gastritis

[doxee]

I was diagnosed with gastritis in mid Dec 2002. This was diagnosed when I had a scope done that examined my stomach.
I was put on Aciphex and it helped only a little. I then was switched to Nexium and took it for 2 weeks and it didn't help either. Was put back on Aciphex 20 mg, twice a day. This was 3 weeks ago. Since mid Dec, my pain has only gotten worse. It is tolerable during the day but at night It wakes me up around midnight and it stays until I get up and move around in the morning. I am not getting sleep between midnight and morning because the pain is really getting bad. I was tested for H Pylori by a blood test and a biopsy when I had the scope done. Both came back negative. I also had an ultra sound done in Jan. 03 and it came back normal. I know people who have full blown ulcers that never had this awful pain and healed with a month on their own. I have had this for 3 months and have only worsening symptoms. I am a 51 yr old female who has never smoked and I don't drink. I'm not overweight and never get heartburn, not even with this. I also had a complete cardio work up done. I excersise nad never get out of breath or any other symptoms. This pain is located right under my breastbone, in the middle and maybe slightly to the right. The Dr that did the scope asked if the pain was slightly to the right because that's when he found the inflammation.  I have taken aspirin on a regular basis for frequent migrains but have not taken any nasids since my doctor told me not to when I started having problems 3 months ago. I can't get back to my Dr until a week from today. I live in a small rural town and the specialist is 200 mi away. I also take Wellbutrin for cronic depression and have been on it for several years without any problems. I do really well on it. I also use an estrogren patch for menopause symptoms. I also take Trazadone at night because I've been having problems sleeping since menopause. What is bothering me is why the pain is worsening and this is not going away. Thanks

[Kevin Pho, MD]

Hello - thanks for asking your question.

There are many causes for gastritis.  You are already negative for H Pylori.  Treating the appropriate cause of gastritis will help your symptoms.

Causes of erosive gastritis include NSAID-related (I would stop the aspirin) and stress gastritis (i.e. from a severe medical illness).

Gastritis can also be caused by a chemical etiology.  This includes GERD or bile gastritis.  You mentioned that your ultrasound was normal.  A 24-hr pH study might be helpful to evaluate for GERD.

A third type of gastritis is autoimmune gastritis.  There is an association with autoimmune thyroid disease and B12 deficiency.  Each of these disorders can be checked by your physician and should be considered.

A test measuring the ratio of pepsinogen isozymes I and II in the serum has good correlation with presence of autoimmune metaplastic atrophic gastritis and pernicious anemia - you may want to be checked for these.    

Followup with your personal physician is essential.

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.

Thanks,
Kevin, M.D.

[nadia]

I have had gastritis since Nov 2000.  It has never gotten better.  I live with moderate to extreme pain everyday.  I also tried aciphex with no significant relief.  It is much worse in the early morning hours and feels like I've been run over by a truck when I get up in the morning.  It does improve slightly after I get moving.  I think this a highly under-rated illness and there should be more done to investigate the source.  I have had gastroscopy, ultra sound, and barium swallow.  I have no sign of reflux, yet I continue to have chronic inflammation of the stomach lining. I find that the only thing that can be done with this is trying to manage it with food, lifestyle and medication. Living with the pain is just a fact of life now.

[girls_chicas]

I have the Hpylori bacteria and have also been diagnosed with gastritis I have been on the prevpac treatment twice now and hasn't worked.  I really don't want to do the same treatment again if it isn't functioning, should I say that to my doctor?  

What is the worst outcome if the bacteria doesn't go away, my doctor just say don't worry it will.  I have bloody stools all the time and they just say it's probably hemroids.  What should I do?  I want clarity in my life be up front with me.