Duodenal Ulcer with Inflammation

[Duodenal_Knight]

I have been diagnosed with a duodenal ulcer on 4/19/12.  After taking Prilosec (20mg/day) the pain still exists today (7/23/12).  I also get earache (with no infection per the ENT) nearly every time I have the pain the the upper mid abdomen region.  It usually hurts 30 or minutes after eating, although it feels better right after eating.  It feels better after exercise.  It feels better to lay down.  I also get back pain and on occasion shooting pain in my neck upon moving my head slightly.  Please help me!  Drowing in anxiety.

[CalGal]

Is there any history of food intolerances or celiac disease in your family? What about inflammatory bowel conditions - any history in your family?

What did the doc attribute the inflammation in the duodenum to? Was a biopsy taken from that region? If so, were the intraepithelial lymphocytes counted by any chance? Was flattening of villi seen? Your posts seem to suggest that biopsies were only taken from the stomach, so I'm wondering if there's anything else on that pathology report.

When organs are irritated they can release inflammatory factors to surrounding organs and tissues that can cause distress to those tissues and organs. It's possible your back discomfort may be the result of duodenal inflammation since that organ is found at the 'back wall.' As an example, when the rectum is having an issue, the bladder can also 'sound off' loud and clear to to 'factors' released by the tissues of the rectum.

[Duodenal_Knight]

Thanks patient915!   The small intestine bowel series (barium swallow) did not uncover any ulcers or growths.  

The GI wants me to go for a "capsule endoscopy," and if there are ulcers below the beginning of the duodenum then I will follow-up with a MRA and MRCP.   He is trying to systematically rule out the cause.

I will take your advice and go back to the GP just to start a parallel effort.
Symptoms now include: 1.) thoracic spine area and up to cervical spine muscular pain, 2.) left tricep pain near medial head, 3.) upper central abdominal pain and 4.) stuffy left ear or ear ache.  No fever, no weight loss, and no temperature.  The back and neck ache are concerning as well.

Have to admit that I have run the gamut on causes as related to symptoms
using the Internet.  It is probably making everything worse.  Stress level makes it difficult to breathe deeply.  It's a vicious cycle.

Will post more as data rolls in.  

-DK

[patient915]

I think seeing your primary is probably a good idea so that you can get everything figured out and decide what to do about the pain.  I don't think a blood tests for H Pylori is needed.

[Duodenal_Knight]

Breath test was negative for H pylori.  

I then asked the receptionist at the GI's office what I do now, since the back pain is persisting.  She said back pain has nothing to do with my problem and to see my primary.  

Completely frustrated!

Should I do a blood test to see if there is evidence that H pylori ever existed?  What other tests should I be doing?  

Thank you again,
Duodenal_Knight

[patient915]

Good, keep us updated!

[Duodenal_Knight]

Thanks again patient915!

Yes, biopsies were taken and tested for H-pylori and cancer according to the GI.  Both were negative.  

He gave me a prescription for a H-P breath test and a prescription for a Barrium Swallow procedure.

Will let you know of any advancements.  Give as much guidance as you are willing to provide.

Thanks again!

[patient915]

This doesn't sound like ischemia to me.  I assume biopsies were taken during your endoscopy?

[Duodenal_Knight]

Thanks patient915 for your feedback.  I am definitely making an effort to eat better now.  Even following principles from documentaries "Food Matters" and "Fat, Sick and Nearly Dead."  Sometimes I do believe that anxiety is getting the best of me for many reasons.  The gym is my outlet.

Today the GI said that he wanted to do a breath test for H-pylori and then a Barium Swallow test.  He would decide what to do after the results are available.  He mentioned that there could be ischemia to the bowel or that that there could be more ulcers below where an endoscopy checks but still in the small intestine.  

He mentioned that my CT scan early in this illness and blood work at 2 months showed that there were no problems with other organs.  I will continue to post updates.  Maybe I need a permanent vacation.

[patient915]

I would recommend you do something to try to deal with your anxiety.  Are you eating better now?  I would say that the ear pain is likely unrelated to the ulcer.

[Duodenal_Knight]

I should also mention that when he did the endoscopy he stated that there was no H-pylori or cancer based on the sample he took.  I do not take NSAIDs or drink or smoke.  Just make bad choices of eating at lunch with my workmates.

[Duodenal_Knight]

It was found by endoscopy back in April.  All together it has been the most depressing five months of my life.  He said it was a "small duodenal ulcer with inflammation."  I see him again tomorrow (7/25/12) for a follow-up.  
BTW, I am a 44 y/o male with the biggest medical issue in my past being an appendectomy 21 years ago.  I have gained 15 pounds from this experience over the past five months.  My temperature stays fairly constant near 98.0 deg F.  Not sure if being a little lower than 98.6 deg F is normal.  I have not had any vomitting or diahrea.  I do have pain in my back a few times a week as well as in my left arm and shooting pains in my neck.  The back, neck and arm pain come and go.  Some days not at all and some days are nothing but painful.  I also hit the gym still to keep my mind off it because it makes me feel better.  The GI said my blood work looked normal at 2 months into this ordeal just before the endoscopy.  Also had a colonoscopy at the same time and everything checked out fine.  

Trying to find the association between the the ear ache and the upper central abdominal pain 30 minutes after eating is difficult.  Looking forward to all of your comments.  Thank you.

[patient915]

Welcome to the gastroenterology community!  What did your gastroenterologist say about the duodenal ulcer?  Was this found on an endoscopy?