Reactive Gastropathy - Is it reversible?

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tex
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Post by tex »

HelpMePlease wrote:I have spoken with two GI's in the past 24 hours. Both said after nine months my stomach is not going to heal any further. It's so upsetting.
That clearly tells you 1 thing — they don't know of any way to treat it. So there's no point in trying to use a medical solution — they don't have a solution. To get different results you have to do something different.

That's exactly the reason why the members of this discussion board use a treatment method that most gastroenterologists insist won't work to control MC — diet changes to eliminate all inflammatory foods. And guess what? It works.

If GI specialists were always right it would be nice. But while they're right about many things, there are a surprising number of things that they are wrong about (such as prescribing iatrogenic drugs such as PPIs and bisphosphonates for example, and denying that diet changes can be used to control MC).

When my digestive symptoms got so bad that I finally broke down and went to see my doctor, he examined me and announced that I had colon cancer. He sent me to a GI specialist who told me the same thing. But guess what? They were both wrong.

5 years later, I had a blockage so I went to the ER. After running some tests they prepped me for surgery and removed a section of my colon. After I regained consciousness the surgeon advised me that it appeared that the section they removed was malignant, but he thought they got all of it. Guess what? Wrong again. It wasn't malignant after all.

So I've learned by experience to take all medical claims and advice with a grain of salt. Some of the time they're right, and some of the time they're not. The trick is in figuring out when they are right and when they are wrong.

We don't keep statistics on gastritis cases, because gastritis is just another satellite issue out of many for MC patients. But one thing most of us learn here is that inflammation is the root cause of disease (especially digestive system disease), and the best way to treat or prevent disease is to prevent inflammation from developing. That beats the heck out of trying to treat inflammation after it develops (which is the medical approach).

If you want to prove those 2 GI specialists wrong, you have to do whatever it takes to change your diet so that your diet is no longer generating inflammation every time you eat a meal. And as Erica suggested, you need to stop taking medications that cause inflammation. Your stomach will heal, if you let it. But you have to help it out by not feeding it things that promote inflammation. You have to avoid inflammatory foods and drugs 100%, even in trace amounts. The damage to your digestive system developed over time and it will take time to heal. But you can do it if you truly want to do it.

In the past 24 hours you've learned some valuable information — you've learned (by their own admission) that those "experts" can't help you. You're in exactly the same position that I was in when that GI specialist who confirmed the cancer "diagnosis" that my own doctor made, informed me that there was nothing more he could do for me. Like I was, you're on your own. And like me, you can heal that inflammation yourself if you really want to get your health back. And you have a big advantage over me — you're much younger, and younger people heal faster than older people.

Tex
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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.
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Post by HelpMePlease »

Thank you all. Everyone is so helpful and I am so grateful. Just a reminder: I do not have colitis. I have chemical gastropathy in the stomach and another issue with inflammation all over my tissues.

I know the prednisone steroid is bad and the stomach does not like it. However, my life is on hold with a disabling amount of inflammation in my tissues. I can accept that I will always be disabled on the couch or I can take the steroids and recover from the inflammation in my tissues. It is a balancing act and a constant worry of which is more important to me and which risks I am willing to take.

I just worry that reactive gastropathy is considered erosive and erosive gastritis is notorious for being irreversible. I read in medical journals that it is much easier to get rid of inflammation in gastritis (inflammation in the stomach lining) vs. dealing with mucosal damage and erosion (which is what I have). I worry very much that regenerating mucosal lining is nearly impossible. That is very worrying.

I like to talk with other people who have chemical injuries to the stomach lining just like I do. Many are from NSAIDs. I ask so many of them if they ever recovered the stomach and virtually all of them have said no. They make improvements, but it's never the same. I also like to read medical articles about the situation. My stomach situation is chemical gastropathy (also known as reactive gastropathy). There are not many medical studies on this but one I have read over 100 times is this one found here:

"Chemical Gastropathy: A Distinct Histopathologic Entity in Children"

http://journals.lww.com/jpgn/Fulltext/2 ... ic.12.aspx

It says the following, in terms of findings:

"Clinical Outcome

All 21 patients were treated with acid-suppressing medications, and the use of NSAIDs was discontinued in all 4 patients. The medications used were proton pump inhibitors in 15, H2 receptor antagonists in 5, and sucralfate in 1 patient. Three patients were also given a prokinetic agent. Four patients were lost to follow-up. In 17 patients, including 4 who were contacted by telephone, the mean follow-up duration was 11.5 months (range, 3–24 months). Eleven patients reported complete resolution of symptoms, and seven of them had stopped taking acid-suppressing medications. Six patients reported partial improvement. Two patients died because of underlying malignancy, and four patients were still taking acid-suppressing medication at the time of follow-up. Four patients had a repeat endoscopy 1 to 14 months after diagnosis. In two there was resolution of histologic features of chemical gastropathy, whereas two patients continued to show milder changes."

