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duodenitis
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duodenitis

I am 26 years old. I have been suffering from stomach pain about 5 years or even more. I have done H pylori test and was positive. I took antibiotic and I done stool test was negative. I was on opemprazole and lazoprozole however both of them seems are not working. I made endoscopy in May 2009 and the result was as follow: everything is normal a part from duedenum first part: Duodenitis (minimal). I am on pain all the time and doctor increase the the use of omeprazole from 40gm to 80 gm. 40gm in the morning and another 40gm at night.

Also in December 2009 I have done ultrasound as I had evaluated liver enzyme ALT. the result of ultrasound was as follow:technically difficult scan due to patien body habitus.
the liver is normal in size and contour. the echogenicity of the liver increased consistent with fatty infiltration.
the posterior aspects of the liver are poorly visualised due to loss of through transmation. situated with the region of the gallbladder fossa are 2 echo poor areas the largest measures 9mm in diameter. appearances are likely to represent area of facal fatty sparing.
pancreas  normal, the spleen, gallbladder, biliary tree appear grossly normal .

in february 2010 I had liver biopsy and the result as follow:
needle cores of hepatic tissue show marked steatosis (grade 3).
occasional mallory bodies are seen. there are small foci of pericellular fibrosis. no evidence of cirrhosis is seen.
the appearance are of a low grade steatohepatitis.
the differential diagnosis(if alcohol has been excluded) includes diabetes mellitus, obesity and drug reaction ? lansoprazole
discussion at an MDT might be helpful.

I stated to do exercises and stop taking alcohol the liver test start to be normal.
however, the pain in the stomach still there, I vomit and sometimes see little bit of blood when I am vomiting. or bitter taste.
my question what are the other test I have to do to find out about the cause of this stomach pain ( Dueodentis)
I have read about Zollinger ellison syndrom (syndrome). please give more help and advise what I have to do to get rid of from this pain

Kind Regards




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For Zollinger Ellison, check your gastrin levels. In addition check to see if anyone in your family have any history of celiac issues and consider asking to be tested for that - do full panel (total IgA; IgA and IgG gliadin; transglutaminase). In some cases it can produce a pattern that could suggest duodenitis. Were biopsies of the duodenum taken? If so, what did the pathology result say?
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thank you for your reply. when they have done the endoscopy biopsy from the stomach has been taken for H.Pylori, which was negative. however, I dont think  they took biopsy from the duodenum. the endoscopy  result was Duodenitis (minimal). in the first part only. the second part is normal.!!
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See if you can get the pathology report and read it. Things can be overlooked when a patient is given a verbal report.
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