Endoscopy likely to affect treatment?
Posted , 1 user is following.
I have a suspected peptic ulcer and I'm booked in for upper GI endoscopy in 10 days time.
My problem is a knee injury which requires minimising activity until the flare-up settles, and I need to decide whether to postpone the endoscopy (for the second time, probably for another couple of weeks).
So my question is, what are the chances that the endoscopy would result in a change in treatment and quicker healing? Or is it merely to confirm the diagnosis? I'm currently on 20mg of omeprazole (PPI) twice daily. H. pylori has been ruled out, it seems very likely the cause was long-term use of OTC NSAIDs. Symptoms: initially acid reflux, but since taking the medication just occasional brief sharp pains, that's all.
0 likes, 22 replies
derek58875 robin93893
Posted
Well brave you (and me) - not to have the throat spray.
But it's not very pleasant is it.
Well I did have a Duodenal and h.pylori But that was cleared up with the Gold Standard regime.
So now we are both in the same boat.
That is we have acidity and inflammation without any obvious cause.
Fairly recent medical science has been researching the question of why millions of people have h.pylori but never experience any gastric problems at all.
The new theory is that the difference lies in the fact that a percentage of the population have - genetically - more acid producing cells than others. So even though I've been given the all clear I have to keep Calcium Carbonate tablets to hand. And if the pain becomes quite severe (often after a couple of gasses of red !), it's back onto Cimetidine for two or three days.
Just to bear something in mind.
The American Food and Drink Administration have sent a warning to US doctors about the dangers of long term use of PPIs. (The sometimes side effects can be very serious).
Best of luck
derek58875
Posted
And my even greater preference for Ant Acids (if I can get away with just them).
robin93893 derek58875
Posted
They did a couple of biopsies, one for HP, saying their test is more sensitive than the one done already (stool sample). I'm now wondering whether maybe the initial irritation was due to ibuprofen but that then allowed HP to get a foothold. The symptoms certainly changed, from acid reflux to pain.
As for the genetic thing, my father and my sister both have had long term GI problems!
Puzzled by your mention of calcium carbonate, it doesn't seem very widely used for this, unlike sodium bicarbonate, which I use sometimes myself.
I'm aware of the problems of PPIs long-term, in fact I already tried to come off omeprazole but the symptoms were a fair bit worse even beyond the usual rebound period so went back on it. As for alternatives, I wonder if you've found this discussion: https://patient.info/forums/discuss/how-i-cured-my-gastritis-185914
derek58875 robin93893
Posted
Me too.
All my mother's siblings had Gastric problems. But I always put that down to them passing on h.pylori.
(My youngest son has just had an Endoscopy - totally clear. So it makes you think ?)
No - your hypothesis that your ibuprofen could have led to h. pylori is highly unlikely.
Long term use of NSAIDs is one of the main reasons for Gastric ulceration.
In your case you would have had to be infected with h.pylori from some separate source for it to have damaged you.
Whilst h.pylori is rampant in Africa and the East, it is in rapid decline in the West - because of our much higher hygiene standards.
Exactly how it's passed on is not really known. Suggestions have been made about mothers sucking babie's dummies to keep them clean - but the oral source seems very unlikely. Much much more likely is faeces contamination - and pretty certainly at child birth where better sterilization is reducing the problem (many children are found to be carrying h.pylori which doesnt affect them until later in life.).
Yes, people have been using Sodium Carbonate since Adam was a lad.
In fact one of the old ways of diagnosing over acidity was to take Sodium Carbonate and then find if you burped the gas a few minutes later as it prouced a chemical reaction with the Hydrochloric Acid.
I don't like taking Sodium.
For a long time I took Aluminium Hydroxide. Then there was a scare about the Aluminium in pans affecting the Brain.
I take the cheap own brand Boots Calcium Carbonate tablets. It seems to be totally benign and it's alkaline !! So it works.
I guess if you want to put more money down Gaviscon would do as well.
Incidentally, whereabouts are you. I'm in Marlow (on the Thames).
I'll look up the link you gave me.
Oh, just an afterthought about your Acid Reflux. No doubt you are aware that that people with normal acid conditions start getting Reflux problems at over 60 yrs. Because a majority of people get an hiatus hernia at that age.
derek58875
Posted
robin93893 derek58875
Posted
Congrats on your son's clear endoscopy! Though I guess that leaves symptoms unexplained, hopefully not for long.
Sorry I wasn't clearer about my theory. I was assuming that I already had HP but it didn't cause any probs until the stomach lining was made vulnerable by ibuprofen. Anyway there's not a lot of point of speculating, I'll have the test results in a couple of weeks.
Don't know why my previous google search on calcium carbonate failed to find much of relevance, I now see that's the active ingredient of the Tesco's tablets I've been using all along! I'm guessing both price and effectiveness will be very similar to the Boots ones. I also use Tesco's liquid which seems very similar to Gaviscon but is a fair bit cheaper.
I'm in central Scotland, so not very handy for getting together!
I was not aware of the prevalence of hiatus hernia in oldsters, I find it slightly shocking!