Grade C - Ulcerated Reflux Oesophagitis

[matt58268]

I am a 24 year old male with a history of heartburn and acid reflux. I weigh around 100kg (220 pounds) and am about 183cm (6 feet).

This morning I had an endoscopy performed, in which the following was noted: -

"In the oesophagus the squamocolumnar junction was at 36cm and there was significant ulceration consistent with Los Angeles Grade C reflux oesophagitis. (Impression: Ulcerated reflux oesophagitis)"

The Helicobacter plyori biopsy will be back some time tomorrow.

My questions are: -

Is this uncommon for my age, or does age play a significant factor? I am concerned that I have some serious damage that people in older age groups would normally get.

How long would the damage have been being caused to get to this stage? Could this have been over 6 months, or more likely many years?

In the absence of any other clinical findings on the report, I assume that a hiatal hernia was not observed, is this correct?

Is Helicobacter pylori a likely cause for this, and if not, what are common causes?

What treatment is available? Just PPI's?

What is the normal progression of this condition?

Thank you very much for your time.

[Stacicp29]

I have stage C esophagitis which was diagnosed after 2 biopsies during an endoscopy.   My gastroenterology Dr. said this was severe and one of the worst he has seen.  I have had painful swallowing since Middle Oct., difficulty swallowing and the feeling like there is constantly stuck in my throat.  I have to clear my throat and cough alot but was told to stop that and drink water when I feel that way as it will only irritate the esophagus more.  I am a 26 year bulimia survivor and suffered a living hell. I am lucky I'm alive but this pain in my throat NEVER goes away.  It's killing me.  They doubled my prilosec,  I exercise, have changed my diet completely, drink lots of water and am not overweight, don't smoke or drink.  Will I have to live with this throat pain the rest of my life.  I literally can't swallow....even salivia hurts to swallow. I live on soup and water.  I know it's my fault since the reflux was from the bulimia but it's hard to live with.  I heard surgery is very risky and doesn't always help.  My primary care Dr. treated me like I was crazy when I went back like 5 times for the same thing over and over. I think she ordered the endoscopy just to get rid of me. It hurt my feelings honestly.  I am finally getting help.  I just want relief from my constant pain.  Any suggestions I haven't tried?

[Imajerk]

Stacip29, your actions may have caused this but I wouldn't say it's  your "fault." Bulimia is a disease, and you didn't have a crystal ball warning you this would happen. I doubt a doctor told you this was a possibility ( it doesn't seem to be on the radar of most physicians), and it's not something most of us think of, when we mull over all the things that can go wrong in our minds.

I think of things I did in the past that probably caused my hiatal hernia and now GERD. And when I read about HH and how it's mostly harmless and many if not most people with it will never have GERD symptoms, I laugh, resentfully to myself. But it's done. Small consolation to someone having as much pain as you (I'm not in that kind of  pain so far, but who knows later?), but kicking yourself will not help.

Be well.

[matt58268]

Thanks for your reply.

H.Pylori biopsies have come back negative. I was almost hoping for a positive test, so at least it was something that had an appropriate treatment option.

In any case, it is motivation to lose the excess weight. I was very thin up until my late teenage years, and since then have been steadily gaining weight.

I don't smoke, and drink fairly rarely, and in moderation, so the main thing for me is to lose the weight!

[Smiley2000]

Hi Matt,

I am 35, female.  Weigh 62,4kg and 1,67m tall.  I have Barrets and some tummy-tissue that grew on my upper esophagus - so I actually have 2 tummies :)  So I understand that you face some sort of PPI for a long term plan, but I also think that there should be other options available to us.  If it wasn't noted on your report, then you don't have a Hiatus hernia.  It is possible that your tummy valve (LES) may be hypotensive as that can explain the GERD.

The tests that was done to check for H.pylori is also very important as this bacteria can cause cancer in the long run and has to be killed with special antibiotics.  That would explain the severe damage.

After my experience last week and the past year, I would advice anyone to go for the 24hr ambulatory test.  It is 99% accurate on getting a diagnosis and to find the cause.

Let us know as soon as you got your biops report back.

On 100kg you are a little bit over weight and you should try to see a Dietician to help you eat an acid-free and fat-free diet.  If you smoke:  STOP.  and if you take the occasional beer or something, it should be okay.

[Stacicp29]

Do you have any advice for stage C esophagitis?  My reflux was from 26 years of bulimia.  Mine was diagnosed after an endoscopy and 2 biopsies.   I'm in constant pain.  Can't swallow, have difficulty swallowing and feel like something is stuck in my throat at all times.  I don't drink or smoke. I changed my diet for the reflux diet.  I'm not overweight. I exercise daily.  They doubled my prilosec by nothing has helped yet and I'm really Struggling with the discomfort.   Do you think it will ever go away?  I can't live like this forever.  It's awful.  My Dr acted like it was all in my head until those results. I'm glad we found the problem but I'm on the prilosec every day 40mg until my next appt in 8 weeks.  I know it's all my fault but I thought I would have SOME relief by now. It's frustrating.  I have to eat just soup because everything else gets stuck in my throat.  Even my meds.  It's very scary. Any suggestions for me please?  Thank you.

[selmaS]

Hi...if ur H.Pylori comes back positive u may need a few rounds of antibiotics....that said, antibiotics can kill off all the good bacteria we need to digest our food.

Do ask about a probiotic after ur know the H.Pylori is gone.

Diet and life style can affect u sin getting GERD issues...H.Pylori is many times found after a Gall Bladder surgery....but, since u have an ulceration it is most likely there that the bacteria settled.

So to me, a non medical person it sounds as if u had some long term gerd issues left untreated.

Do look into modifying ur diet and life style to help the meds and ur system get back into proper balance.

http://www.medhelp.org/health_pages/list?cid=236

"selma"