Just started H. Pylori Treatment...

[tornado82]

I guess the pains are due to the biopsies as they would cut little tissue from the polyps as well as the normal areas for Hpylori test. One thing you should understand is, the standard ranges are not correct always. You might be having those polyps for years and never even known about it. I can understand how worried you area, but you should understand that in life you only can be in control of some things. Those results will be normal. The more and more you try to understand it with the online literature, the more worried you will get. Just go out there and enjoy the Labor day.

Regarding my situation, the Doc said, I may have a blood disorder/disease which is attacking my platelets. He said all the cell sizes, shapes, numbers are good and no blast/cancer cells but some T-cells appear to be clonal (little higher than normal). Then I got online and I couldn't find any information on this except for some research papers and even the Doc didn't appear to have any idea about what he was talking about. He give me copy of 2 research papers to read and nothing was helpful. I guess he didn't know how to read the results from flow cytometry test. The bad thing here is I don't have a reference range to check what my platelet count was (never went to the Doc before June). So donno whether I am having this from long time or it started this year. So he said we have to watch you, get your blood work done every 2 months to 3 months. He also ordered an ultrasound of the spleen to make sure I am not having an enlarged spleen (he did physical exam and said he suspected slight enlargement). It was a depressing news but Yesterday I decided, fuck it whatever happens as there is no point in keep worrying and wasting time.

Like you my only worry is/was we are in early 30s

Sorry to hear that man. If I had a real intimate knowledge of polyps I probably could relax, but when you read about them, you see the terms "Gastric cancer" all mingled in there. I understand your frustration as well... Doctors never seem to be very thorough to me, even ones that people highly recommend to me. They never can answer my questions, and I often have to do my own research to find things out. If it was up to my General practitioner (Who is a great doctor by everyones accounts) I wouldnt have even tested for h.pylori. She tried to tell me she thought I had GERD. No history of acid reflux ever in my life, No heartburn issues my entire life, but suddenly one day I have full blown GERD? I didnt accept that diagnosis and instead began to research. I called the doctor back and personaly requested that they draw blood and test for H. Pylori. They agreed to do it, and here I am....Blood test came back positive, and then the rest is documented on the pages of this thread. I worry that tuesday my GI wont be able to answer my questions either, but I hope he will. I love when a doctor talks to me in details instead of the typical generic responses.

My concern with the polyps is what has caused them. A polyp is an unnatural growth in the body, and something is behind the cause of that. I just want to get to the bottom of this mess. Its been like going on 3 months now chasing symptoms and seeking answers. My hope is that tuesday sheds the light on all of it, and that I dont get handed bad news. Been trying to stay busy and stay positive. Its nearly saturday, and I only have to wait a few days now...

My stomach has been feeling sore and achy all day...It has to be due to the endoscopy because I have not been having these feelings at any time prior to the procedure. Ill keep watching for blood in the stool, so far however stools have remained light brown in color, so no signs of blood at all.

[Helico_expert]

If Barjammar says is ok, I believe it's going to be ok. Worrying is not going to help. In addition, I think "worry" is a worse disease. You'll have to treat it by thinking positive or perhaps distraction. You are still young. If you dont have genetic background and eat healthily, I dont think there is anything to worry about. The good news is, you are aware of the polyps. Just get a constant monitor with your specialist.

[tornado82]

If Barjammar says is ok, I believe it's going to be ok. Worrying is not going to help. In addition, I think "worry" is a worse disease. You'll have to treat it by thinking positive or perhaps distraction. You are still young. If you dont have genetic background and eat healthily, I dont think there is anything to worry about. The good news is, you are aware of the polyps. Just get a constant monitor with your specialist.

