Seeing a Specialist - Have my Report - Need Input

[nanci]

You may remember me posting about my diagnosis of Chronic Gastritis w/intestinal metaplasia.  My gasatro doctor didn't seem concerned and said my condition would eventually heal and I would be able to have a normal lifestyle.  It's been since April and I am still having burning and discomfort off and on.  I'll have a few good days and then it starts all over again.  I stopped taking PPP's (they don't help) and just take OTC stuff now.

I am seeing a specialist downtown (Chicago) and just got all my reports to take to him.  The Operative Report reads as follows:
"The visualized mucosa of the esophagus was entirely normal.  The gastric fundus, body and antrum were notable for erythema, edema and granularity consistent with gastrits.  No erosions or ulcers were seen.  The duodenal bulb and postbulbar duedenum were notmal.  The GE junciton and cardia were examined from below and found to be within normal limits.  Biopsies were taken for H-pylori.  (Biopsy negative for that).

The reason I am seeing the specialist is to cross reference what my doctor is telling me which basically is there is nothing I can do other than take PPI's, I shouldn't be concerned about the intestinal metaplasia, it doesn't mean pre-cancer.

I want to prepare myself and act knowledgable when I meet the specialist on Tuesday.  

If anyone has medical knowledge, can you interpret the Operative Report above and adivse what appropriate questions I should ask the specialist?  I am just not getting better. I feel if I don't heal and get better, then down the road, will this develop into cancer.

[nanci]

Is there a way you can get a second opinion?  This is what I'm doing.  While my doctor is good and I trust what he tells me, I feel it's my responsibility to cross reference what he is telling me.

This is the definition of atrophic gastritis that was actaully given by a doctor on this board awhile ago.  

"Chronic atrophic gastritis is a disorder of the stomach where gland loss and intestinal metaplasia (change in the lining of the
stomach-the lining appears more like the intestine). It is found in the stomach of 80-90 percent of patients with gastric cancer. One type of chronic atrophic gastritis is associated with pernicious anemia (sometimes associated with other autoimmune disorders). Pernicious anemia is associated with a higher risk of gastric carcinoma as compared to the general population. Another type of chronic atrophic gastritis is called multifocal atrophic gastritis and is the predominant type in most populations at high risk of gastric cancer.   Helicobacter pylori infection is frequently found in patients with multifocal atrophic gastritis. However, treatment of Helicobacter pylori
infection does not reverse multifocal atrophic gastritis. The routine surveillance for patients with chronic atrophic gastritis in the United States is not currently recommended, since the number of diagnosed cases of gastric cancer would be very small. However, if dysplasia (glandular distortion) is encountered on tissue biopsy of the stomach close follow-up is recommended."

Based on this, I would either insist that your doctor do a biopsy or find another doctor.  I never heard of h-pylori diagnosed via a urine sample.  But then again, I don't live in Japan!

I do believe that PPI's and antacids can worsen a condition.  I found this true in my case.    

If you have any questions, let me know - maybe I can share some of the things I do that seems to help.

[MKIK]

Dear Nanci, here i am like you I have my last endscope in Sept. 2002 which shows a chronic gastritis w atrophic gastritis w/o biopsy !!. I was test negative for HP. Doc said probably your case is due to stress!!! after your last posting to me about biopsy. I asked the Doc to have a biopsy but he told me that we here in japan has a very advanced scopes and in your case at that stage no need for biopsy then I told him how did you now that I hadn't HP he said via your urine examination!

He told me that STOP taking anti-acid it sometimes make things very bad espically strong type like lansprazole. I have also abdomenal pains, stomache hurt and burning on off also I am consipated. Doc also was very clear to me and told me that atrophic gastritis could develop cancer but with yearly endscope we can catch cancer at early stages BUT there is no medication for it right now and only gave me a medication to easy pass my stool and to reduce the pain but not anti-acid.

I have also a teeth pains on and off I do not know exactly if it is related with my atrophic gastritis or not also recenty my HG drop from average of 14 to 13.4 I am very concerned about bleeding. Doc. said this rate is not very dangerous and he tested my stool for hiden blood and the results come negative so where this amonut gone! my life style is completely changed I can not eat what i used to eat also I can not drink except water/milk/ and some time green tea. I would like to share with you our situtations

sincerely
Mohammed