endoscopy normal?

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theacidrefluxman
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Date Joined Oct 2009
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   Posted 8/18/2011 7:52 AM (GMT -6)   
Hi Everyone,

Sorry for so many recent questions. I have an appt. with my GI and am just making a list of questions to ask him.

As many of you know for the past 3 years, and year especially, I have struggled with almost constant heartburn broken up with periods of improvement. For the most part I have not been on PPI's. After the worst year ever for me, with constant reflux day and night, my dr. did an endoscopy and said my esophagus was fine, and "as healthy as anybody's"...He said he did not foresee me getting Barrets, even if I were off pills (but I think he was assuming I'd be taking PPI's)...

My question is: For those with really bad symptoms, do your endoscopies come back as sound as mine did? It made me think my whole problem might not even be reflux (maybe hypersensitivity to stomach acid). Or is a completely normal endoscopy fine?

I did have a small hiatal hernia and irregular Z line, but tested negative for Barrets and the dr. said everything else looked great. This endoscopy was 4-5 months ago.

theacidrefluxman
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Date Joined Oct 2009
Total Posts : 739
   Posted 8/18/2011 7:52 AM (GMT -6)   
FYI it is IMO a great doctor at Duke Medical Center, a huge university hospital. So I don't doubt the quality of his testing.

theacidrefluxman
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Date Joined Oct 2009
Total Posts : 739
   Posted 8/18/2011 8:17 AM (GMT -6)   
One last thing :)

A Barium swallow showed "Spontaneous gastroesophageal reflux was noted to the level of the
clavicles."

I think my doctor said that everyone has that, and it doesn't show whether its strong acid or weak acid, so it is not a significant finding". Is that true? For me it seems it would be a clear-cut finding of GERD.

Chuck T
Regular Member


Date Joined May 2011
Total Posts : 143
   Posted 8/18/2011 8:34 AM (GMT -6)   
I think you should request a ph test. It would answer a lot of your questions, and may put your mind at east.

mudmagnetmum
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Date Joined Apr 2011
Total Posts : 1604
   Posted 8/18/2011 8:59 AM (GMT -6)   
I had a totally normal gastroscopy in 2007. I was on Omeprazole but it was doing nothing for me and I was very symptomatic. I was puzzled and annoyed that the scope was normal, especially as it was an ordeal I never wanted to repeat.

My second scope this year was done after recurrence of symptoms. I was again on Omeprazole with only partial relief and a ton of side effects. Main reason was to rule out Helicobacter with a biopsy. This time I was told I had mild gastritis, mild oesophagitis and a small hernia and a minute area of Barretts. Yet my symptoms were identical to when I had the normal scope in 2007. So there seems for me no definite match between the degree of unwellness and the actual pathology. I was told the hernia was causing the reflux; if so what was causing my reflux in 2007 when they said there was no hernia?! I suspect either the hernia is irrelevant as it is very small, or it was missed in 2007. Either way, the scopes never correlated well with my symptoms.

I would also say I've had days when the pain has been scarily bad but I've woken near normal the following day. So neither symptoms nor scopes reflect the degree of dysfunction or "activeness" of my particular breed of GERD!

I've recently found my gastritis/GERD makes me anaemic and my haemoglobin is a far better indicator of what's actually going on; it goes up when I'm tolerating ppis and feeling ok, and goes down when I come off them and get symptomatic! And it's way easier to do than a gastroscopy!!

MMM
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma

kazbern
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Date Joined May 2010
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   Posted 8/18/2011 9:09 AM (GMT -6)   
My daughter has been complaining of upper GI pain for a long time, and we finally resorted to a scope last January when she had just turned 11. The findings on her scope showed minimal inflammation in the esophagus and duodenum. No redness on visual exam.

The GI talked with us after the scope and noted that perception of pain and evidence of damage on biopsy are not always directly related. Response to pain stimulus is a very individual thing. He'd seen plenty of patients with severe damage and no reports of pain, and plenty of the opposite, too. My daughter was somewhere in the middle of this range.

Now my daughter is 11, and her descriptions of pain are immature and kind of wacky. Even when she's shown the chart scaling pain from 1-10, and the smiling/frowning/grimacing faces that go along with the numbers, she still reports her upper GI pain as a 7. While she's sitting calmly in the chair and smiling. It is very hard to get a realistic understanding of her pain from such a conflicting self-report. Her pediatric GI noted that they have a psychologist on staff who works with kids on biofeedback and other pain control approaches. We haven't yet taken any steps in that direction.

None of this comment is meant to belittle your experience of reflux pain. I only mean to tell you that while your pain is unpleasant, it isn't necessarily indicative of severe physical damage. What to do with that information is hard to say, though.
*******************
49 yrs old, IBD diagnosis in spring '01. Proctitis, gastritis, ileitis.
Currently taking Pentasa (3g/day), Sulfazine (1.5 g/day), Prevacid, folic acid, vit. D (2K iu), flax seed oil (2 tsp/day), mesalamine enema as needed. Gluten free as of 5/30/11.

theacidrefluxman
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Date Joined Oct 2009
Total Posts : 739
   Posted 8/18/2011 9:48 AM (GMT -6)   
@ mugmagnetmum - did you have a PH test done? Did it show anything? I have had 3, one while on PPI's, and they have been borderline ok I think, with the first one showing strong acid. But not enough for doctors to say anything about surgery or anything.

theacidrefluxman
Veteran Member


Date Joined Oct 2009
Total Posts : 739
   Posted 8/18/2011 9:49 AM (GMT -6)   
thanks Kazbern. Interesting, I guess its kind of like "wait and see til next scope", until then I just won't know...

mudmagnetmum
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Date Joined Apr 2011
Total Posts : 1604
   Posted 8/18/2011 10:55 AM (GMT -6)   
No, I was not happy at the prospect of having a tube shoved up my nose and being left there; I only managed the 2nd scope under GA cos of bad experience (failed sedation) with the first. So I didn't ask for pH monitoring or manometry. It also seemed to be the case that the consultant only would want them done as a preliminary work up to surgical solutions. I was told I was not bad enough to consider surgery and so further tests were not warranted and I was discharged from hospital care, despite poor symptom control at the time. The underlying message, though politely put, was basically "go find a way to live with the ppis" ! So pH monitoring was never really offered to me, and I wasn't sorry!
New stuff: GERD. Interstitial Cystitis
Lifelong stuff: Food allergies, eczema, asthma
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