Gastritis that will not go away?

     Hi, I have been battling with terrible nausea and gnawing stomach pain for the last 8 monthes.  Gastritis is most likely the cause of this.  Gastritis was diagnosed during an endoscopy I had 4 months ago.  Because I had pain under my right rib, I was also tested for gallbladder and other digestive problems.
     I had an ultrasound, abdominal CT scan w/contrast, gastric emptying scan, Hida scan and an EGD.  All tests came back normal except for EGD which found gastritis in my antrum.   The only thing that I know of that could of caused this was the fact that I was a smoker at one time (I quit 5 months before my EGD).   I tested negative for H.Pylori bacteria, as well.
    It has now been 8 months and my symptoms have not improved.  My gastritis was diagnosed as "mild."  I have never used Nsaids at all and I do not smoke or drink alcohol.  I eat only healthy foods now and I do not eat spicy food at all.  I still have some caffeine from soda, but I have cut this way back and mainly drink water now.  I also have no milk allergies.  Could drinking caffeine free soda still irritate my stomach?
    I have taken Nexium and Zantac 150mg and find very little relief from either of them.  But is it critical to reduce acid?  I just don't understand why my symptoms have not improved at all.  Is it possible that i could have functional dyspepsia?  I just don't think gastritis could last so long.   Could carbonated beverages be the whole problem, regardless of caffeine content?
    I would appreciate any advice you can give me.  I feel so bad I can hardly eat and my doctors are out of answers.

[Kevin Pho, MD]

You have had a pretty thorough evaluation of the symptoms, all the tests I agree with.

The endoscopy and the imaging scans would have excluded most of the major causes.  At this time, you may want to consider more specialized tests, like a 24-hr pH study to determine whether GERD is present, or measure its severity.

Another consideration would be a gastric emptying scan to evaluate for gastroparesis, or an esophageal motility study to exclude an esophageal motility disorder.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin Pho, M.D.

KevinMD.com
Twitter.com/kevinmd

[Matthew007]

hey shoop couldn't help but respond to your post but..I also have nausea and gastritis..and we're thinking it's some form of food allergy.  You could try lactose free for like a week and see what happens or go see an allergist/GI to test for celiac...something is causing your stomach to rebel.  The gastric emptying test isn't a bad idea but I think you've got some possible allergy as well.  (btw celiac tests are not very accurate so might help to go off gluten for a while too!)

anyway just an idea..I suffer from chronic nausea as well.

[Jojewel]

A related discussion, Continuous Gastric Issues was started.

[MissyGirl1982]

A related discussion, Is it really gastritus? was started.