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Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.
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Subject: Re: EGD results I am a 41 yr. old female with a long history of recurrent stomach problems. I had a cholecystectomy in '91. I don't drink, smoke, or use any drugs. Two years ago I had a positive blood test for H. Pylori and was treated with two antibiotics. Pain went away after awhile, but slowly came back months later. Last week I had an EGD which, in my physician's words, revealed numerous ulcers, erosion and inflammation. He pointed out some superficial ulcers and prescribed Prevacid 30 mg., twice a day and to return in one week for a followup. I know he took about 3-4 biopsies for H. Pylori. I do not have those results yet. I was given a copy of the pictures and, quite frankly, I was sickened by what I saw (good thing I'm not a doctor). The one thing he repeatedly said during the procedure was, "I did not expect this." Okay, so now I'm worried, right? The one thing on the pictures that has my curiosity going is a long, dark (coffee ground like), somewhat straight, line going around the stomach. He took several pictures of that. I thougt ulcers would be rather circular, but this looks a little deep in areas and is a line, wider in some areas, but straight and long. It stands out, to say the least. Also, the pictures shows many, many areas where it looks like coffee grounds are embedded, not in a collectively large area, but scattered all over. Last of all, since taking the Prevacid I have noticed pain AFTER taking it and feeling rather lethargic. Is it my imagination or could it be the medication? I've been searching the Internet for pictures similar to mine, but, thank God, none of them look like mine. I just still wanna understand what's going on and what I can do to have a healthy stomach.
Dear Dee, Ulcer disease of the stomach and small bowel is not as uncommon as you might think. Approximately 5-10% of people will develop ulcers in their lifetime. This number is much higher for people infected with H. pylori. Treatment to eradicate H. pylori infection is far from perfect. Depending on the regimen, only 80-85 % of people will eliminate the bacteria. Allow me to elaborate. H. pylori is a bug that can infect the stomach and cause ulcer disease. This bug is present more often in older people. It is not clear how it is transmitted but experts think it may be related to poor sanitation. Infection usually occurs in childhood. Almost all duodenal ulcers and about 85-90% of gastric ulcers are due to H, pylori infection. Drug regimens are available for treatment. Most of the two drug regimens have cure rates in the range of 75-85%. Another major cause of ulcer disease is nonsteroidal anit-inflammatory agents like aspirin, motrin, bufferin, excedrin, advil, naproxen, anacin etcetra. Tylenol does not cause ulcers. Since I cannot see the pictures I am unable to offer you a diagnosis. From what you have described it seems that you have ulcers and erosions. It is essential to exclude H. pylori infection (either due to failure to eradicate with your previous treatment or recurrent infection). If you practice life style factors that can cause ulcers, you should stop. Smoking, drinking alcohol or taking non-steroidal agents can cause your symptoms. Rarely, certain tumors can cause increased acid production and ulcers. Prevacid belongs to a class of drugs called proton pump inhibitors. These are very effective in the treatment of ulcer disease. I do not think that the pain you feel after taking Prevacid is related to the drug. The pain may be a manifestation of the ulcer disease or something else. Lethargy can occur with Prevacid though it is not common. You need to discuss these symptoms with your doctor and make sure that there is no other cause. If the lethargy is felt to be due to the Prevacid your doctor can prescribe an alternative medication. I hope we have been able to answer some of your questions. This information is presented for educational purposes only. Always consult your personal physician for specific medical questions. HFHSM.D.-sg |
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