Posted 5/29/2008 8:48 PM (GMT 0)
Endo showed a few ulcers in the esoph and the stomach. Ped Gastro said they did not look like H. Pylori. The antrum was very inflammed and his pylorus was closed to the size of a dime. All the biopsies came back fine. They could not find any H. Pylori. My DH had been laid off work and the insurance ended a couple of days after his scope (Mar 28th). As soon as we could purchase new insurance (through COBRA at $850 a month), we set him up for an Upper GI with SBFT. He had that done on May 1st. That was all normal. At this point, DS is still having nausea, but not throwing up. Still on 40 mg Nexium twice daily, Carafate 4x. Zofran as needed (usually going through a box of 10 every 2-3 weeks).
He had another Endoscope with a balloon dialation and a colonoscopy on May 22nd. Now his pylorus is opened to about the size of a nickel. I understand it should be closer to a quarter. I didn't get to ask the Dr. about why it couldn't be opened more (I will at our appt), but am guessing that the stricture is very firm/tight and that it wouldn't be good to force it or it just wouldn't stay open more.
Anyway, this time, biopsies still fine. Nothing unusual in the large intestine. Dr. had asked his partner to be with him during the procedures to get his opinion. They decide to go ahead and treat for H Pylori, because he said after having been on the Nexium for so long, that the bacteria can hunker down in the inflammation and be harder to catch in a biopsy. They also had taken blood to check for yeast antibodies.
They asked a Gastrology Pathologist to look at all his stuff. He agreed that they were probably on the right course. Pyloric strictures just aren't supposed to happen at his age without cancer, etc. As far as gastroduodenal crohn's, I understand it usually involves this area but also other areas of the colon in conjunction. They can't do the capsule because it wouldn't go through the pylorus and Dr said that there could be inflammation there.
Well, the blood work came back with a slightly elevated number of yeast antibodies. Nurse said not so high that they would say "oh yeah, it's Crohn's", but high enough that they may pursue some type of treatment. Nurse said "he has a slight case of Crohn's). (I'm thinking is that like being slightly pregnant, lol, but think she is meaning a mild case). We see the Dr on June 13th (a week after he finishes the antibiotics).
DS has lost 20 lbs since March 6th, mostly from eating way smaller meals and more juice/yogurt/soft stuff, as well as exercise. I have been keeping a food/med diary to watch for trends, nothing significant so far. He hasn't throw up since his first endo (dr tried to open the pylorus some with the scope he was using). He had still been nauseated, rarely had pain. He has been on the antibiotics almost a week and says he feels a little better (no Zofran since last Saturday night).
Anyway, that's our story. Slight Crohn's with a pyloric stricture and possible h. pylori.
Anybody else have a pyloric stricture? Did balloon dialation help? Dr hasn't mention surgery, but I know it is done.
Sorry I got long-worded, Chedva