Wednesday, August 01, 2012

Biopsy Results

Something really annoying seems to have happened over my recent endoscopies.  As far as I was concerned Dr Peter Nash was the referring physician.  The only reason I ended up under anaesthetic was because he wanted me tested for Whipple's disease and he seemed to be concerned about the pain in my right side I was nursing that day I saw him and he wanted to rule out small-bowel Crohn's before he treated me for anything muscular-skeletal.  That was how I thought it all started.  I have a copy of the referral.  The Colonoscopy was added when I went to the IBD clinic which changed the waiting time from priority one to three months waiting list because I was now getting both ends done.  As far as I was concerned, the top half belonged to Dr Peter Nash's referrals and it was in the biopsies done at his end that I was particularly interested in.  But it seems only Jo English (who I have not seen all year if I remember rightly) has had a copy of the results.  I only just found that out.  She is stated on both procedures as being the referring physician.  I am now starting to wonder if I was even tested for Whipple's disease and I wonder if I will ever find out if she does not even know the name of the test stain that needed to be done.  All I know now is that all my biopsies have been marked NO ACTION REQUIRED.  There you have the result but you don't have an explanation.  I don't have an explanation.  I don't have any useful information.

Here is the endoscopy report for which I don't have any explanation.

No gross lesions in oesophagus.
Gastric mucosal abnormality characterized by erythema (that means red and inflammed).  This was biopsied.
A single gastric polyp.  This was biopsied.
No gross lesions in duodenum.
Biopsies were taken with cold forceps for evaluation of coeliac disease.

That "single gastric polyp"  I would have to assume is the same lump that they have re-labeled from GIST to pancreatic rest to now a sessile gastric polyp.  All I know is the biopsy requires no action which means it is not cancer but it looks like I am not going to get told what tissue they found in there or whether it has grown in size compared to the years before.  This is all because I am not getting to see the gastroenterologist himself.  At least after the RBWH procedures I was referred back to a gastro.  Now days all I ever see is a nurse practitioner.  I am getting lost in the system.
In the gastric Fundus

What about the cause of the gastritis (the erythema of the mucosa of which there is a photo above)?  OK, the biopsy says it has not become cancerous but why is it burning?  What is the irritation?  Well from the results of NO ACTION REQUIRED we can assume it is not coeliac disease.  But what about the rest of the information I need?  Was I even tested to find out if sucrose or gluten intolerance (as opposed to allergy) was even a potential cause for the redness.  Was I tested for any bugs besides Whipples assumping one of them was even for Whipple's?  I tried to ask that surgeon for those intolerance tests before I went under - I certainly mentioned gluten intolerance distinct from coeliac but without knowing if I was tested for it - specifically Anti-gliaden antibodies, I still don't know if I am in the all-clear to eat wheat etc.  That to me would have been useful information.  Do I still have a maltose intolerance?

Everything else has changed.  Those bleeding angioectasias have not returned after getting sealed up.  No sign of them was mentioned in the report.  The inflammation in my esophagus from other years is gone but the gastritis that had disappeared is back again.  There is absolutely no sign of Crohn's disease in the only biopsy they took of my colon either because the results are NO ACTION REQUIRED yet I have had a distinct change in my bowel problems in the last two years with its tendancy to back up.  I blamed the doxycycline when it first started happening but it did not stop.  But the report on my colonoscopy was mostly unremarkable (an internal hemorrhoid and a negative biopsy of my rectum).  If you did not look at the section discussing the procedure, an interpreting GP honing in on the summary results may fail to notice one important sentence - "The colonoscopy was performed with difficulty due to significant looping".  So, why have I got looping all of a sudden?  No other colonoscopies have ever mentioned it? It certainly is an explanation to me of why things seem to get stuck these days.  I remember when all I ever complained about was diarrhea.   Things change.  I don't get those mini fevers (rises in temp) I used to get either so somehow I beat Crohn's disease.  But I have IBS so badly that I am often just as handicapped by it.  Like the days I cannot even put clothing next to my stomach skin that might happen to press a touch that results in cramps.

Bottom line, I am glad I don't have cancer.  I don't know why my stomach is inflamed (except that I have stopped taking the Losec remember?) When I know what I was tested for I will maybe know more about what I haven't got.  Like I said, I would really like to know what foods are not going to irritate.  I am going to see Dr Jo English my "referring" GP tomorrow but I already fear she will not enlighten me much.

1 comment:

zena said...

Seems like a lot to go through for nothing. Hopefully she will be amenable to sharing the results with Peter Nash so don't forget to ask her. xx Zena