What does it mean?

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MayOK
Regular Member


Date Joined May 2010
Total Posts : 111
   Posted 7/7/2010 10:21 PM (GMT -6)   
So, the reason I got referred to my GI is due to lower GI issues (diarrhea, cramping, slight blood, etc.).  He's been looking for Crohn's disease after some blood test came back positive.  Been scoped from top to bottom and the only inflammation he's found is esophagitis and gastritis, for which I think I have no symptoms.  I have a follow-up with him next Tuesday, and provided he doesn't tell me that this upper GI inflammation is a manifestation of Crohn's (which I doubt), then am I going to get dxed with GERD?  I have NO heartburn, and he slapped me on 40 mg of Prilosec daily.  I'm taking it, but I'm going to ask him about lifestyle changes as a first course of treatment.  I am not happy with what I am reading and hearing about PPIs.  Ack.  I know y'all aren't doctors, but was just curious if having esophagitis and gastritis = GERD.

lilitiger2
Regular Member


Date Joined Mar 2010
Total Posts : 89
   Posted 7/7/2010 10:53 PM (GMT -6)   
hi mayok
all i know is my mom has barretts and no sx...that she can feel. None. has never had heartburn or pain (just a hoarse voice occasionally).

i would definitely ask your doc.

there are lots of lifestyle adjustments. i have made them all i think and still need a ppi (and do not want to go to the next dose at this point, in spite of what docs tell me )

the lifestyle adjustments for me are hard (eating before 7pm? no caffeine?) but I do them anyway and they do help.

good luck
hope you get some answers.
Lila

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6933
   Posted 7/8/2010 7:25 AM (GMT -6)   
Hi MayOK,
Unfortunately, you can have "Silent GERD", and have serious corrosive damage to your esophagus with absolutely no knowledge that you're having it. If you have inflammation of your esophagus without treatment you can put yourself at risk for getting Barrett's, which is a pre-cancerous condition that is serious, but treatable--with PPI's.

While we'd all perfer to be prescription-free, PPI's are sometimes a necessary evil. I can imagine that it must be hard to believe that you need them when you don't have symptoms. Those of us with severe burning take them much more readily, because they are able to stop a very painful condition.

However, keep in mind that just because you can't feel the acid in your esophagus, it's there just the same. Getting the inflammation cleared up is very important to your long-term health.

While you still should pursue the lifestyle changes, the PPI's that you've been prescribed will help to heal the damage that's already been done. I'm sure you've been given literature by the GI doc, or have been online looking for how to avoid GERD episodes, so by all means follow the advice that you read.

Discuss your concerns with your doctor. I'm sure that he'd be willing to follow you through your lifestyle changes and re-scope you to be sure that they're being effective. The problem with silent GERD is that you can be experiencing serious damage to your esophagus without knowing it. Therefore, you could go merrily away, changing your lifestyle and diet, and end up with continued damage that you're not aware of.

I'm sure your GI doc will understand your hesitancy about taking medications. Hopefully you have a good relationship and can discuss the issue thoroughly with him.

Good luck with your dilemma! There are many here who've experienced the same worries.
Take care,
Denise

MayOK
Regular Member


Date Joined May 2010
Total Posts : 111
   Posted 7/8/2010 3:13 PM (GMT -6)   
Yeah, when I was doing a lot of research on Crohn's, a common theme was that inflammation should be treated, regardless of whether you have symptoms or not. It's weird, like you said, wrapping my brain around this problem, which I can't feel. I think I've had heartburn twice my whole life and one time was when I was pregnant. On my EGD report he put "Grade A esophagitis." I'm assuming that's not too severe, right?

I guess PPIs are typically long-term type medication, then?

My inflammation was incidentally found via scope. So if you feel heartburn does that mean your inflammation is worse? Or is it just different from person to person?

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6933
   Posted 7/8/2010 8:25 PM (GMT -6)   
Hi,
I looked online, and WikiAnswers had the following information:

What is Grade A Esophagitis?
* Grade A
Definition - At least one mucosal break no longer than 5 mm, none of which extends between the tops of the mucosal folds.
* Grade B
Definition - At least one mucosal break more than 5 mm long, none of which extends between the tops of two mucosal folds.
* Grade C
Definition - Mucosal breaks that extend between the tops of two or more mucosal folds, but which involve less than 75% of the mucosal circumference.
* Grade D
Definition - Mucosal breaks which involve at least 75% of the mucosal circumference.

I don't know if that provides any information you can use, but it looks like Grade A is the least serious of the grades.

GERD treatment with PPI's is long-term. They're also used to clear up ulcers, which is more limited term use.
Most of us have been on PPI's quite a long time.

I don't think that feeling the heartburn means it is worse. Some feel the symptoms differently. Silent GERD can be just as damaging as GERD that is felt.

Actually, I had GERD that was pretty severe at times, and I didn't have any damage or symptoms of the esophagus. Probably mainly because I was already on PPI's.

Good luck getting to the bottom of your problems, MayOK!
We're here for you.
Take care,
Denise

MayOK
Regular Member


Date Joined May 2010
Total Posts : 111
   Posted 7/9/2010 8:48 AM (GMT -6)   
Thanks for the reply. That's very helpful. Well, I see my doc on Tuesday, so I'll see what he says about all of this. I'll be curious as to his conclusions.

lilitiger2
Regular Member


Date Joined Mar 2010
Total Posts : 89
   Posted 7/9/2010 9:15 AM (GMT -6)   
denise thanks for this, very helpful!!
Lila
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