Gatro Infection

Long history of gerd, irritable bowel, gastritis, esophegisits, hyatal hernia, re-occurring ulcers in stomach and esophagus.  I have had a successful nissen fundoplication in 1998.  
3 yrs ago more problems, gall bladder removed.  I had an EGD and Colanoscopy  in which the equipment was not disinfected properly.  Another EGD (different hospital) severe ulcers in my esophagus with "something growing in them” Sent to UCLA for testing.  

Cultures
Viridians Group Streptococcus - few
Haemophilus Parahaemolyticus - Rare
Coag - Neg Staph Like Colonies - Rare

Biopsis
Stomach - Mild chronic antral and oxyntic gastrtis with out activity
No H-pylori (Giemsa on A)
No intestinal metaplasia or oxyntic athrophy

Squamocolumnar Junction at 37 CM
Squamos mucosa with features consistent with gerd
Mild cronic (chronic) cardia-type grastritis with moderate activity
No interstinal metaplasia

At 36 CM
Squamos mucosa with features consisten with gerd
Mild acute and chronic inflammation of columnar cardia type mucosa
No interestinal metaplasia

At 30 CM and 25 CM
Squamous Mucosa without pathologic abnormality
No intestinal metaplasia

Motility study and a 24 HP monitoring study, Some reflux but not anything that would account for the ulcers.

UCLA indicated that a pill probably became suck at the juncture and dissolved causing the ulcers.  The bacteria that I had was not enough to worry about and she did not think antibiotics were warranted.

It is now 4 months since I have had these tests and I find that while I have improved I see myself slipping and becoming worse.  I had managed to gain about 10 lbs, which I have now lost; the pain is increasing in intensity and how often it occurs. incontinence  has again become an issue

Do you think that since my symptoms (while not as severed) are returning It is necessary for me to head back to UCLA for another EGD or am I not giving myself enough time to heal Can't my doctor here in Vegas perform the same EGD

[Kevin Pho, MD]

It's difficult to give specific recommendations without evaluation.  That said, I agree with the comprehensive evaluation performed at UCLA.

I would agree with repeating the upper endoscopy.  It's true that it can be performed at a variety of locations across the country, but the advantage of having it done back at UCLA is that they can compare it to the previous tests.

You have already had more specialized tests like a 24-hr pH study and motility study.  You can further consider a gastric emptying scan, as well as abdominal imaging to evaluate for other causes of the pain.

These options can be discussed with your GI 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