Oh believe me I know. Worry is something hard for me to handle though. Its my anxiety coupled with my INTJ personality type. I over analyze everything. I've tried really hard these past few days to keep my mind off of it but its a constant struggle. It makes me feel depressed as soon as my mind thinks about it. Some people can handle bad news in stride, but its always been a weakness for me. I've tried to just stay busy doing something. Mowing grass, working outside, watching football. I've managed it pretty well. Today is the big day for me though. I SHOULD find out a lot of things today. My follow up is this afternoon and we will be going over my biopsy results. I'm taking a list of questions with me to ask the doctor. Today will either help me finally move past this long ordeal, or make it worse. Im hoping and praying for H. Pylori to be gone, and for the polyps to be small, benign, and few in number. Ill try to post back this evening with what I find out.

To anyone who may happen upon this in the future, a good starting point to read more about Gastric polyps can be found here: http://www.medscape.com/viewarticle/813500

It should be noted that both in the above paper, and in my other reading, Ive learned that Fundic gland polyps rarely show up in individuals with H. Pylori infection. This is one thing that has worried me. Fundic gland polyps arent very scary, especially if they are around the typical 1cm size. The other types of polyps are more worrisome, and are usually seen more in H. Pylori cases.

[tornado82]

As promised, Im back to deliver a bit of closure to this multi-month ordeal Ive beengoing through. In short, the results of my endoscopy and pathology report are about as good as could be expected. I will post my full report tomorrow to hopefully get some more expert feedback on it, but this is the basic run down, Ill be posting it verbatim as it is listed on the reports.

Endoscopy Findings:

The examined duodenum was normal.

Patchy erythematous mucosa was found in the gastric body and in the gastric antrum. Biopsies were taken with a cold forceps for Helicobacter pylori testing. Estimated blood loss was minimal.

A few 3 to 4 mm sessile polyps were found in the gastric fundus and in the gastric body. Biopsies were taken with a cold forceps for histology. Estimated blood loss was minimal.

The lower third of the esophagus was normal.

Mucosal changes including longitudinal furrows were found in the upper third of the esophagus and in the middle third of the esophagus. Esophageal mucosal changes suspicious for eosinophilic esophagitis. Biopsies were taken with a cold forceps for histology. Estimated blood loss was minimal.

Images of my esophagus were included with the report showing the areas mentioned, and showing the polyps in the stomach. I was glad they included images so I could see it with my own eyes.


Pathology Report:

Diagnosis:
1- Biopsy, antrum:
changes consisten with reactive gastropathy. Helicobacter Negative.

2- Biopsy, Stomach, Body:
changes consistent with reactive gastropathy. Helicobacter Negative.

3- Biopsy, Gastric:
Fundic gland polyps. No dysplasia or malignancy is identified

4- Biopsy, Esophagus:
Scattered eosinophils. Quantitative evaluation of eosinophils does not suggest eosinophilic esophagitis. Changes consistent with reflux esophagitis.


Each of these 4 biopsies are then further broken down into a more lengthy microscopic description. That is where some of my questions still remain, but they are more curious questions than things that worry me. The doctor strongly suggested I go back on PPI. He thinks that I definitely have eosinophilic esophagitis, and not reflux esophagitis. Aside from that, there is no further follow ups. In their eyes I am pretty healthy, with no concerning issues that need further evaluation at this time. The polyps did in fact turn out to be fundic gland polyps, and there were only 3 or 4 polyps total, and he said the biopsy of them essentially removed them. They were between 3 and 4 mm in size, and showed no signs of ulceration. This was of course all great news to me. I drove home with a huge weight off my shoulders. H. Pylori has been eradicated. I have some minor inflammation in the stomach and some mucosal changes in the esophagus, but these are things I can work to correct and get healed. I decided to take the doctors advice and began Prilosec OTC again tonight. I will take it for a few months I think and then drop it for a while. I told the doctor I was not a fan of being a long time ppi user. He encouraged me to atleast take it every other day or on a week, off a week. Not sure how effective it would be taking it like that. Ill take it for a while, until I feel I have been symptom free for a long period and then I will slowly come off of it and see how I do. Im glad to FINALLY have some answers to this mess. I finally know and understand what is actually going on.

[Helico_expert]

I am very happy for you. I wonder if you can start writing a book about your case.

