Help needed for definition of endoscopy result please

[Advice1]

Hi everyone i would very much appreciate some help, i am 35 yr old Asian Female i recently had Endoscopy in Asia and am now back in the UK and have a copy of the result can anyone explain my recent result for a Biopsy i had of:

A. Antrim antral mucosa

B. Body,from Gastric body Mucosa

C. Incisura Angularis mucosa ,

Microscopic Description:

Sections A-C of gastric mucosa show mild infiltration of Chronic Inflammatory cells in lamina propria .The surface epithelium is intact without atrophic change .Complete intestinal metaplasia without dysplasia is noted at antrum .H.pylori can not be identified

Diagnosis :

Site ( H.pylori) (Neutrophils) (Mononuclear cells) (Atrophy )(Intestinal metaplasia)

Antrum : Absent Absent Mild Absent Mild

Body : Absent Absent Absent Absent Absent

Incisura: Absent Absent Mild Absent Absent

Gastric Mucosa Biopsy: Gastritis mild, inactive

: Complete intestinal metaplasia without dysplasia

: No H.pylori

[strangetimes]

I've not much advice to offer I'm afraid but don't like to see you with no replies .

I think the best I can offer is to suggest you visit a GP and discuss what led you to having the tests abroad .Of course if you show them the report they may be able to comment on it .

It looks to my completely un trained eye that you have been experiencing some stomach pain and they were investigating a possible cause .And they've ruled out a H pylori infection which often causes ulcers .

Hope you get it sorted .

[Advice1 in reply to strangetimes]

Hi violetqueen for your advice

unfortunately i have to wait 2 weeks for an appointment .

Thanks for your kind reply, i am grateful to you.

Good Luck

[Hidden]

Intestinal metaplasia is a process of the cells in the oesophagus changing to become like the lining of the stomach and designed to combat acid reflux. There are some international variations in whether this is defined as Barrett's oesophagus or not, but I believe that in the UK you would be regarded as having Barrett's. The significance of Barrett's is the increased risk of oesophageal adenocarcinoma, which is low for you as they have found no dysplasia. More people die with Barrett's than from it. But you do need to be monitored with further endoscopies at intervals, probably a period between 2 - 5 years in case dysplasia does develop, and you may, if dysplasia does develop, be a candidate for radio frequency ablation that can remove the dysplastic cells with the aim of preventing the cancer from developing. There are more details on actionagainstheartburn.org.uk

I am not an expert at interpreting the details described on the report though.

I think the thing to do would be to wait for a period of a couple of years, or earlier of you believe you have problems, see your GP and ask to be referred to a gastroenterologist.

You may well have been prescribed medication like Omeprazole to reduce the acid rising from your stomach. Like all medication it is a good thing to review these periodically.

[Advice1 in reply to Hidden]

Hi OPA_AlanM

That is very generous of you to take the time to

explain your opinion

which is very interesting especially, Barretts,

and has made me feel much more

reassured from

your explanation and detailed information.It is great to have such knowledgable volunteers here on Healthunlocked.

I will follow your kind advice ,thank you so much

for sharing your advice helping me to understand

things clearly.Thanks for the link i will certainly sign the petition.

Good Luck

and Good health.

Thank You.

[gutlesswonder]

It's difficult to read your photo-

there is an Antrum in the Oesophagus however in this case my hunch is that they are referring to the Antrum in the Stomach. This Antrum ( could be translated as "Hallway") is the short passageway at the bottom curve of the Stomach just before it bends up to the exit - the Pyloric sphincter. Two samples were snipped from the lining of that area.

The third sample was taken from the main body lining of the gross Stomach itself.

The fourth sample was removed from the wall of the lining of the inner curve just before the aforesaid Antrum.

This was a pretty thorough examination.

That gives us a clue as to the area of concern -- crudely the bottom end of the Stomach.

The samples were de-watered, stained and mounted in three paraffin wax blocks preparatory to slicing into microtome sections, mounting on slides and being examined under a microscope (presumably by a Pathologist).

It would have been nice if you had been given the slides as they could have then been further examined by an expert here in the UK ----- maybe you could arrange for them to be mailed to you?

My (unqualified) interpretation of the report is that it indicates mild concern requiring a watch and wait approach after some further consultation.

In lay terms --- the lining of your stomach has undergone changes in the structure of the cells (metaplasia), for unknown reasons. Frequently this can be due to the presence of the notorious infection of Helicobacter --- but in your case (if the bacteriology can be relied upon) this organism was not detected. Good news, but a puzzle.

What then has brought about the changes? Smoking/Alcohol/Pickled Fish/Stress? Only you can hazard a guess. You are young.

The metaplasia is described as 'complete'......IE the change has gone all the way. So you have arrived in stage 3 of the cascade pathway which can eventually, occasionally lead to cancer. But happily the surface skin is still intact and there is very little, if any invasion of the underlying structures by cells from your immune system.

Good news, it's early days but time to take precautionary action.

Metaplasia may be reversible (five year time scale) if you can identify and negate the causative agents(s). hence the need for further investigation.

YOU DO NOT HAVE BARRETT'S.

[Advice1 in reply to gutlesswonder]

Hi gutlesswonder

that's very generous of you

to detail the report in such a way i can understand it much easier ,

as it was quite a complex report and the mention of the getting hold of the slides is worth

pursuing and also good advise which i never thought about.

I am in my 30's and would like to thank you for taking the time to

explain things in detail you sound very knowledgable on the subject which is

very good for the forum members.

Good Luck and big thank you for your kind help.