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Question about pain and gastritis

The various unpleasant manifestations of Helicobacter can be described here. Remember however that the great majority of persons with Hp have no symptoms that they are aware of and consider themselves normal.

Moderators: Toni, barjammar

ankiwo72
Posts: 57
Joined: Fri May 17, 2019 2:45 am

Question about pain and gastritis

Post by ankiwo72 » Sat Nov 30, 2019 5:49 am

Dear Helico expert,

I have been attempting to understand but can’t seem to piece together the mechanism that causes me pain if I don’t eat for any reasonable length of time. It is like I constantly have to suck on a candy or snack in order to not feel pain.

I thought H. Pylori didn’t like an acidic environment, so doesn’t eating stimulate a more acidic environment? Shouldn’t the additional acid irritate my gastritis? So, for past year or so, if I go 20-30 min without eating I feel pain which radiates around to my back and is probably due to some inflammation happening. The H. Pylori has migrated to my corpus, was eradicated in that area from previous failed treatment and is now predominantly in my fundus. I don’t know if location of the infection affects the acid secretion in any way? I do not have any IM or atrophy (still awaiting endoscopy results but most look clear except for fundus) but do seem to have iron deficiency getting worse. My histamine, n-methylhistamine, chronic urticaria index, IgE, IgG, CgA, gastrin, basophils levels very high.

Can someone explain in plain English what might be happening to my stomach? Thanks so much!

Helico_expert
Site Admin
Posts: 3526
Joined: Wed Mar 02, 2011 7:20 am

Re: Question about pain and gastritis

Post by Helico_expert » Sat Nov 30, 2019 4:26 pm

If you have HP, it will be everywhere in your stomach - Antrum, Corpus, Fundus, ..

as a result, your whole stomach will be inflamed. It's like the whole stomach is now a war zone. Some regions will be more severely damaged that other regions. The body of course is trying to heal and so rescue missions will be happening everywhere. To maintain the front line, some emergency rescue missions directly replace the killed cells with other cell type (intestinal metaplasia). This strategy may hold the front line a little, but not a long term solution. In fact, may cause more trouble later on, as intestinal cells cannot perform like gastric cells.

So if you read up OLGA strategy. If you found IM in either Fundus or Antrum, your chance of gastric cancer is higher than normal. If you found IM in both Fundus and Antrum, your gastric cancer risk it the highest.

The most important factor is to get rid of HP. Then the war will slowly come to end. Then the war zone will slowly recover. The younger you are, the better is the recovery. The older population, the war zone is usually harder to recover as there will be scars everywhere.

ankiwo72
Posts: 57
Joined: Fri May 17, 2019 2:45 am

Re: Question about pain and gastritis

Post by ankiwo72 » Sat Nov 30, 2019 9:31 pm

Thank you for that explanation. Is there a reason for the gastritis pain resolving with food ingestion though? I would have thought eating would cause more pain due to more acid output and thus damage, but without evidence of hypochlorhydria (no atrophy or metaplasia), why would relief occur with food?

Helico_expert
Site Admin
Posts: 3526
Joined: Wed Mar 02, 2011 7:20 am

Re: Question about pain and gastritis

Post by Helico_expert » Sun Dec 01, 2019 10:27 am

it depends if the pain is really cause by acid. Sometimes, it could be due to swelling of the lymph nodes that press on nerves.

anyway, one explanation is that food can neutralize the acid a bit. So you feel less intense.

ankiwo72
Posts: 57
Joined: Fri May 17, 2019 2:45 am

Re: Question about pain and gastritis

Post by ankiwo72 » Sun Dec 01, 2019 11:45 am

Helico_expert wrote:
Sun Dec 01, 2019 10:27 am
it depends if the pain is really cause by acid. Sometimes, it could be due to swelling of the lymph nodes that press on nerves.

anyway, one explanation is that food can neutralize the acid a bit. So you feel less intense.
Thank you! That makes lots of sense :-) I didn’t know those possibilities!!

Maria.b
Posts: 42
Joined: Wed Apr 25, 2018 2:50 pm

Re: Question about pain and gastritis

Post by Maria.b » Mon Dec 02, 2019 10:28 pm

Hi sorry to jump post just want to ask ive tested by stool every 3 months 2 endoscopes and its been 2 yrs next march since i did treatment but ive still got stomach issue but just read it could be inflammation. How long does it normally take to fully recover i know i have mild chronic gastritis and havent taken ppls for 14 months but its uncomfortable and the drs because they dont c anything bad on endoscope there not intrested pls advice

Helico_expert
Site Admin
Posts: 3526
Joined: Wed Mar 02, 2011 7:20 am

Re: Question about pain and gastritis

Post by Helico_expert » Tue Dec 03, 2019 8:43 am

i am afraid to tell you that some symptoms may be permanent.

the younger you are free of HP, the higher then chance of returning to 100%.

Since there is no more abnormality seen in your stomach during endoscopy, i think you just have to tolerate it. Take ranitidine or PPI if they help. They are not very harmful. If they can improve your quality of life, you should take them.

Maria.b
Posts: 42
Joined: Wed Apr 25, 2018 2:50 pm

Re: Question about pain and gastritis

Post by Maria.b » Tue Dec 03, 2019 12:30 pm

Hi thanks for yr reply im 46yrs and yes im probably stuck with this unlucky i guess i think cause i still have issues its the reason i test so often very upsetting to know i probably wont make a full recovery

ankiwo72
Posts: 57
Joined: Fri May 17, 2019 2:45 am

Re: Question about pain and gastritis

Post by ankiwo72 » Tue Dec 03, 2019 7:19 pm

Helico_expert wrote:
Tue Dec 03, 2019 8:43 am
i am afraid to tell you that some symptoms may be permanent.
Gastritis can become a permanent condition even after successful eradication? I always thought that as long as it didn’t progress to metaplasia that stomach would revert to normal, but that’s not true?

Maria.b
Posts: 42
Joined: Wed Apr 25, 2018 2:50 pm

Re: Question about pain and gastritis

Post by Maria.b » Tue Dec 03, 2019 9:10 pm

I wonder if helico expert is right and its inflammation pressing on nerves that causes pain but not sure if inflammation can be seen on endoscope as my dr has no idea why i still have stomach issues

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