Acute Gastritis

[thetefldon]

I have had stomach problems for a few months. Indigestion, reflux and the like. Much worse at night and sometimes painful. Anyway given that my father died from stomach related cancer I went and had a gastroscopy this week. Apart from the procedure, which initially was very uncomfortable, before I zonked out under the sedative, the Dr gave me a clean bill of health except for inflammation of the lining of the stomach which he diagnosed as "Acute Gastritis." The private hospital I attended only had a Gastroscope with a camera which was not capable of taking samples.

 

My doctor has prescribed Omeprazole 20mg and over the counter Gaviscon. He also suggested some lifestyle changes, like stopping drinking and smoking as well as avoiding some possible trigger foods and drinks like coffee. Neither my doctor nor the specialist at the hospital suggested a test for h. pylori which to me seems like a bit of a no brainer. As already mentioned they could not take a sample with the gastroscope.

 

Advice sought:

 

1. Should I find a way to get tested for h. pylori, hopefully without another gastroscopy, presumably any hospital can do the blood or breath test?

 

2. Any advice on things to eat and drink that might help my condition. Think I have a fair idea of what to avoid.

 

For your info I only use bottled water(not from the Baht machines) for drinking and cooking.

 

I am aware of a thread earlier this month on a similar subject, which I have read.

 

 

 

[scubascuba3]

Getting the HP test is a good idea for peace of mind. I got my Breath test in Bangkok and blood test in Pattaya Lifecare labs.

 

As for what to eat, its trial and error i think, eat and see what happens. Once you reduce the inflammation you will be able to have coffee, etc in moderation. I've had 2 today already with no symptoms. I'm on Omeprazole every other days.

 

My stomach loves porridge for breakfast, i add sugar, soy milk and banana.

 

Best to avoid acidic food and drink to start with, alkaline is best but once inflammation is reduced it seems ok to have in moderation

[thetefldon]

11 minutes ago, scubascuba3 said:

Getting the HP test is a good idea for peace of mind. I got my Breath test in Bangkok and blood test in Pattaya Lifecare labs.

 

As for what to eat, its trial and error i think, eat and see what happens. Once you reduce the inflammation you will be able to have coffee, etc in moderation. I've had 2 today already with no symptoms. I'm on Omeprazole every other days.

 

My stomach loves porridge for breakfast, i add sugar, soy milk and banana.

 

Best to avoid acidic food and drink to start with, alkaline is best but once inflammation is reduced it seems ok to have in moderation

Many thanks, unfortunately I live in upper Thailand(Phetchabun) but I will see if I can get the test done locally. I eat porridge every day and bananas when available. Generally I consider I eat a healthy diet but will take a look at possible acidic food.

 

Sounds like you might have had similar, can I ask do you have problems sleeping with discomfort? The Omeprazole 20mg first thing before breakfast certainly helps in the day time with little or no discomfort.

 

Again many thanks, appreciate your help.

[scubascuba3]

5 minutes ago, thetefldon said:

Many thanks, unfortunately I live in upper Thailand(Phetchabun) but I will see if I can get the test done locally. I eat porridge every day and bananas when available. Generally I consider I eat a healthy diet but will take a look at possible acidic food.

 

Sounds like you might have had similar, can I ask do you have problems sleeping with discomfort? The Omeprazole 20mg first thing before breakfast certainly helps in the day time with little or no discomfort.

 

Again many thanks, appreciate your help.

we all seem to have slightly different symptoms, I don't have reflux or any problems at night. I read that if you have problems at night with reflux you can tilt the bed by putting something under the legs.

 

It's trial and error it seems, online or consultants don't seem to shed much light on what's going on. I still don't know the cause, only triggers.

 

I take Omeprazole later in the morning, you might find taking later in the day helps with the night time symptoms, just trial and error

Edited November 23, 2019 by scubascuba3

[thetefldon]

Just now, scubascuba3 said:

we all seem to have slightly different symptoms, I don't have reflux or any problems at night. I read that if you have problems at night with reflux you can tilt the bed by putting something under the legs.

 

It's trial and error it seems, online or consultants don't seem to shed much light on what's going on. I still don't know the cause, only triggers

Thanks again, yes regarding the bed, currently looking for some UK size house bricks????

