Grade 3 oesophagitis after endoscopy - new here

[grannyjogger]

Hi, this is the first time I have posted on this forum. I have a diagnosis of undifferentiated auto immune disease with a wide range of symptoms and I get a lot of support on the Health Unlocked Lupus forum. I have had GI problems for many years, hiatus hernia (for over 30 years!!) and acid reflux treated with 2x15mg Lanzoprazole daily for the past 10 years. I had my gall bladder removed July 2016 because of gallstones and had hoped this would clear up the pain. Things have deteriorated since then and I now have bile reflux as well as acid reflux and developed severe pain (upper abdomen, under ribs and radiating to my shoulder blades). GP temporarily increased my PPI to 2x30mg, tested for H.pylori and had an ultrasound to check my pancreas. When nothing obvious was found, she referred me on the 2-week cancer protocol and I had an endoscopy this week. The report confirmed a sliding hiatus hernia length 6cm and Grade 3 oesophagitis, mucosal breaks that are continuous between the tops of mucosal folds but not circumferential, and gastritis, mild erythematous/exudative with no bleeding. Advised I remain on my double dose PPi and they have arranged a CT scan of the pancreas which I will have next week.

Sorry for the longwinded explanation but this is a whole new ball game for me. Any advice about managing this condition would be welcome such as diet (what foods to avoid) and pain management. I currently alternate between paracetamol and co-codamol on bad days to manage the pain associated with my autoimmune symptoms like joint pain.

Thanks for listening.

[Zantri]

Grannyjogger,

Sorry to hear about all your challenges. Changing your diet to more alkaline then acidic may help but also smaller meals more frequently & make sure you do not eat too late at night. For sleeping, I use a triangular pillow which raises my chest & head at nighttime, stops regurge during the night. Best thing is contact Dr & get referred to dietician who can help. Also keep food diary of what may set you off, what works for you may not work for someone else & visa versa. Hope you manage to get it under control.

[grannyjogger in reply to Zantri]

Hi Zantri, thanks for this information. I already try not to eat too late and I don't really have large portions. My problem is I'm a bit of a grazer and I find it heard not to snack. I think I need to take your advice about getting referred to a dietician and also keeping a food diary. That's really useful. I used a triangular pillow many years ago when I was expecting my children (both now grown up), don't know why I stopped so that's something I should do again. Time to take control of what I can.

Thank you again.

[Hidden]

Your stomach acid is very strong; it needs to be to undertake its digestive processes, but this can cause havoc to your oesophagus, because its lining is not made like a stomach lining. You will have to be careful about Barrett's Oesophagus, but if the endoscopy report has not mentioned it that is a very good sign.

The treatment for your oesophagitis will normally be medication to reduce the acid or bile so that the lining has a chance to heal itself without the strong acid being around. But this will have to be carefully judged because bile is an alkali and the normal anti acid medication will not combat that.

Taking Gaviscon, which will normally work against both for a short period, is worth considering as you can get it over the counter and it won't affect any other medication you are taking.

I would concentrate on bland food that slips down easily, avoid things that are spicy or difficult in texture, and keep a diary to note and avoid an particular food that gives you a problem. All foods have a relative acid / alkali component but most are very much less intense than your natural stomach acid / alkali.

I think I would also ask advice about whether your hiatus hernia could be repaired; you have had it for long enough!

[grannyjogger]

That sounds reassuring about Barrett's Oesophagus, they were very open at the GI clinic and talked me through what they had found and the other tests they wanted to do and Barrett's was not mentioned.

I'm never without Gaviscon and I take it usually at night. Sometimes it takes a bit of juggling because I also take hydroxychloroquine which needs to be taken with food, Lanzoprazole that I take half an hour before food and I try not to take Gaviscon within 2 hours of the Lanzoprazole. The food diary is a good idea (also suggested by Zantri) and I think that will help me focus on what and when I'm eating.

I will make a list of things I want to ask at the next clinic appointment and will add the hiatus hernia to the list. I had this diagnosed many years ago following an endoscopy to test for H.pylori - that indicates how long ago it was because there weren't blood/stool/breath tests for diagnosis. At that time I was told it was too small to bother about, perhaps I should have followed that up sooner but my a autoimmune disease has been a bit of a challenge for the past few years.

Thank you so much, you have been really helpful.

[gutlesswonder]

It's bad luck that you needed the Cholecystectomy since I am sure that that will have made things worse, in the general sense, particularly apropos bile reflux.

Would you please state your age, height, and weight?

Do you suffer from intermittent diarrhea?

[grannyjogger]

I had gallstones and ended up with acute pancreatitis in September 2015 and after further bouts of severe pain over the next six months my GP referred me for the Cholecystectomy. The bile reflux certainly didn't help after the gallbladder was removed, but the acid reflux is something I've battled for over 30 years (I'm approaching 63) since I was expecting my first child. I was violently sick - at least a dozen times a day - for the whole of the pregnancy and a year later was diagnosed with the hiatus hernia. I'm a little overweight which I'm sure doesn't help the reflux.