This gave me hope. I thought, "Okay, I have like at least a 50 percent chance of complete resolution of symptoms". But, then I emailed the authors of the article. Only one author responded, a GI pathologist. He was kind and said he looked through his decades of research and could not find any biopsy-proven resolutions of reactive gastropathy and said, anecdotally, that it was rare to actually see a resolution but that could be because patients were basically maybe not responsible and continued bad habits, etc. Another GI pathologist at a major medical hospital in the USA was kind enough to exchange many emails with me and he said he looked in his databases and could not find one biopsy-proven resolution either. I have been nice to my stomach. They act like my stomach should heal as long as the inciting agent has been removed. Well, it was removed over nine months ago. I have been eating safe foods that do not aggravate. I worry it's just humanly impossible to heal this stomach. It is devastating because it was an avoidable stupid decision and error in judgment of the doctor but also because it prevents me from taking steroids for a very physically disabling and life altering issue.

I just never hear any success stories of someone legitimately healing from a chemical/reactive gastropathy. Here on this board there are countless success stories of colitis and that is fantastic. But where are the success stories of a chemical gastritis? I do not find them and I have been looking. That study I mentioned above made me optimistic, but then I talk to the actual author and he was a bit negative about it. And then I wonder if they messed up or skewed the results to make things seem better than they actually were.
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Post by Gabes-Apg »

for starters, you are not comparing apples with apples
Majority of those type of studies - the patients are not making diet and lifestyle choices to optimise healing

secondly, whether it is Chemical Gastritis, MC, GERD, Crohns, UC, IBS or any other name - it is inflammation and damage of the digestion system with ongoing symptoms that are impacting your life.
there are loads of people not just in this website forum that have healed from these issues with Diet and lifestyle changes.

There is a discussion with a recent new member and she reported the following today
http://www.perskyfarms.com/phpBB2/viewt ... 4&start=15
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.
the bold highlight was done by me, in the short period of time that this member has been with us and started the suggested changes there has been improvement!

Another conversation with inputs yesterday regarding UC
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=22304
Robb wolf is the paleo guy who had uc, was scheduled for surgery to have part of his colon removed. Decided to go paleo diet and was able to cancel his surgery. http://againstallgrain.com/about-me/
Is about Danielle walker also had uc and went into remission with paleo.

He can read up on Robb wolf and Danielle walker on Internet.
I know that these are not the EXACT same as you, albeit these examples, and the others I provided show that with the right eating plan and lifestyle changes these people healed and got well!
please open your mind to opportunities that there to get well and improve based on the suggestions that are being offered.

long story short - the choice is yours
do you want to stay as you are? or open your mind to what has worked for thousands of others with major gut damage and give it a go.
Gabes Ryan

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Post by tex »

To add to what Gabes posted:

I/we are well aware that you do not have colitis. I/we are simply suggesting a way for you to resolve your health problems if you are actually serious about getting your health back.
HelpMePlease wrote:I ask so many of them if they ever recovered the stomach and virtually all of them have said no.
Ask them if they are following the same diet restrictions that most of us here follow. You will find that none of them are, and that's why they will never heal. And I don't mean following this diet for a few weeks or months. It will take at least 2–3 years (or more) to heal

You seem to be hung up on a pointless question, the answer to which has no possible benefits regarding your potential treatment or recovery. If you choose to believe that you cannot heal, then I can assure you that you will not be able to heal because the negative placebo effect is just as powerful as the placebo effect itself. If you want to recover despite the odds though, then you will be doing what all of us do when we come here, because in most cases, our GI docs tell us that this will not work.

Forget the pediatric studies. Kids heal quickly. Adults do not. We already know that the medical treatment methods do not work for adults. 2 GI docs told you that yesterday.