[Sheryl]

Yes, get tested for h. Pylori as that is often the cause of gastritis. Treating for it empirically would also be an option if you can't get tested 

 

I would certainly not skip it. Not only is it a common cause of gastritis but it is a risk factor for gastric cancer.

 

As to what to avoid:

 

#1 alcohol

#2 the following  medications and anything containing them" aspirin, NSAIDs

#3 carbonated sodas

#4 coffee... if you can't completely avoid then try to minimize and take with food.

 

As to foods just be guided by how you feel. If something seems to irritate, avoid it.

 

 

 

 

[thetefldon]

2 minutes ago, Sheryl said:

Yes, get tested for h. Pylori as that is often the cause of gastritis. Treating for it empirically would also be an option if you can't get tested 

 

I would certainly not skip it. Not only is it a common cause of gastritis but it is a risk factor for gastric cancer.

 

As to what to avoid:

 

#1 alcohol

#2 the following  medications and anything containing them" aspirin, NSAIDs

#3 carbonated sodas

#4 coffee... if you can't completely avoid then try to minimize and take with food.

 

As to foods just be guided by how you feel. If something seems to irritate, avoid it.

 

 

 

 

Thanks Sheryl, hoped you might be around, appreciate the advice. Not sure about empirical treatment. How do you figure out what antibiotics to use etc?

[Sheryl]

There are stabdard protocols which any competent GI specialist should know. You can also find them online. But try first to get tested. The treatment entails 3 different meds one of them usually flagyl or tinidazole for 10'14 days  and can be a little unpleasant (nausea).

[thetefldon]

1 minute ago, Sheryl said:

There are stabdard protocols which any competent GI specialist should know. You can also find them online. But try first to get tested. The treatment entails 3 different meds one of them usually flagyl or tinidazole for 10'14 days  and can be a little unpleasant (nausea).

A test it is then. Thanks for your time.

[IvorBiggun2]

1 hour ago, thetefldon said:

1. Should I find a way to get tested for h. pylori, hopefully without another gastroscopy, presumably any hospital can do the blood or breath test?

A blood test is not accurate to spot H Pylori. Your best bet would be a simple stool sample test done at your local government hospital or private clinic. 

[thetefldon]

Just now, IvorBiggun2 said:

A blood test is not accurate to spot H Pylori. Your best bet would be a simple stool sample test done at your local government hospital or private clinic. 

Many thanks.

[scubascuba3]

2 minutes ago, thetefldon said:

Many thanks.

Let us know if you manage to get a stool test, when i checked the only choice was Breath Test or Blood Test

[thetefldon]

2 minutes ago, scubascuba3 said:

Let us know if you manage to get a stool test, when i checked the only choice was Breath Test or Blood Test

Will do. I did read on an earlier thread that they don't do stool tests here in Thailand, but I shall ask.

[IvorBiggun2]

15 minutes ago, scubascuba3 said:

Let us know if you manage to get a stool test, when i checked the only choice was Breath Test or Blood Test

I saw the Gastroenterology specialist at Suranaree University of Technology in Korat and they didn't have a breath test machine. So the likelihood of many hospitals having one I'd say to be rare. My H Pylori was detected using a sample of my intestine using a scope. I took the course of antibiotics prescribed and was found to be clear after 3-4 weeks by submitting a stool sample.

 

Quote

Serology remains the most commonly used non-invasive H. pylori test; however, it is less accurate than urea breath test and faecal monoclonal antibody testing.

 

Edited November 23, 2019 by IvorBiggun2

[IvorBiggun2]

5 minutes ago, thetefldon said:

I did read on an earlier thread that they don't do stool tests here in Thailand

Utter rubbish.

[scubascuba3]

3 minutes ago, IvorBiggun2 said:

I saw the Gastroenterology specialist at Suranaree University of Technology in Korat and they didn't have a breath test machine. So the likelihood of many hospitals having one I'd say to be rare. My H Pylori was detected using a sample of my intestine using a scope. I took the course of antibiotics prescribed and was found to be clear after 3-4 weeks using a stool sample.

