Introduction: I am diagnosed with Weak LES, Erosive Easophagitis Grade 1 (The endoscopist didn't take a biopy of this), H Pylori negative + Coeliac Disease + Autoimmune disease negative Chronic Inactive Diffuse Antral Gastritis and IBS - D.
I have lost 19 kgs over 5 months, reasons for which hasn't been found conclusively. Other conditions i have include, Sinus Tachycardia, Obstructive Sleep Apnea, Mild Benign Prostate enlargement, Grade 1 Fatty Liver. All these conditions have developed in the last 5 months. It started off with me being put on PPI when i had no GI symptoms but some pricks in chest, more on the left end.
Tests done so far: Endoscopy has been done twice and colonoscopy, PET CT, Abdominal CT and Ultrasound and plenty of blood & stool tests. Stand out aspects from blood tests include - High HS-CRP, High Homocysteine, Low Vitamin D (I took 6k Vitamin D supplement for 8 weeks), Low B3 & B7, High Vitamin E, conflicting results related to B12, Folic Acid (I verified three times). Tested full thyroid panel, parathyroid, fecalprotectin, ova & cysts, pheochromocytoma, chromogranin - A - All are fine.
More details: I had severe Sleep Apnea (86 AHI 3 years ago). I used CPAP for 2 years. But when i started dropping weight, i had severe bloating and my stomach was full of air, possibly because of wrong pressure setting CPAP. I had stopped using it for 3 months. I did both PSG and HST recently. PSG says i have 49 AHI and HST says i have 19 AHI. PSG say i have Central apnoea, HST says i don't have. HST also says that i have low oxygen saturation (min being 83) and advises me not to use Central Nervous system depressants.
I have had umpteen symptoms come and go. At present i have bowel movement (Stool 6 - soft, large lump, undigested food) 2-3 times a day but not post prandial distress has come down, Voice cracking, sore throat in morning, pain/stuck (possible globus) above sternum beck, mucous in back of throat, stomach distension, constant clearing of throat, dry cough, heartburn, epigastric burn, increased heart rate (It used to go up to 140 bpm and has miraculously come down after covid. Could also be because i recently took Vitamin D, Vitamin B supplements and Montek - LC for 1 month. I was taking propranolol 10 mg till very recently), soaking feeling in the back whenever i eat, frequent urination, TMD/TMJ, noise in ears when speaking (Audio and ear pressure tests seem to be fine), occasional tingling/numbness in extremities
a) My doctor is asking me to take CINITAPRIDE-3MG and PANTOPRAZOLE 40MG. I am extremely vary of PPI, given my past experience, should i take Pantoprazole or stay on Fomatidine?
b) Can i take Cinitapride given the low oxygen desaturation during sleep? If not, which medicine with minimal side effects can be given to strengthen LES?
c) I'm taking Peptest to find out if Pepsin is causing Extra easophagal symptoms next week. If the issue with pepsin, what could i take?
d) With IBS-D (It also has marginally improved with reduction in post prandial epigastric burning, post prandial diarrhoea), though i have no cramps/painful bowel movement, i get severe pain / dripping feeling 5 cm left of umbilicus every now and then. Doctor says it's because of IBS. What could i take for IBS / FD - I understand i cant take benzodiazepines given my rather low oxy levels during sleep.
e) How will i know if my esophagitis or gastritis has healed without having to do another endoscopy and possibly come out of H2RA?
f) For my Sinus Tachycardia, i have already one TMT/ECG/Echo couple of months back. They were ok, doctor just asked me not to check heart rate. Every now and then, my heart rate goes above 100, mostly after eating. My stomach is distended. I have read about Romheld syndrome.
g) My gastric biopsy said Plasma cells and lymphocytes seen in Lamina Propria. What else could cause this chronic inflammation?
h) And finally, i'm exhausted trying to find out why i'm losing weight though i am eating normally. Is there anything else i should check - SIBO, full Gut check, adrenal insufficiency, small fibre neuropathy, chronic pancreatitis, Pancreatic insufficiency, etc.,
Sorry for a long post....