That's OK Tex -
Your insight was very helpful. I have to agree that the "chronic gastritis" is most likely lymphocytic in nature. Especially considering a few years ago the lymphocytes were in my duodenum. I am so disappointed in my previous GI Dr. though. If I hadn't been persistent and asked multiple times for the pathology report to be mailed to me I would never have known about the gastritis findings. How frustrating is that? As a Veterinarian when I call a client with a biopsy result I tell them the actual results and never try to cover anything up. Freaking unbelievable. I am waiting to get in to see a new GI Dr. at OHSU in Portland but they are a referral only clinic so it is just taking awhile. Not that I am expecting anything to come of it...but I at least need to establish a relationship with another GI Dr who is somewhat competent and ditch this other dude. The ONLY other thing I can think of that would potentially cause the chronic gastritis would be bile acid reflux which apparently happens in some patients post-cholecystectomy and can cause gastritis. I did have my gallbladder out 16 years ago when I was only 18 so I guess this is a possibility. Who knows. All I know is that I've been feeling a little better with diet changes, lots of mag, Vit D, B12, and 6 mg of budesonide (which my Dr. doesn't know I'm on....because he would rather have me on Imuran, hah!). Let's hope this keeps up. And hopefully I can get some weight back on.
You're never going to believe this
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Katie,
Please don't feel like the Lone Ranger. The "What they don't know won't hurt 'em" policy toward patients seems to be rather common in the GI specialty. After my colonoscopy exam in 2010 (in which he failed to take biopsy samples) my doctor told me that other than a few patches of slightly darker pink areas that could be seen against the light pink background (that I could clearly see on the monitor screen — and I even asked him about them), there was nothing wrong with me, so he couldn't do anything more for me. That was years before I learned (from Dr. Fine) that the inflamed patches associated with MC are actually visible through a scope if you know what to look for.
5 years later I had to have emergency surgery to remove a stenosis in my sigmoid colon because of a blockage. So after I recovered enough to take a trip to the hospital's records department to obtain a copy of the original (colonoscopy) endoscopy report, I discovered that the stenosis was clearly described in the report. I can only conclude that he didn't want to worry me with the facts.
Yes, your history of PPI use certainly opens the door to bile acid reflux, IMO. Of course my observation isn't verified by medical research, but because it's well known that PPIs destroy the integrity (clinching strength) of the lower esophageal sphincter (LES), one could certainly deduce that PPIs might also weaken the clinching strength of the pyloric sphincter, especially after long-term use.
The fact that the gastritis was noted as "minimal" in the report suggests to me that it may be (probably is) resolving as your pyloric sphincter is slowly regaining it's clinching strength now that you are off the PPI (if bile acid reflux is indeed the cause of the gastritis).
Here's hoping that your healing progress continues.
Tex
Please don't feel like the Lone Ranger. The "What they don't know won't hurt 'em" policy toward patients seems to be rather common in the GI specialty. After my colonoscopy exam in 2010 (in which he failed to take biopsy samples) my doctor told me that other than a few patches of slightly darker pink areas that could be seen against the light pink background (that I could clearly see on the monitor screen — and I even asked him about them), there was nothing wrong with me, so he couldn't do anything more for me. That was years before I learned (from Dr. Fine) that the inflamed patches associated with MC are actually visible through a scope if you know what to look for.
5 years later I had to have emergency surgery to remove a stenosis in my sigmoid colon because of a blockage. So after I recovered enough to take a trip to the hospital's records department to obtain a copy of the original (colonoscopy) endoscopy report, I discovered that the stenosis was clearly described in the report. I can only conclude that he didn't want to worry me with the facts.
Yes, your history of PPI use certainly opens the door to bile acid reflux, IMO. Of course my observation isn't verified by medical research, but because it's well known that PPIs destroy the integrity (clinching strength) of the lower esophageal sphincter (LES), one could certainly deduce that PPIs might also weaken the clinching strength of the pyloric sphincter, especially after long-term use.
The fact that the gastritis was noted as "minimal" in the report suggests to me that it may be (probably is) resolving as your pyloric sphincter is slowly regaining it's clinching strength now that you are off the PPI (if bile acid reflux is indeed the cause of the gastritis).
Here's hoping that your healing progress continues.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.