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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6689
Experience:  14 years experience in the field of Family Practice
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Hello. I just had endoscopy on Friday. Very concerned, my

Resolved Question:

Hello. I just had endoscopy on Friday. Very concerned, my stomach feels like it's starving, but yet I have no appetite. I just had 2 slices of pizza, and I feel worse than before. I'm waiting for the biopsy and blood work results. After the endoscopy, the doctor said I have water in the stomach and gastritis. The empty feeling in my stomach is making me bend over since it feels like there is nothing in it
Submitted: 10 months ago.
Category: Medical
Expert:  Anthony Bray, MD replied 10 months ago.

Anthony Bray, MD : Hello!
Anthony Bray, MD : First of all pizza is not good for you with gastritis--- too spicy and tomato sauce is quite acidic!!
Customer:

thank you for going into chat.. This is really frustrating me.

Anthony Bray, MD : Are you on medicine to reduce the stomach acid??
Customer:

yes, I noticed it got much worse after I ate the pizza

Anthony Bray, MD : Gastritis is irritation of the lining if the stomach and this would explain and be consistent with your discomfort ....
Customer:

Yes, I took it for 2 days before I had the endoscopy, and I left the bottle at work. So i start again tomorrow.

Customer:

isn't gastritis a pre-curser to gastric ulcer?

Anthony Bray, MD : the tests from endoscopy will have included looking for H. Pylori which is a bacteria that may live in the stomach and may lead to ulcers....
Customer:

It's called pantoprazole

Customer:

I had blood work done yesterda

Customer:

yesterday

Anthony Bray, MD : Yes --- gastritis is irritation of the stomach limiting that is generalized... An ulcer is basically the same type process with superficial erosion of the stomach lining ( think of a cold sore)
Anthony Bray, MD : yes-- do restart the acid medicine tomorrow!!
Customer:

Here is what the report said so far. Fluid in the stomach, Hiatal Hernia, Erythema in the antrum compatible with non-erosive gastritis, erosions in the duodenal bulb compatible with duodenitis (biopsy)

Anthony Bray, MD : Avoid alcohol and coffee!!
Customer:

so, is gastritis the same as gastric ulcer?

Anthony Bray, MD : Avoid hot/ spicy/ acidic food for next two months at least!!! Tomatoes, onions, peppers and citrus fruits...
Anthony Bray, MD : Avoid anti- inflammatory medicines---Aleve/ aspirin/ Advil but Tylenol is OK....
Anthony Bray, MD : mylanta or TUMS may give fast but brief relief of discomfort...
Customer:

what do the findings mean? and is gastritis the same as gastric ulcer?

Anthony Bray, MD : No it is not the same--- both gastritis and gastric ulcers could exist at same time...ulcer is step worse than gastritis...
Anthony Bray, MD : The findings mean that you have irritation of the inner lining if the stomach . You need steps to take and time for this to heal. You will expect to feel better as it heals .....
Anthony Bray, MD : if you smoke that it is not good for the condition either...
Anthony Bray, MD : heavy psychological stress is not good either...
Customer:

eating that pizza was a mistake. I am feeling like there is a hole in my stomach. Your right about the stress part. I have been under a great deal of stress. I think that contribulted greatly towards it.

Anthony Bray, MD : you do need good nutrition to heal ... Acid reduction with medicine helps this to heal( Prilosec / Prevacid/ Nexium / Dexilant/ Protinix) are common meds for this...
Customer:

Worst part is I have lost about 20 lbs. in the process of all this. I feel starved and yet I have no appetite

Anthony Bray, MD : Right the heavy stress and weight loss may contribute to the condition ... Stable weight would be goal for next two months I would say....
Anthony Bray, MD : if dropping more weight then your body is not getting enough nutrition to heal at its best...
Customer:

I have been really trying to put the weight back on, but I just have no appetite, and that is stressing me out too

Anthony Bray, MD : try to do what you can to reduce anxiety and stress if possible!!
Customer:

if I have no appetite, what can I do to eat the right foods? and yet not feel like my stomach is starving?

Customer:

my blood pressure last checked was 157/87

Customer:

not good either

Anthony Bray, MD : the gastritis may cause nausea and poor appetite is just step behind nausea as symptom...
Customer:

what can I eat that wouldn't have acid in it? Is milk ok? cereal?

Anthony Bray, MD : eating bland type foods may help... For example mainly carbs... Gatorade is good... Soups are well tolerated often... Carbs are the easiest component for our body to digest...
Customer:

I used to weigh about 130 lbs. several month ago, now I'm down to about 107. Not happy about it at all

Anthony Bray, MD : milk may feel good with the condition as milk is a buffer-- it neutralizes stomach acid and may give those with ulcer or gastritis a sense or relief....
Anthony Bray, MD : Right that sounds that you do need to recover weight! How tall are you???
Customer:

I hope the doctor does find something wrong, so that something can be done. the emptyness is just killing me

Customer:

5'6"

Customer:

what can I eat to put the lbs. on quicker.?

