Endo Results - Duodenum With Focal Gastric Metaplasia

[ravenwoodglass]

I had an endo a couple of weeks ago. After 5 years gluten-free there was no evidence of celiac so I guess I have healed nicely. However the biopsy report stated that they found Focal Gastric Metaplasia in the specimens. My doctor thinks they messed up at the lab and made a mistake and is comfortable waiting a year or so and then redoing the biopsy. He said visually everything looked fine. To my understanding the finding suggest either cancer or a precancerous condition but I don't want to jump to conclusions.

Would you want a second opinion? Do you think they can reuse the same slides or do I have to go through everything again. It was a horrible experience as the doc was in a hurry and started everything before the meds had a chance to take effect. Not something I want to repeat in a hurry unless needed.

[Jestgar]

I would totally get a second opinion or I'd be a basket case for a year.

Have the slides read by a different person/lab/technician, whatever is appropriate, and if the same results are found you can consider another biopsy (by a different doctor would be my suggestion).

[Jestgar]

I just found someone's powerpoint presentation about this

FGM

It looks as if it's associated with H.pylori, focal has a low risk of progressing to anything more serious, and treating the H.pylori may have some benefit.

[ravenwoodglass]

Thanks for the reply and the link. Do you know how they test for H pylori, would it be likely in someone who only rarely has any signs of heartburn or reflux? I am assuming it would be prudent to ask for a test for it. The treatment is antibiotics, correct?

[Jestgar]

I think it's a blood test to look for antibodies.

The treatment is (or was a couple years ago) antibiotics along with PPIs to decrease the acidity of your stomach and make the bacteria more susceptible to the antibiotics.

I read somewhere that H.pylori is really prevalent, but not everyone has symptoms from it.

Still, it's just a blood test...

[ravenwoodglass]

Good, I am going to call my GI Monday to find out if he tested for it. I should think he would have suggested testing but but then again this guy doesn't even know celiac can cause any symptoms other than GI. You set my mind at ease a bit. I guess I can stop labeling my treasures as to who gets what for a bit longer. I don't know what I would do if I did have cancer, I would be afraid they would poison me with treatments or hospital food.

[Jestgar]

I guess I can stop labeling my treasures as to who gets what for a bit longer.

Put my name on your collection of gluten-free recipes!

[mamabear]

Thanks for the reply and the link. Do you know how they test for H pylori, would it be likely in someone who only rarely has any signs of heartburn or reflux? I am assuming it would be prudent to ask for a test for it. The treatment is antibiotics, correct?

Ravenwoodglass,

Ask for a copy of the pathology report. Most EGD biopsy specimens are stained for H Pylori as a routine. The report should state on there somewhere if it was done. Otherwise there are 2 available blood based tests..one is from a venipuncture and the other is a rapid fingerstick method similar to a strep test. Both test for antibodies to the bacteria.

[ravenwoodglass]

Ravenwoodglass,

Ask for a copy of the pathology report. Most EGD biopsy specimens are stained for H Pylori as a routine. The report should state on there somewhere if it was done. Otherwise there are 2 available blood based tests..one is from a venipuncture and the other is a rapid fingerstick method similar to a strep test. Both test for antibodies to the bacteria.

Thanks so much for the reply. I did get the actual report along with copies of all my labs. It does not mention any yes or no as far as the HP issue.

The microscopic finding were: 'partial gastric metaplasia with foveolar epithelium. Brunner's glands present. The segment with gastric metaplasia some of the glands show increased nuclear cytoplasmic ration and hyperchromasia. Also patchy inflammation.'

I will contact Monday and ask directly. Perhaps it is there and I missed it. Or he may not have tested for it because I haven't had any stomach pain. I have wondered if the ?discomfort? that I have been interpreting as hunger may actually be related to an ulcer. I had not felt hungry in years before my diagnosis. I have at times gone days without eating and lived off very little food for a long time. I think my brain learned how to just ignore hunger. Pain is perceived differently by different folks and I endured so much for so long that a couple occasional twinges seem pretty insignificant.

I wish the doctor and I could have spent more time discussing the findings but most of the visit was spent with me telling him the drugs didn't work and him telling me they did. He was supposed to not do the endo if there were problems with the colonoscopy but I think he thought I was out of it and wouldn't remember so he just went ahead anyway. I had nightmares for almost 3 weeks and some bruising on my jaw, arms and strained back and leg muscles. I, thank goodness, do not remember anything after they made me swallow the scope, at least not consiously.

They are doing a CT on Tuesday with water soluable (and I pray gluten-free) solution and no IV contrast so hopefully the 'tortuous' colon and the 'lump' that I have had growing for a while will no longer be a mystery after that. That was my main concern to begin with and the endo was just done IMHO to satisfy the doctors very long desire to do one on me. He brushed off IBS for years as I got sicker and sicker, insisting it was all in my head. I don't want him to just consider the biopsy report a mistake and ignore it.

[mamabear]

Ravenwoodglass,

I read the link provided by Jestgar and it looks like annual EGD is the best way to monitor the metaplasia. Getting the CT scan will add extra information...sometimes MRI's of the abdomen are also done . If H pylori is involved, looks like treatment lessens the chance of malignancy.

Let us know what your follow up tests show.

[Maddiecl]

Hello Ravenwoodglass,

I know this is a verrry old thread but I recently got some biopsy results that also said I had Gastric Metaplasia.  Can you tell me what you are doing to monitor this condition, and what you know about it?  My doctor just told me not to worry about it, but the fact that it is considered a pre-cancerous condition is freaking me out. 

I really appreciate it.

Thanks!

[cyclinglady]

@Maddiecl — Be patient!  Ravenwoodglass is still very active on the forum.  I am sure she will reply soon.  ?

Try not to worry.  I know, easier said than done!