The breath test is just a bag you blow up, like a sick bag with a tube. The specialist then took the bag externally for the results, maybe a machine for that, I don't know

[IvorBiggun2]

1 hour ago, scubascuba3 said:

The breath test is just a bag you blow up, like a sick bag with a tube. The specialist then took the bag externally for the results, maybe a machine for that, I don't know

 

The machine is a mass spectrometer and I doubt many hospitals will have one.

 

 

 

Quote

 

H pylori diagnostic breath tests rely on a simple chemical reaction which is based on the natural behaviour of the bacteria. Naturally occuring gastric urea is made up of 99% carbon isotope ¹²C and 1% carbon isotope ¹³C. The breath test uses urea enriched with ¹³C (that is, 99%).

Patients first drink a sachet of orange juice or citric acid. This rapidly closes the duodenal sphincter to contain the stomach contents. They are then asked to blow through a straw into a glass tube with a screw cap lid. This provides the baseline sample.

Next, they consume a drink containing ¹³C enriched urea (about 100 ml) and after 30 minutes repeat the blowing exercise into a second tube. This provides the post-dose sample. Both samples are sent away for carbon dioxide isotope analysis by mass spectrometry (laboratories usually return the results within a few days).

The level of ¹³C in the baseline sample will be normal. If levels rise in the post-dose sample, this suggests the presence of H pylori. The enriched urea provided by the testing kit must have been broken down to produce high levels of ¹³C in the breath and this implies the presence of urease excreting H pylori in the stomach.

If the post-dose ¹³C concentration is 3.5 parts per 1000 more than the baseline sample, the test is considered positive for H pylori. The higher the level of ¹³C, the greater the extent of the infection. Levels of 30-40 parts per 1000 over the baseline result are typical of H pylori infections.

Two back-up tubes are generally also taken at baseline and post-dose stages.

The sensitivity of such diagnostic kits is 96% and the specificity is 100%.

 

 

 

Edited November 23, 2019 by IvorBiggun2

[cooked]

I suffered from mild acid reflux for many years. People doing a Keto diet are commonly dismissed as being fad diet fanatics but I can honestly say that going Keto was the best thing I ever did. Weight, blood pressure and sugar down to normal, acid reflux GONE, more energy, and a lot of other things. Eating bananas or indeed any other source of carbohydrates (including sugar) are out, so no more bananas, restrict alcohol consumption, no more seed oils or other seeds (rice, wheat, quinoa, whatever). 

Do your tests but think about the fact that your doctor will be earning nothing if you go on a diet, which I recommend even if you do start taking even more meds.

... might be of interest.

[Sheryl]

He has endoscopically confirmed gastritis. Not same thing as acid reflux. (Though a person can have both.)

[scotsman]

https://th.iherb.com/pr/Doctor-s-Best-High-Absorption-Curcumin-with-C3-Complex-and-BioPerine-1-000-mg-120-Tablets/12137?gclid=CjwKCAiA8ejuBRAaEiwAn-iJ3sb86pguOJjR5UvztQWy_Z990CQrtt4J00uI5ayg_-IRr5T1wY4b0BoCMi4QAvD_BwE&gclsrc=aw.ds    I have had gasstritis for 5 years now with no H-pylori I also take this with my 20mg of Omerprazole and it has reduced my symptoms a lot and helps with the inflammation.   I also changed my diet to eat as much alkali foods and drinks I can find also celon cinnamon in my juice shakes it also helps reduce inflammation.  

regards 

Scotsman 

Edited November 24, 2019 by scotsman

[thetefldon]

On 11/24/2019 at 6:02 PM, scotsman said:

https://th.iherb.com/pr/Doctor-s-Best-High-Absorption-Curcumin-with-C3-Complex-and-BioPerine-1-000-mg-120-Tablets/12137?gclid=CjwKCAiA8ejuBRAaEiwAn-iJ3sb86pguOJjR5UvztQWy_Z990CQrtt4J00uI5ayg_-IRr5T1wY4b0BoCMi4QAvD_BwE&gclsrc=aw.ds    I have had gasstritis for 5 years now with no H-pylori I also take this with my 20mg of Omerprazole and it has reduced my symptoms a lot and helps with the inflammation.   I also changed my diet to eat as much alkali foods and drinks I can find also celon cinnamon in my juice shakes it also helps reduce inflammation.  

regards 

Scotsman 

Many thanks. Just out of interest, seeing as you have been taking Omerprazole for a long time, do you have a problem sleeping? The drug seems to control my Gastritis in the daytime but I frequently wake up at night with discomfort. Not sure if this is a side-effect or symptoms of the actual condition. As a starting point to dialing back on triggers I have cut out coffee and alcohol, although after a week that doesn't seem to make things any better.

[thetefldon]

On 11/24/2019 at 11:02 AM, cooked said:

I suffered from mild acid reflux for many years. People doing a Keto diet are commonly dismissed as being fad diet fanatics but I can honestly say that going Keto was the best thing I ever did. Weight, blood pressure and sugar down to normal, acid reflux GONE, more energy, and a lot of other things. Eating bananas or indeed any other source of carbohydrates (including sugar) are out, so no more bananas, restrict alcohol consumption, no more seed oils or other seeds (rice, wheat, quinoa, whatever). 

Do your tests but think about the fact that your doctor will be earning nothing if you go on a diet, which I recommend even if you do start taking even more meds.

... might be of interest.

Many thanks. Reflux is not an issue as far as I can tell, I had a camera down inside and the doctor confirmed acute gastritis. I shall take a look anyway.

[scubascuba3]

2 hours ago, thetefldon said:

Many thanks. Just out of interest, seeing as you have been taking Omerprazole for a long time, do you have a problem sleeping? The drug seems to control my Gastritis in the daytime but I frequently wake up at night with discomfort. Not sure if this is a side-effect or symptoms of the actual condition. As a starting point to dialing back on triggers I have cut out coffee and alcohol, although after a week that doesn't seem to make things any better.

I had to take Lansoprazole for a few weeks for symptoms to subside. I then switched to Omeprazole once in Thailand. It can take weeks for gnawing symptoms to reduce then you get flare ups randomly.

 

Re the nighttime, I've read people take 2 a day so maybe one at night until symptoms are under control

[Orton Rd]

Those two drugs are exactly the same, took it for 15 years, best to get off it

[Sheryl]

13 minutes ago, Orton Rd said:

Those two drugs are exactly the same, took it for 15 years, best to get off it

Not the same exactly but chemically telated.

 

While it is best not to take long term a person with gastritis has no choice but to take an acid lowering medication. The gastric mucosa needs a period of reduced acidity to heal.  It also needs eradication of h. Pylori if present much it is in majority of cases.

[scotsman]

3 hours ago, thetefldon said:

Many thanks. Just out of interest, seeing as you have been taking Omerprazole for a long time, do you have a problem sleeping? The drug seems to control my Gastritis in the daytime but I frequently wake up at night with discomfort. Not sure if this is a side-effect or symptoms of the actual condition. As a starting point to dialing back on triggers I have cut out coffee and alcohol, although after a week that doesn't seem to make things any better.

I dont have a problem with symptoms at night that keep me from sleeping. Once you get the symptoms under control with the change of diet and the supplements that I take along with my Omerprazol which include omega 3, and curcumin.  As other people have said you may need to take 1 in the day and 1 at night untill your symptoms have come down.  I still get some very small symptoms some days but its usualy a trigger that has done it and I need to cut them out, other times I just don't know what triggered it. I think from were I started from 5 years ago I am in a much better place and I keep on trying to improve my condition. 

Hope this is helpful 

regards

Scotsman 

[justin case]

APPLE cider vinegar in TOPS / Villa market might solve your problem

 

I tablespoon (start with a teaspoon) in a glass of water, 30 min before ANY meal

 

99 percent of the world don't have enough STOMACH ACID to digest food.

 

The food stays to long in your stomach, start to ferment and the nasty gastric gasses comes up and burn your unprotected lower esophageal sphincter (LES)

 

believe me, I had this 5-6 years ago, saw 3 "specialists" with no cure.

 

They give omeprazole = kill your stomach acid, you might feel better, but you will create problems in the small intestine .... SIBO 

 

and was never ment to be taken longer than 2 weeks anyway but some people take it for months or years

 

 

you want to know what kind of reflux I had ?   I would wake up in the middle of the night with an acid attach and had to sit up or would VOMIT...

 

this was going on for 3-6 months and "experts" in fance expensive hospitals, gastroscopy, omeprazole, ... solved ..... NOTHING AT ALL

 

kind of serious, not ?

