location where the doctor has taken the picture (near of far away from Z line)
- Amount of flu air insufflation used by doctor.

If you want to check again you hiatal hernia size I would suggest performing barium swallow study in Trendelenburg position.

With regards to gastritis it is mild gastritis and nothing worrisome.

Wish you health!
Dr. Shehu

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar