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Endoscopy negative but with gastritis

There are several types of tests for H.pylori. The major ones have a their own forum.

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ruedo6
Posts: 2
Joined: Wed Mar 09, 2022 2:33 am

Endoscopy negative but with gastritis

Post by ruedo6 »

Hi there. I hope you are doing well.

I had H pylori when I was 19 years old. It was successfully eradicated.

I am now a 35 year old male experiencing stomach issues. Those issues include: heartburn, lump in throat, nausea, post-nasal drip, burning in my stomach.

I was on Nexium 40 mg twice a day and then switched to 60 mg Dexilant once a day. I went for an endoscopy while I was on these medications. I raised this with my GI doctor who said that it would not affect the results. He did tell me not to take any medications the morning of the procedure. I followed his instructions. The endoscopy included a biopsy for h pylori. The results are as follows:

HISTOLOGY
TISSUE:
1) Gastric bx

CLINICAL DIAGNOSIS:
1) R/O h. pylori
2) erosion

DIAGNOSIS:
STOMACH, BIOPSIES:
- antral mucosa with mild chronic gastritis.
- stain for h.pylori is negative.
- oxyntic mucosa not identified.

I was then prescribed 40mg pantoprazole twice a day, which does help most of the time, and I watch what I eat. I have been told that my gastritis is due to a very poor diet (lots of spicy food and fried food) and high stress and anxiety (I have a newborn baby and we also moved into a two bedroom apartment). I always thought that gastritis was caused either by h pylori or NSAID use, but many doctors and GIs have told me that it is not always caused by those two and that it can be caused by poor diet and stress. Basically, I can't eat whatever I want like I used to do in my 20s.

All the doctors (and there's been at least 7 of them) I have asked have told me that biopsies with a stain to test for h.pylori would not result in a false negative even while on a PPI. They've just told me that gastritis and GERD take a long time to heal. They have also told me that reinfection of h pylori after successful eradication is very unlikely in a developed country (I live in Canada). It has been 16 years since successfully eradicating h pylori.

I want to believe them and put this fear and anxiety to bed. Am I just worrying needlessly and has my anxiety gotten the best of me?

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Endoscopy negative but with gastritis

Post by Helico_expert »

Although no test is 100%, I agree with your doctors. Reinfection in a developed country is rare. mainly because the prevalence is low to start with. secondly, with a good hygiene practice, catching H. pylori is really difficult.

I also agree that some symptoms can be persistent. H. pylori can cause some serious damages that may last a long time even after eradication.

I also agree that some symptoms can be triggered by mental stress. We have conducted a clinical trial where we infect healthy volunteers with either H. pylori or placebo. It was a double blind study. in the middle of the study, one of the volunteers ended up in emergency because of all the gastric symptoms. In the end of the study, we learnt that he had taken the placebo. But because of all the stress in believing in taken the real deal, his body responded with all the symptoms.

So, try to stay calm and be positive. If PPi is working for you, just continue taking them.

ruedo6
Posts: 2
Joined: Wed Mar 09, 2022 2:33 am

Re: Endoscopy negative but with gastritis

Post by ruedo6 »

Thank you so much for the quick reply! I really appreciate it!

Honestly, I was expecting a "go back and retest" but to hear this makes me believe the doctors more.

Everyone has been telling me it's my stress and anxiety which has been very, very, very high. Like I said in my post, all my doctors said that the lab results from the biopsy were both very common and not very impressive.

Thank you again.

I will continue to take my PPI as prescribed and will follow-up with my GI if there are any further complications.

bekean
Posts: 4
Joined: Sat Dec 02, 2023 3:09 pm

Re: Endoscopy negative but with gastritis

Post by bekean »

Regarding your concern about the accuracy of an H. pylori test while on proton pump inhibitors (PPIs), it's generally known that PPIs can affect the sensitivity of the test, potentially leading to false negatives. Stopping PPIs for a period before the test, under the guidance of your healthcare provider, is sometimes recommended to increase the accuracy of the results.
However, your doctors seem to be confident that the stain for H. heardle pylori is not affected by PPI use, and they have emphasized that gastritis and GERD can take time to heal. Given that you successfully eradicated H. pylori 16 years ago and the recent negative result, it might be reasonable to trust the medical advice you've received.

guetoo
Posts: 3
Joined: Tue Dec 12, 2023 5:29 pm

Re: Endoscopy negative but with gastritis

Post by guetoo »

All biological tests are flawed. They are all less than 100% sensitive. The proportion of known positives in which the test will be positive is expressed as sensitivity. Specificity, on the other hand, is represented as the proportion of known negatives in which the test will be negative. No test that I am aware of has a 100% specificity. If you want to go very technical, you can compute positive and negative predictivebasketball stars values for most tests. Those figures, however, are very reliant on knowing the prevalence of the ailment in the general population (screening test) or the test group (those with symptoms).

ronaldo99
Posts: 6
Joined: Fri Sep 15, 2023 12:59 pm

Re: Endoscopy negative but with gastritis

Post by ronaldo99 »

Relax, your anxiety is likely the culprit. While unlikely, discuss false negative concerns with your doctor and manage stress with relaxation techniques for optimal gut health. build now gg

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