 

 

this is when I start to do health research and found out it is not too much acid most people have but not enough to digest the food !!!

 

you could try with a short 2-3 day FAST if you feel better

 

one moment in time, I even thought I got a BEZOAR

 

Gastric bezoars are usually asymptomatic. When symptoms are present, the most common include postprandial fullness, abdominal pain, nausea, vomiting, anorexia, and weight loss.

 

Edited November 27, 2019 by justin case

[Sheryl]

Once again - OP does nto have reflux.

[scubascuba3]

29 minutes ago, justin case said:

APPLE cider vinegar in TOPS / Villa market might solve your problem

 

I tablespoon (start with a teaspoon) in a glass of water, 30 min before ANY meal

 

99 percent of the world don't have enough STOMACH ACID to digest food.

 

The food stays to long in your stomach, start to ferment and the nasty gastric gasses comes up and burn your unprotected lower esophageal sphincter (LES)

 

believe me, I had this 5-6 years ago, saw 3 "specialists" with no cure.

 

They give omeprazole = kill your stomach acid, you might feel better, but you will create problems in the small intestine .... SIBO 

 

and was never ment to be taken longer than 2 weeks anyway but some people take it for months or years

 

 

you want to know what kind of reflux I had ?   I would wake up in the middle of the night with an acid attach and had to sit up or would VOMIT...

 

this was going on for 3-6 months and "experts" in fance expensive hospitals, gastroscopy, omeprazole, ... solved ..... NOTHING AT ALL

 

kind of serious, not ?

 

 

this is when I start to do health research and found out it is not too much acid most people have but not enough to digest the food !!!

 

you could try with a short 2-3 day FAST if you feel better

 

one moment in time, I even thought I got a BEZOAR

 

Gastric bezoars are usually asymptomatic. When symptoms are present, the most common include postprandial fullness, abdominal pain, nausea, vomiting, anorexia, and weight loss.

 

If you didn't have enough acid hence you took apple cider vinegar presumably Omeprazole made your symptoms worse? so if Omeprazole makes the symptoms better then it isn't too little acid?

Edited November 27, 2019 by scubascuba3

[Sheryl]

14 hours ago, scubascuba3 said:

If you didn't have enough acid hence you took apple cider vinegar presumably Omeprazole made your symptoms worse? so if Omeprazole makes the symptoms better then it isn't too little acid?

 

This is where again it is important to understand the difference between reflux and GERD. And also to understand the difference between symptomatic relief and actual cure.

 

Reflux occurs when the lower esophageal sphincter is weakened (due to age, certain medications etc) or there is increased pressure in the stomach (as from obesity, overeating or hiatal hernia) or both.

 

Drugs like omeprazole do not decrease the occurrence of reflux. They just make it less painful, or even asymoptonmatic, by making the refluxed  liquid less irritating to the esophagus.  

 

Reflux itself is not caused by  too much acid.  However  the pain and esophageal irritation resulting from reflux is due to the acid normally present in gastric secretions, so reducing the gastrc acidity will make the reflux less painful or noticeable. However, there is some suggestion that unusually low levels of gastric acid may, over the long term,  actually increase the occurence of reflux though it may be "silent reflux' i.e. not felt.  This last point is not fully established and needs more research.

 

Gastritis on the other hand is an inflammation of the lining of the stomach wall, with or without actual ulceration. Since the normal protective lining of the stomach is damaged/inflammed, ulcers easily form and even if not present initially will likely develop if the lining does not heal. It is a painful condition -- so much so that it can initially be mistaken for a heart attack -- and in order for the lining to heal it is essential that gastric acidity be controlled through acid lowering medications. These can and should be weaned off once the gastric lining has healed. So in gastritis, unlike in reflux, PPIs actually serve a curative function. If h. pylori is the culprit, though, other medicatons will be required as well.

 

If there is esophagitis present then the PPIs will help cure that in the same manner as described for gastritis.  Though it may recur if the underlying cause of reflux is not addressed.

 

There is a lot of "junk science" on the web around "acidity". As regards apple cider vinegar, its pH is quite similar to the normal gastric pH so drinking it, whatever else it may or may not do, is not going to change the acidity of the stomach.