Anthony Bray, MD : you may benefit from adding supplemental Boost or Ensure to your diet... Taking myivitanib to help ensure you get what you need in all nutrients may be helpful....
Customer:

thinking of having some chocolate ice cream

Anthony Bray, MD : Milkshakes/ ice cream / these are dairy and usually comforting to gastritis ... High in calories ... Would help you to gain back weight...
Anthony Bray, MD : Exactly chocolate ice cream is the right idea!
Customer:

I am hoping the results would be in soon so I know what the next recourse would be

Anthony Bray, MD : I hope do as well. The
Customer:

I used to eat a LOT of strawberries few month back.. that had a lot of acid in it too.

Anthony Bray, MD : one of the main results of interest would be the test for H. Pylori...
Anthony Bray, MD : this bacteria is common source of irritation and would need two weeks of double antibiotic treatment...
Customer:

how long will it take for the pills to take effect?

Anthony Bray, MD : yes the strawberries would be acidic too... Keep in mind that these are healthy in the long run but you need to heal first!! So wait until about 6 to 8 weeks and few weeks if feeling better and back to normal!!
Customer:

I just put my 92 yr old mother in a home, and that put a lot of stress on me. these last several months with her did not help at all

Anthony Bray, MD : the pills will lower the acid production of the stomach by over. 90 % by 24 hours after dose... It may take many days to weeks for the stomach healing to follow the improvement in stomach acid though...
Customer:

I took it for 2 days, then the 3rd day I did not take it because I was not allowed to eat and drink after midnight. But I left the pills at work. So tomorrow I will start up again.

Customer:

I am going to look up what foods to avoid that has acid in it

Customer:

hopefully the blood tests will reveal some things too

Anthony Bray, MD : I understand. That is a difficult situation . I'm sorry to hear that you have this stress and worry on you! You need to be assured that you can't personally handle everything on your shoulders though - nobody can!! There does come a time when this step may be a necessary step for many or most of us as we approach the end years of life...
Anthony Bray, MD : That is good idea to research this in more detail---
Customer:

non-acidic foods to look up...

Anthony Bray, MD : citrus fruits are acidic because they are high in vitamin C ( vitamin C is an acid itself - ascorbic acid) so fruits other than citrus have vitamin C but less of it ( apples / grapes )
Customer:

so cantaloupe and honeydew melons are out too, which I just bought

Customer:

and orange juice

Anthony Bray, MD : citrus fruits are high in acid.... Oranges/ grapefruit/ bananas/ lemons ....
Anthony Bray, MD : tomatoes/ onions/ peppers are best to avoid...
Customer:

surprising. I was going to put some bananas in with the chocolate ice cream

Anthony Bray, MD : Right there are surprises on the list ...
Customer:

between avoiding acidic foods, less stress and taking those pills, hopefully I should see some results.

Anthony Bray, MD : even chocolate is a minor offender but I'm not telling you not to eat your chocolate ice cream!!
Customer:

understand. But I have to eat something, othewise I will be a walking stick..

Anthony Bray, MD : Yes I am confident that adjusting your diet and the medicine will help you!!
Anthony Bray, MD : Yes you must eat!!
Anthony Bray, MD : The foods can become more open again as you improve of course!!
Customer:

you have been a great help. I am going to research the internet and find foods I can eat without acid.

Anthony Bray, MD : orange juice for example is good for you in general but just not right now!!
Anthony Bray, MD : Ok that sounds good!!
Anthony Bray, MD : let me know if you have further questions!
Customer:

might if I ask what state you are in?

Anthony Bray, MD : i will be happy to get back with you!
Anthony Bray, MD : If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. That would be much appreciated! Thank you and best regards!
Anthony Bray, MD : yes - North Carolina
Customer:

you have been very helpful. I thank you very much. Yes, it is only 9:20 pm here.

Anthony Bray, MD : I see ... You must be on West Coast state or is that mountain time??
Customer:

we are on mountain time, but our clocks never change. So we are on same time as California for the time being until the clocks change in a few weeks

Customer:

only 2.5 state do not change their clock. Arizona, Hawaii and half of Indiana

Anthony Bray, MD : I see. Well it has been a pleasure talking with you this evening. I hope that you feel better soon!!
Customer:

thank you. I will take the advice and avoid all acid food products.

Anthony Bray, MD : Interesting! I didn't know that...
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6689
Experience: 14 years experience in the field of Family Practice
Anthony Bray, MD and 8 other Medical Specialists are ready to help you
Expert:  Anthony Bray, MD replied 10 months ago.
Hello!

