Is Endoscopy Needed?

Jim was diagnosed as having tertiary contractions of the esophagus and slight gastritis. He has substernal chest pain that does not go away after eating. His doctor feels it is not cardiovascular. You may ask: What is the cause of this burning pain and what Jim can do about it?

Substernal burning chest pain that starts while eating and lasts for some time after that is highly suggestive of acid from the stomach regurgitating into Jim’s esophagus. The medical term for this is gastroesophageal reflux disease. If this had been present for a long enough time, the effects could have been seen during his endoscopy. If Jim antacids helped in his burning pain, it is a good indication that acid reflux is a large part of his problem. Some new medications called H2 antagonists are quite effective.

In addition to medications, he should identify how his eating and activities after eating affect his problem. Typically, eating smaller amounts more slowly, chewing foods more completely and not lying don shortly after eating can be helpful.

It is best that Jim should return to his doctor and try to get a better understanding about hi problem, especially understanding why the antispasmodic was recommended.

Peter wakes up in the morning feeling like someone has pored cement throughout his torso. He cannot sleep on his back or he would never be able to move. It is painful enough to sleep on his side. After he is up and around, it gets better.

For hundreds of years, doctors thought stomach ulcers were primarily caused by too much stress or eating too much of the wrong foods. More recently, it has been shown that the real culprit is bacterium called Helicobacter pylori.

Usually, when an ulcer is suspected, an endoscopic test is recommended. During this, the person is sedated, a tube is passed into the stomach and samples are taken of the stomach contents and the stomach lining. If this test shows that Helicobacter pylori are present, treatment with antibiotics will be very effective in eradicating the bacteria and the ulcers.

But now here comes an easier method. The person suspected of having this problem drinks a drug called Pranactin. Then they breathe into a special collection bag. Their breath is sent to a lab to be analyzed. This analysis will tell whether the person is infected with the bacterium.

Obviously, this test is much more convenient, less risky and less costly than an endoscopic exam. Because about one in three people are infected with the Helicobacter pylori bacterium, but only one in 10 are showing signs of ulcers, it may be used in the future to detect and prevent ulcers before they start.