I had an upper endoscopy last week to evaluate oesophageal damage due to GORD. The results showed oesophagitis and gastritis with prominent (what ever that means!) intestinal metaplasia in the stomach, not in the oesophagus, but no evidence of H Pylori infection. Since I don't drink or smoke and can't tolerate aspirin based medications, I'm wondering what the possible cause of MI could be? My gastroenterologist says that the MI appeared in one biopsy and there was no dysplasia but he only took 2 sets, one from the oesophagus and one from the stomach, although I think there were several samples in each set. He says that means a greater predisposition to cancer, but there's nothing to worry about at this stage. He says I should have a repeat gastroscopy in 3 years when he'll do more extensive biopsies. Is it safe to leave it 3 years before more extensive biopsies are done? He's given me Nexium to take only when I get heartburn, which I have been on for 6 months anyway, but that just cuts the pain, it doesn't stop the bloating, breathlessness, constant cough and lately, hoarseness. Is there anything else I can do to relieve the symptoms? I am already on a low fat, low carb diet because of type 2 diabetes and have lost about half the weight I need to lose, although I still have about 15kg yet to go. Do you have any suggestions? All I can find on the internet is references to clearing H Pylori to reverse the MI, but since I don't have that, I'm wondering what else can be done to reverse the MI.
Intestinal metaplasia is a condition which can lead to cancer.
First confirm with your doctor whether the intestinal metaplasia is in the stomach or the lower end of esophagus.
1. If it is in the stomach it is invariably due to H.pylori infection. Even if they did not find h.pylori take treatment for it as intestinal metaplasia in stomach is a reversible condition which disappears with eradication of h.pylori.
2. If it is in the lower end of esophagus it is called barrett's esophagus. This is due to long standing GERD. It is irreversible. But it can lead to cancer and hence regular follow up is essential. If there is no dysplasia then endoscopy every three years is done.
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