This is Dr. Anthony Bray with Justanswer.com. We spoke yesterday with regard to your concerns wit gastritis. I wanted to thank you for your positive feedback and bonus! That was very much appreciated!

Feel welcome to reach me in the future if you should have other health or medical questions! You may reach me by going to my profile page on the site at http://www.justanswer.com/medical/expert-anthonybraymd/

From there just type question or comment in the box and it will be directed to me. I hope that you feel well again soon and improve quickly from the gastritis! Take care and best regards XXXXX XXXXX!

Anthony Bray MD
Customer: replied 10 months ago.

Hello. Hopefully your online. I have some of the results from the endoscopy that was done last Friday. The biopsy results aren't back yet. But the blood work came back that showed some signs of anemia. I don't know what that has to do with weight loss.


 


Yesterday, for example, I was only able to finish half my dinner. My husband wanted to have some ice cream. I was actually already full, but i thought I need to eat more. Well, I could only finish half of that too, and I felt like I just had a huge buffet.


 


I just want to get my weight back to normal. My skin is sagging and I feel like a walking stick. Down from about 130 to 108

Expert:  Anthony Bray, MD replied 10 months ago.
Hello!

Well the weight loss may indeed be strongly related to your anemia. Anemia is a low red cell count. This may be caused by malnutrition --- your degree of weight loss would suggest protein/ calorie malnutrition --- this would cause a slow down in your bone marrow's production of new red blood cells...

The GI tract is very common culprit with regard to anemia though. Ulcers / bleeding from other sources in your bowel may cause blood loss and thus anemia ..

Checking the stool for occult blood is commonly part of our work up of this .

Checking for iron deficiency too is needed... Tests include serum iron level and ferritin

Anemia may be caused by specific deficiencies of folate and B12...

Your weight loss is concerning as to why this has been the case.. You having low appetite may be due to gastritis /ulcers as irritation of the stomach would be common reason for this.

I would advise boosting your intake with Ensure/ Boost or similar nutritional supplement to help stabilize your weight. Just plain milkshakes or ice cream is helpful to boost calories and protein intake too. Often a person with severe lack of appetite may benefit from an appetite stimulant too-- this helps you to boost your intake without feeling as forced in the process.... Taking a multivitamin would be recommended for your current circumstance as well...

I hope this helps! Let me know if you have further questions!

Best regards!!

Anthony Bray MD
Customer: replied 10 months ago.

thanks. you've been quite helpful. I have a confession to make.. Although I am not proud to say this, and a bit embarrassing. About a year ago, unfortunately had to have top dentures. For the several months following, I had trouble eating. So I think psychologically that may have a bearing on it. And stuck with me.But it has been a long time, and I have been trying my darnest to eat whatever I can.


 


I think the anemia is caused by me not eating properly. Had I been eating normally and did not have the teeth issues long ago, then I would not have this problem.


 


But what is concerning is like I said. My stomach feels hungry, but have no appetite. I eat a portion of my plate and I feel stuffed. What do you suggest as an appetite stimulant?


 


By the way, the gastro person is scheduling me for a stomach CT scan. Is that really necessary ?

Expert:  Anthony Bray, MD replied 10 months ago.
Hello!

You may be right that the psychological factors may be very important . I have seen cases of severe weight loss due to depression as an example...

The poor nutrition may have likely contributed to irritation of the stomach lining -- once irritated it may make you have further symptoms as you describe. The early feeling of being full is medically referred to as early satiety... Ulcers / gastritis may certainly cause early satiety as symptom.

I think the extra steps to get abdominal CT is warranted because such weight loss can be a symptom of certain cancers too unfortunately. So the abdominal CT would help to rule out certain cancers as a possible cause related to symptoms. Hopefully your cause is completely unrelated to any malignancy . I agree with this test as being a prudent step for you at this point however.

Megace is potential appetite stimulant. Zyprexa may work for this purpose. There are other options. Discuss this with your doctor. He/ she may have reason to strongly consider this option for you. Certainly close watch of your weight over next weeks and months would be very important!!

I hope this is helpful for you! Let me know if you have further questions!

Best regards!

Anthony Bray MD
Customer: replied 10 months ago.

Just one more question. these appetite stimulants you recommend sound like prescriptions. Anything I can buy at the food store or over the counter drug store?

Expert:  Anthony Bray, MD replied 10 months ago.
Hi again,

You are right they are by prescription. Nothing over the counter effective for this purpose comes to mind...

I think this would be optional as possible help with you stabilizing weight and getting adequate nutrition. The adequate nutrition needs are the botXXXXX XXXXXne for you though ...

Let me know if you have further questions or concerns.

Best Regards,

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 6689
Experience: 14 years experience in the field of Family Practice
Anthony Bray, MD and 8 other Medical Specialists are ready to help you

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