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Internist
Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 4761
Experience:  Int. Med., Gastroenterology. Fellow American College of Physicians. Trained, located in the U.S.
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Hi Doc, I was diagnosed of gastric antral type mucosa with

Resolved Question:

Hi Doc, I was diagnosed of gastric antral type mucosa with mild chronic gastritis, focal intestinal metaplasia (negative for dysplasia) and junctional glandular mucosa with mild chronic inflammation. I feel kind of burning around my chest especially in the middle of the night when my stomach is empty. Sometimes, the pain is even radiated to my upper back and shoulder blades. My doctor said that I have acid reflux and prescribed me "Dexilant 60mg". Can mild chronic gastritis and inflammation of junction glandular mucosa be cured? Does chronic gastritis cause focal intestinal metaplasia? Per my endoscopy report, giemsa stain is negative for H. Pylori. If my chronic gastritis is not caused by H. Pylori, what other causes will there be? I was so worried that focal intestinal metaplasia will developed into cancer, how can I prevent it? Also, if my acid reflux is cured, does it mean that chronic gastritis will also be cured? Please help and advise.

Thanks
Submitted: 3 years ago.
Category: Medical
Expert:  Internist replied 3 years ago.
Your symptoms are typical for acid reflux and the Dexilant is excellent anti-reflux medication. It is not unusual for the pain to radiate to the shoulders and or back. The chronic gastritis and inflammation can be cured by reducing the acid in the stomach. If your H. pylori was negative most likely hyperacidity it is causing the gastritis and inflammation of the junctional mucosa. I will make some suggestions for you for treatment of GERD but and first I will try to answer Your questions. Focal intestinal metaplasia usually is caused and occurs in conjunction with chronic gastritis. The best way of preventing progression of your intestinal metaplasia to dysplasia would be to rid the stomach of acid in order to prevent gastritis and thus prevent metaplasia. The causes of reflux inflammation has several different factors including relaxed esophageal sphincter which leads to the reflux. With the appropriate medication and diet you may have one or the other(gastritis) cured or both cured. On rare occasions if the acid reflux is severe even medication will not cure it and then surgery would be necessary. It is unusual in this day and age with strong acid suppressing agents. Hopefully this has addressed your concerns. following is the most up today information on GERD. Eat bland foods. Although many doctors tell their patients to avoid spicey foods, fatty foods, citrus fruits, tomato juice or sauce, chocolates, alcohol and carbonated drinks, coffee (also decaf), there is no scientific evidence that is is helpful. You should avoid PROVOCATIVE foods which are any foods that specifically causes you discomfort. You should also stop smoking. You should not eat anything 2 hours before bedtime. The head of the bed should be raised 6-8 inches (can use large cans with sand) and try sleeping with left side down IF you have nighttime reflux. Don't lie down for 2-3 hours after a meal. Some medications may make the reflux worse, including anti-cholinergics, NSAIDS, antibiotics, anti-depressants, nitrates, progesterone, beta blockers and calcium channel blockers, iron, potassium, sedatives and bronchodilators. Several non-prescription agents may help; Gaviscon, Mylanta or Maalox as directed on bottle, acid suppressing agents such as OTC Tagamet, Zantac, Pepcid, or Axid or the stronger agents ( PPI's) such as Prilosec or Nexium, Prevacid, Aciphex and Protonix. Again follow instruction on the labels. Your Doctor may want to double your dose if you fail to improve.

It is important to LOSE WEIGHT if you or overweight. This has been clearly associated with worsening of reflux disease.

If you do not improve on the above regimen or if you have trouble swallowing or pain upon swallowing your doctor may want to proceed with other tests such as endoscopy or pH monitoring.

If your symptoms persist or worsen, surgery ( laparoscopic Nissen Fundoplication ) may be considered.

Here are useful websites:

http://www.aboutgerd.org/

http://health.howstuffworks.com/difference-between-heartburn-and-acid-reflux.htm

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Customer: replied 3 years ago.

Thanks for your medical advise.

 

I took Dexilant for almost a week and it seems that I still have acid reflux and upper back pain. Does it mean that the dosage is not enough for me?

 

Besides, I have hungry feeling 2-3 hours after meals. However, if I burps, I feel better. Should I take some snacks "when I feel hungry" or this "hungry feeling" is actually excess stomach acid. As you indicate, I can take Maalox if I have excess acid. However, I don;t want to rely on those non-prescription agents all the time because I am afraid that it has some side effects. What other natual methods to reduce stomach acid?

 

Thanks for your help.

Expert:  Internist replied 3 years ago.
Side effects of antacids are minimal. There are no effective natural remedies. Follow what I wrote and you will improve.
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Customer: replied 3 years ago.

Sorry for the additional questions... In order to reduce excessive stomach acid, should I eat "when I feel hungry" or should I take Maalox instead? It sounds like if I feel hungy and eat (besides of the regular daily meals), my pain will be relieved for a while....

 

Thanks for your help.

 

Expert:  Internist replied 3 years ago.
Yes, as long as what you eat is not spicey. Small frequent meals, if they help, are OK.

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Expert:  Internist replied 3 years ago.
cancer is al
Customer: replied 3 years ago.

If I take Dexilant for 2-3 months, can chronic gastritis, focal intestinal metaplasia and junctional glandular mucosa with mild chronic inflammation be cured? I was so depressed for a while due to my illness. It sounds like focal intestinal metaplasia will easily cause cancer...

Expert:  Internist replied 3 years ago.
Many questions have already been answered and much time spent. You may accept now before this can be addressed.


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Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 4761
Experience: Int. Med., Gastroenterology. Fellow American College of Physicians. Trained, located in the U.S.
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