Forget the prednisone. It is now poison as far as your stomach is concerned. You can heal the inflammation in your body with the food you eat if you eat the right food and totally avoid the wrong foods.
He was kind and said he looked through his decades of research and could not find any biopsy-proven resolutions of reactive gastropathy and said, anecdotally, that it was rare to actually see a resolution but that could be because patients were basically maybe not responsible and continued bad habits, etc.
That doctor knows what he's talking about — he's right on target. Most patients are their own worst enemy because given a choice, they will almost always choose to continue self-destructive habits rather than to choose a more difficult option, especially if it involves stringent diet changes. And they will almost always choose to follow bad advice that just happens to be what they want to hear, and choose to ignore good advice if it is contrary to their beliefs.
HelpMePlease wrote:They act like my stomach should heal as long as the inciting agent has been removed. Well, it was removed over nine months ago. I have been eating safe foods that do not aggravate.
I don't understand how you can be so sure that you are only eating safe foods. Most of us here find that tracking down all of our food sensitivities and keeping them out of our diet is a huge challenge, probably the biggest challenge that many of us will ever face. Have you had IgA antibody stool testing to verify that your immune system is not producing any antibodies?

And please be aware that a safe diet includes not taking any medications known to cause digestive system inflammation, such as PPIs. PPIs IMO are capable of causing bile acid reflux back through the pyloric sphincter, and this can certainly cause gastritis, erosion, and all sorts of negative effects.

As Gabes pointed out, you can continue to worry (which only makes the inflammation worse) and continue to flounder around and search for hidden "miracle" solutions in places where you already know that solutions do not exist, or you can buckle down and do what needs to be done and begin healing your body. No one can force you to heal yourself. You have to have the self-discipline and the dedication required to do that on your own. We can tell you how we would go about it, but we certainly wouldn't try to force you to do anything. Your future is in your own hands. You already know that your doctors can't help you.

If you came here (or anywhere for that matter) simply to find out if your stomach can be healed, no one can tell you that because no one can predict the future and no one knows what you are going to do tomorrow or any other day, and no one knows what you are willing to do to heal your stomach and get your life back. And if you came here looking for guarantees of any sort, obviously we can't provide any of those, either. No one can. Health outcomes are never a sure thing. So if that was your reason for joining this forum, I'm afraid you wasted your time (and ours), because we can't guess the answer to that question any better than you can (you know your body better than we do and we can't control what you do), nor can we provide any guarantees.

On the other hand, if you came here to learn how to stop the inflammation so that your body can heal and allow you to get your life back, then you came to the right place and we are more than happy to help, because that's what we do here every day. We help members to resolve cases when their doctors are unable to help. But we can't heal you. We can only tell you how to heal yourself. Every one of us here learns how to heal him or herself. We don't just resolve our MC symptoms — we stop or at least minimize inflammation, and that resolves all sorts of health issues. But whether or not you take advantage of this information to get your life back is totally up to you.

Tex
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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.
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Post by Gabes-Apg »

regarding the 'clean diet'
what you think is clean, may not be low inflammatory gut healing clean

on the first page of this discussion you mention that you are eating gluten and dairy - these two ingredients are the most inflammatory to the gut and I provided articles explaining why.
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Post by HelpMePlease »

Thank you all. Can't type much now as I am on my phone, but I will try the diet. I need to learn more about it to make sure I do things correctly and not mess up out of ignorance.

However, I still do not know what to do about the 40 mg daily omeprazole I take. Should I get off it? I have had GI doctors tell me to stay on it and get off it, so it is confusing. If the "goal" is to reduce inflammation then should I stay on it since it supposedly does an excellent job of limiting inflammation/acid?
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Post by Gabes-Apg »

However, I still do not know what to do about the 40 mg daily omeprazole I take. Should I get off it? I have had GI doctors tell me to stay on it and get off it, so it is confusing. If the "goal" is to reduce inflammation then should I stay on it since it supposedly does an excellent job of limiting inflammation/acid?
Tex answered that question in his reply.

wait till you can be on a tablet /computer and read the responses again...

later on I will type out the fundamentals of what we call a low inflammation gut healing eating plan
Gabes Ryan

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Post by Gabes-Apg »

Check out this post- i typed this up tonight
it is a draft - but a starting point with an outline of eating plan.
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=22318
Gabes Ryan

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Post by tex »

HelpMePlease wrote:However, I still do not know what to do about the 40 mg daily omeprazole I take. Should I get off it?
Omeprazole is one of the most inatrogenic drugs ever sold. It causes the very symptoms that it is prescribed to treat. That's why you can't get a straight answer from GI specialists. Omeprazole causes more health problems than it treats.

As I pointed out in my previous post, my guess is that the omeprazole has weakened your pyloric sphincter and this is allowing bile acid reflux to continue to erode the mucosal lining of the antrum of your stomach. If that has happened, it will probably take at least several months for your pyloric sphincter to slowly regain it's strength so that the bile acid reflux will stop, and after it stops it will take a long time for that damage to heal, but you should feel much better as soon as the bile acid reflux stops.

