HelpMePlease wrote:May I ask, which of those two options do you think it could be? Not yet healed or irreversible damage unable to heal?
I have had vitamin d checked and it's well within the normal range. Diet is good and bland, nothing to aggravate the stomach. I used to love eating salads but I cannot eat a Caesar salad still! I guess it's the black pepper or garlic in the dressing?
I am so worried this is irreversible damage to my stomach lining. How long should I wait for a reversal before I give up hope and think of it as permanent?
Histological damage to the mucosa of the digestive system virtually always takes far longer to return to normal than most physicians realize. They incorrectly assume that because resections to the intestines and other digestive system surgery heals relatively quickly, cellular damage should also heal relatively quickly. But that simply is not true. Here are some examples to illustrate why it isn't true. Research shows that it takes 3–5 years for the damage done to the small intestine of celiacs to heal, after they adopt a gluten-free diet. Extended use of PPIs (including omeprazole of course) causes long-term damage to the parietal cells of the stomach. After the use of PPIs is stopped, it typically takes a year or more for the histology of the parietal cells to begin to approach their original histology. In many cases though, the damage caused by PPIs will not completely heal, although it will usually be good enough for all practical purposes.
So based on that evidence, I would guess that the damaged cells in your antrum will probably be mostly normal again after a year or so has passed.
I'm not a fan of prednisone, but I don't understand why you feel that it will damage gastric cells. According to my research, corticosteroids reduce inflammation by suppressing the production and activation of mast cells. Mast cells are a part of the immune system, and while they exist in mucosal cells in the digestive system, they are not a physical part of the cellular architecture. So unless I'm overlooking something, prednisone should not antagonize previously damaged gastric mucosal cells. Have you asked your doctor for her or his thoughts on taking the prednisione at this point?
HelpMePlease wrote:Yes, I eat gluten and dairy but it does not aggravate me. Celiac biopsy was negative.
I'm guessing that Gabes is assuming that you have been diagnosed with MC. Whether you have been diagnosed with MC or not, please be aware that neither the celiac screening (blood) tests nor biopsy analysis for purposes of celiac diagnosis apply to non-celiac gluten sensitivity. For every person who receives a celiac diagnosis based on the official tests, roughly 20 others fail to be properly diagnosed, even though they are as sensitive to gluten as the average celiac. This happens because of the extremely poor reliability of the screening methods used to diagnose celiac disease. The bottom line is that a negative celiac test result can never, ever be assumed to rule out gluten sensitivity.
Biopsy-based celiac diagnoses require a Marsh III level of damage, while most people who have non-celiac gluten sensitivity have a Marsh I level of damage. IOW, the people who have a Marsh I level of intestinal damage often have enough damage to cause the same basic clinical symptoms as those who have a Marsh III level of damage, but they are not diagnosable simply because of the out-dated diagnostic criteria that are still in use today. This is why it still takes the average celiac an average of over 9 years from the onset of symptoms, to be able to get an official diagnosis of celiac disease. And unfortunately, because of these poor diagnostic practices, 19 out of every 20 celiacs are never diagnosed.
But it's unlikely that any of this has anything to do with your stomach damage. You are correct that corticosteroids taken in conjunction with doxycycline can cause a synergistic effect. However, as long as you are not using doxycycline, I don't see any reason why taking a corticosteroid would be any more risky than it is normally. But I would certainly check with my doctor to verify this before beginning another treatment.
One last thought — I have no idea why you need to take prednisone, but research shows that corticosteroids do not speed up healing as most physicians believe. In fact, corticosteroids actually slow down healing. So if you do use corticosteroids it will almost surely slow down the healing process in your stomach. How much effect it will have is difficult to guess, because it depends on many variables.
You're very welcome,
Tex
