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Gastroscopy abroad and possible misinterpretation
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Gastroscopy abroad and possible misinterpretation

Hello, I am currently abroad with no access to my family doctor, and I made a Esophagogastroduodenoscopy as a result of abdominal pain, the result of which was this (I hope that the technical translation is understandable ) : " Esophagus : Z Line faded , faded, normally located . Small island of Barrett's esophagus with a diameter of about 8mm . Stomach : Mucosa with soft pleats , that extend normally at insufflation , punctate erosions covered with hematin and hemorrhagic spots scattered in the antral part, mucosal edema and erythema of moderate level in the antrum and body. Bile reflux present. No blood in the gastric lake nor stigmata of bleeding. duodenum : normal duodenal bulb to D II. DG : GERD , Barrett's esophagus island , cr hemorrhagic gastritis , HDS ( upper gastrointestinal bleeding ) Forrest IIC "

The main problem of the diagnosis , however, is that no biopsy was taken . Searching the internet it looked like they should have taken at least two: one for the presence of Helicobacter Pylori , and the other to be able to give a clear diagnosis of Barrett's esophagus .
The doctor seemed very professional, but now I doubt his diagnosis .
1) Given this scenario, would it be advisable to repeat endoscopy and take the two biopsies ?
2) Or could I avoid it, and maybe only do the examination of the H. P. from feces (breath test is not available where I'm now), ignoring Barrett's esophagus given the size that is very small ( if confirmed ) ?
3)Are there any possible problems in repeating the Esophagogastroduodenoscopy so early?
4)If I have to repeat the Esophagogastroduodenoscopy ,how long after the end of treatment should I wait, since I have read in the information leaflet that some of these drugs may mask the symptoms?
5) If I do fecis examination, how long after the end of the treatment?
6) What does Forrest IIC means?
Following my symptoms that borught me to make the Esophagogastroduodenoscopy.
Initially I had pain concentrated in an area about two centimeter (1 inch) to the right of the umbilicus and that extended several centimeters above this point, up to the beginning of the ribs. After a few days the pain also intensified in the area of the solar plexus .In the first week pain was intense and localized . I also had inflammation of some lymph nodes (visit and ultrasonography were ok) , especially under the chin, a lot of air in the stomach that made me burp a lot, nausea, and many times (more than normal) I went to the bathroom, but with a normal consistency . Sometimes the episodes were accompanied by tachycardia and shortness of breath, which improved after defecation, but this might be connected with an anxious state. This was particularly in the first week, after which symptoms were relieved spontaneously but not gone, and the pain turned into annoyance, and less localized in defined areas.
After the Esophagogastroduodenoscopy and diagnosis I started a treatment with esomeprazole 40mg , Domperidon 10mg and  bismuth subcitrate, for one month, which I finished without fully resolving the abdominal discomfort, that is still concentrated under the ribs, 2 cm (1 inch) to the right of the sternum.
I also did some blood tests and ultrasonography of the abdomen , and  no problems were found.
Thank you for the help
2 Comments Post a Comment
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Avatar_dr_f_tn
Hi, usually with h pylori infection there is evidence of peptic ulcer disease. As PUD was absent, he may not have screened for h pylori infection. Barrett's esophagus is most often diagnosed in people who have long-term gastro esophageal reflux disease (GERD). As this has a pre cancerous potential, the focus now will be on periodic exams to find precancerous esophagus cells. In consequent examinations a biopsy for the lesions is needed for monitoring. So, please follow up for monitoring. Regards.
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Avatar_m_tn
Thank you for the answer. How long should I wait after stopping esomepremazole to make a new endoscopy? On-line I found contrasting indications, from 1 week to one month. Thank you
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