Should I be worried??

[PrettyNoona]

Hi everyone. I have persistent Anemia. I recently had an endoscopy, biopsy was taken and I got my results from the lab last week. I’m waiting to go to my hematologist, my appointment is in few days . I read I have chronic gastritis, no H-pylori. What does it mean?? Should I be worried?? I want to be prepared with whatever news my Hematologist will tell me.

[fbirder]

Pernicious Anaemia is another name for Autoimmune Metaplastic Atrophic Gastritis. So it should be no surprise that they found it in your stomach.

It's nothing to worry about.

It can cause (in a small number of people) cells to grow into Neuroendocrine Tumours (NETs). But, if you had them then they would have been found during the gastroscopy.

[PrettyNoona in reply to fbirder]

I don’t think I have Pernicious Anemia, I have iron deficiency Anemia. A persistent one. I was doing tests to know the cause. I wasn’t sure in which community to ask exactly.

[MissKota]

It’s nothing to worry too much about. I was diagnosed with it five years ago and I’m fine. I take a PPI to cut down on acid reflux and try to avoid a fatty diet.

I think the main thing they will be looking for is what is causing it. Whether it is stress/trauma related; caused by medication such as NSAIDs of a specific bacteria such as H-pylori.

It is fairly simple to treat so please don’t worry.

[PrettyNoona in reply to MissKota]

Oh thank you, I needed to hear that!! Do I have to go through more endoscopy to find the cause?? And there was no presence of H-pylori in my 1st endoscopy.

[MissKota in reply to PrettyNoona]

I had the same result - no H-pylori. I doubt they’ll do another endoscopy yet as they’ll have a record from the first. It will be a case of looking at your diet/life style/medications and possibly more blood tests.

Depending on the cause, they may decide to take your gallbladder out if bile is getting into your stomach. Again that’s a really simple procedure done as a day patient.

They may never actually identify the cause and instead just begin treatment based on your symptoms.

In my case, I had my gallbladder removed and take a daily capsule (lansoprazole) to control the stomach acid. I also avoid fried and fatty foods.

[PrettyNoona in reply to MissKota]

That was helpful, thank you so much.

[FlipperTD]

[A scientist, not a medic]

You say that you have a persistent iron deficiency anaemia. In these circumstances it's worth making sure that you don't have an inherited condition such as a thalassaemia or haemoglobinopathy. These can cause chronic microcytic pictures that can be mistaken for iron deficiency. It's possible to have a complex picture of multiple pathologies which can confuse until you know them. Just a thought!

[PrettyNoona in reply to FlipperTD]

I have Sickle Cell Trait, but they say that shouldn’t affect my hb level that much.

[FlipperTD in reply to PrettyNoona]

That's sound advice but it might result in a slightly lower MCV, which could be mistaken for iron deficiency. It's all complicated! It's good to know that you've been investigated! Good luck.

[PrettyNoona in reply to FlipperTD]

Yeah, the MCV was low, I didn’t know what that meant though. It sure is complicated. I’ll figure it all out one day, hopefully soon. Thank you for the encouragement.

[FlipperTD in reply to PrettyNoona]

The Mean Cell Volume is the mean size of the red cells, and 'normally' would be somewhere between 80 and 96; some labs might use a wider range. Microcytic means smaller, and in Thalassaemia traits the MCV is smaller. Some Haemoglobinopathies can have an associated thalassaemia gene as well, which makes it even more complex.

In Iron Deficiency the MCV is reduced but will return to 'normal' with replacement therapy, although it takes months. If there is an underlying cause for a lower MCV, then, when iron deficiency is present they'll be even smaller, but will return to their own 'normal' on treatment.

Hope this isn't too complicated!

[PrettyNoona in reply to FlipperTD]

Thanks to the frequent visits to hospitals I know a lot of terms, It isn’t that complicated. Thanks a lot, I really appreciate you taking your time to explain these things. It’s really helpful.

[JDFBell]

I have had really bad gastritis before. It can cause nausea, heartburn and fatigue. Start the ppi, use gaviscon. Maybe try a probiotic. It can take over 3 weeks to see much of an improvement, but it will get better.

[PrettyNoona in reply to JDFBell]

I will, I’m waiting to see my hematologists in few days. I think she will prescribe one of those. Thanks. So, Is your gastritis completely healed? Was it acute or chronic? I heard acute are more painful since they’re sudden.