PPIs typically cause a severe rebound effect (acid reflux) after they are stopped (remember, I pointed out that they cause the very problem that they are prescribed to treat). If you have severe acid reflux you may have to take an H2 blocker and/or antacids to stop the burning in your esophagus until you lower esophageal sphincter regains it's strength so that it can hold back the acid reflux.

Tex
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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.
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Post by HelpMePlease »

Thank you so much for all of your help, everyone.

Tex, I sure hope you are right. To be honest, I am so devastated by this. I am not a depressed person at all but this has made me so upset. I am going to get off the omeprazole and alter my diet some more and see what happens. I am so, so, so devastated by this. It's very upsetting to me that I may never have a normal stomach again. My stomach was perfectly fine a year ago and a few days of antibiotics and steroids gave me irreversible damage? That is so upsetting.

I'm just terrified and devastated I will never get my stomach to be normal again.
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Post by Gabes-Apg »

there are not many people over the age of 35 that have 'normal' or perfect stomach.
as we have mentioned with the right combo of inputs, you can improve things

now that you have a sensitive stomach, managing stress, our emotions, our reactions to life is important
we cant avoid stress, stressful events will happen, with health issues in our lives we have to be able to manage our reactions to stress.
there is saying that life is 10% what happens to us, and 90% how we react..

One thing that can help to reduce stress are guided meditation / breathing techniques / relaxation activities

I put some details of them in the guidelines section.
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=22350

spending 20 minutes a day in relaxed state can help alot..
this could be playing relaxing music while you do some colouring in or going for a 20 minute walk in nature.
or do some yoga at home.
there are loads of free podcasts on these types of things (so it doesnt have to cost very much at all)

Many here have had to go through the stages of grief as we embrace life with possible chronic illness - denial, anger, bargaining, depression and acceptance
doing some journalling and guided grief processing may be helpful for you at this stage,

take care
Gabes Ryan

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Just a thought

Post by Janie »

Many of my patients have taken Prednisone with Carafate. But you are on a ppi. Others have used inhalation or IM, to by pass the gut All this has to be done under MEDICAL supervision. I am a retired R.N., not a GI nurse but telemetry (heart- lung). Ask your Internist and concentrate on relaxing and making simple changes like forget the salads and cook your veggies. Stay away from Gluten.
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Post by HelpMePlease »

Thank you all! I am so grateful everyone here is so eager to help. I feel so lost in this and very uninformed and confused.

Just wanted to announce that as of yesterday I am officially OFF the omeprazole (Prilosec). I wondered, if anyone had any opinion on the following:

QUESTION #1: Is it okay to take any Tums or Gaviscon or Carafate as I did a fairly quick taper? Or, should I stay completely away from those things?

QUESTION #2: A doctor is offering me LDN for my other inflammatory issue but also possibly to help the stomach (I think). Does anyone have any thoughts if LDN is good or bad?

Gabes-Ang: I had a perfect stomach before the strong antibiotic and steroid combination hit. It is so upsetting. I never had a single problem with my stomach before. It's so upsetting that a few days of bad drugs can cause potentially irreversible damage.

Janie: I had a Kenalog shot (steroid) in my rear end last week. It still aggravated my stomach! I do not know if it is normal that my stomach is so unreasonably sensitive or what. I am really up a creek and it is devastating that I can no longer take the steroids which are so important to my mobility and quality of life. I do not have colitis. I just had a chemical injury (chemical reactive gastropathy) in my stomach from antibiotics/steroids.

I am so terrified and devastated that my stomach may never be perfect or normal again, like it was before, no matter how hard I try. I worry it's potentially humanly impossible to heal.
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Post by brandy »

Great news that you are off of PPIs. http://www.webmd.com/alzheimers/news/20 ... k-in-study
Mom was on PPIs for about 30 years and I think it contributed to alzheimers.
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Post by Janie »

I've been thinking of you and wondering how you are doing?
Prednisone is notorious for making gastritis. But you need the meds or alternative meds.
There are a lot of people who have 2ndary illnesses on this site regardless of there colitis. I just read some blog on here for LDN therapy. Hopefully someone who isn't so new as me can help.
When anyone who has an upset stomach, nausea, vomiting or diarrhea, bland is better good ol' homemade chicken soup with veggies. But try broth first. Hope you are tolerating more food now.
Janie
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