[tornado82]

That would be a very short and boring book Helico_expert! No one would buy it. lol

Ive decided not to post my full report becaus I would have to edit it heavily because it contains a lot of personal info. I do have some questions about the pathology report however that use a lot of medical jargon that Ive not been able to find good info on yet. See if any experts here can shed some light on these sentences from my pathology report:

Multiple specimens were tested and the report is broken down into each specimen. Some specimen's included multiple biopsy samples however. Specimens seem to be grouped by where the biopsies were taken (Antrum, Gastric body, Esophagus, etc.)

Area's in bold in the following text are items Id like to get some more understanding about. A lot of medical terms are used that make it difficult to really understand, in laymans terms, what some of this actually means.

Specimen 1: Antrum (area where inflammation was observed)

Histologic sections show gastric mucosa with elongate branched glands and increased smooth muscle in the lamina propria. The surface epithelium shows mucin depletion. There is a minimal lymphoplasmacytic infiltrate. Significant acute inflammation is not seen. There is no ulceration, erosion, atrophy, epithelial dysplasia or intestinal metaplasia. Special stain for Helicobacter is negative. Features are of reactive gastropathy as can be seen with bile reflux, nonsteroidal anti-inflammatory drug use, healed ulcer site, or alcohol use.

Specimen 2 is from the Stomach Body and mirrors specimen 1 findings, so Ive not included it.

Specimen 3: Gastric (the polyps)

Sections show fragments of polypoid gastric mucosa with dilated glands lined by foveolar epithelium. An increase in smooth muscle is present in the background lamina propria. No dysplasia or malignancy is identified. A special stain for Helicobacter is negative.

Speciment 4: Esophagus

Histologic sections show squamous mucosa with a chronic inflammatory infiltrate, scattered eosinophils, elongation of the mucosal papillae, and basal cell hyperplasia. Specialized intestinal mucosa is not present. There is no evidence of epithelial dysplasia or malignancy. Quantitative evaluation of eosinophils does not suggest eosinophilic esophagitis.



If anyone can break down the area's in bold that would be awesome Does this report sound like mild issues or more moderate issues? Im trying to moreso gauge how bad the inflammation that I have is. For example what does "Mucin Depletion" mean exactly? and what exactly is "lymphoplasmacytic infiltrate" etc?

[Helico_expert]

i donno histology very well, need to ask pathologist.
From my basic understanding, when you have elongated and branched crypts and glands, it indicated chronic/long term inflammation.
Lymphoplasmacytic infiltrate basically means inflammation - so whites cells are present. Minimal infiltates means minimal inflammation.
Mucin depletion - maybe due to scarring??

[tornado82]

Thanks helico_expert. Ive done a little reading around by using the key terms to search for material. It seems that some of what I have found has suggested that pathologically my stomach and even my esophagus to some extent has suffered some ongoing irritation and inflammation. This could entirely have been aresult of the H. Pylori, but I guess I wont ever really know. If I have been having inflammation in the stomach body, I've not had any noticeable pain or symptoms from it Over the months or years that it has been occurring,aside from the chest pain which started this whole investigation many weeks ago. From my reading, and speaking to the doctor, it seems that right now the mucosal changes in my esophogus and stomach have been mild. My job now is to try and prevent it from getting worse. This is one reason why I reluctantly started taking PPI again. The doctor wanted me to go back on it to help these area's continue to heal up. My plan now is to continue with some of the positive diet and lifestyle changes Ive made (Dont eat late or lay down after eating, kick carbonated drinks, minimize foods known to upset my stomach etc) and to take the PPI for a course of probably several months. I will take the PPI until I have been symptom free for a long period of time, then I may try to gradually drop it. If it was all caused by the H. Pylori then hopefully it heals up and I never have trouble again, but who knows if H. Pylori had anything at all to do with any of this...I may have simply discovered it on a whim.

Newhpyloridaig, how did your test results come out on your platelet levels? Havent heard from you lately.

[newhpyloridiag]

Tornado, hope you are feeling better. I haven't seen the Doc since 4 weeks. I am feeling better, have a follow-up visit with the hematologist in 2 weeks.