What could be the cause of my ulcer

[badstomach]

My GI problems all started with an ER visit because I found that I could no longer eat in large quantities without feeling sick. I went into the ER complaining of nausea and "hunger" pains. Originally they thought I had a gallbladder problem. I was supposed to make an appointment to get an ultrasound but I decided to leave the ER early because I did not want to wait 7 hours over night before I could be seen by an ultrasound.

Fast forward two days later,I went right back to the ER. Got my ultrasound and gallbladder ended up looking good. My problems still persisted so I was taken in for observation. Almost immediately a GI specialist walked in and got me ready to have an endoscopy(I think thats what its called,they put a tube down my mouth and looked around. It turned out that I have about 4 small duodenal ulcers with the largest being 4mm, they took a biopsy and put me on Protonix,Carafate,and Zofran for nausea.The doctor asked me about NSAID use and I said I only used them sporadically.Usually duodenal ulcers are either caused by NSAIDs or H Pylori.I was taken back for observation overnight.The next day I got discharged at around 2pm, I lied and said I felt better so I could finally go home to get the rest I needed. 3 days later and I am feeling much better with the meds I am on.

Now here is where things get tricky. I got my biopsy result today,I came out negative for H pylori which really saddened me because now I have absolutely no idea what caused the ulcers. I was told over the phone that it was not crohns and it was not cancer. Now I know that Crohn's patients can have clean biopsies and still have crohns.

I am now losing alot of sleep because I am worried about what may have caused the ulcers. I was almost sure it was crohns since about a week ago but maybe it is just my paranoia. If it isnt the bacteria and it isnt NSAIDS then what could have possibly caused the seemingly random duodenal ulcers? Please help me out guys,I am absolutely desperate to find out whats wrong with me. I feel way better than last week but I keep getting thoughts of how the ulcers even got there to begin with. In a patient with duodenal crohn's do the PPI still get rid of the ulcer? How does a person with crohns even respond to PPI? Please guys I am absolutely desperate and I don't know what to think.

Any advice will be GREATLY appreciated from the bottom of my heart.

 

[ronroush7]

I don't know what it is but i have read that people with Crohn's disease can have ulcers. I hope you get answers soon.

 

[badstomach]

I don't know what it is but i have read that people with Crohn's disease can have ulcers. I hope you get answers soon.

So I have read. Apparently duodenal Crohn's only occurs in about 5% of Crohn's patients. I just don't know what other tools they have to diagnose Crohn's in the duodenal. I dont have diarrhea(constipated sorry for TMI)I have been reading everything on google on duodenal Crohn's and it seems like I wont have an answer for a long time. Would my ulcers heal with the PPI even if I had Crohn's? I guess what I am trying to say is how do you differentiate between Crohn's ulcers and normal ulcer's?

 

[eleanor_rigby]

You need to be tested for celiac disease and get a colonoscopy. I get duodenal ulcers but at each endoscopy they have healed and a new one formed. I have Crohn's disease (although my ulcer biopsies are always "negative for Crohn's") and I also have suspected celiac disease.

 

[Ozboz]

Duodenal ulcers are caused by a variety of thing's food allergies especially if you eat alot of spicy food and your body can't handle it stress is a major factor in ulcer's.

I would start by doing a food intolerance breath test try and cut down on the stress.

Lack of seep and like I said poor diet and ot's of soda or carbonated drinks can also be a factor.

Just because it's not crohn's or not h-pylori or NSAID'S it can be a of other stuff as well you shouldn't get fixated on one cause try the breath test for food allergies and go from there.

 

[badstomach]

You need to be tested for celiac disease and get a colonoscopy. I get duodenal ulcers but at each endoscopy they have healed and a new one formed. I have Crohn's disease (although my ulcer biopsies are always "negative for Crohn's") and I also have suspected celiac disease.

If you don't mind me asking,did you start with duodenal ulcers first or was it a colon issue first that got you in.I guess a colonoscopy wouldn't be a bad idea.Also can celiac disease cause constipation? I was constipated for a while up until recently. I appreciate the help Eleanor.

 

[badstomach]

Duodenal ulcers are caused by a variety of thing's food allergies especially if you eat alot of spicy food and your body can't handle it stress is a major factor in ulcer's.

I would start by doing a food intolerance breath test try and cut down on the stress.

Lack of seep and like I said poor diet and ot's of soda or carbonated drinks can also be a factor.

Just because it's not crohn's or not h-pylori or NSAID'S it can be a of other stuff as well you shouldn't get fixated on one cause try the breath test for food allergies and go from there.

Really? I thought it was a myth that food and stress cause ulcers. I will try the breath test I guess. I just assumed if it isn't NSAID and it isn't H pylori it MUST be crohn's. Is this the right line of thinking??

 

[badstomach]

Duodenal ulcers are caused by a variety of thing's food allergies especially if you eat alot of spicy food and your body can't handle it stress is a major factor in ulcer's.

I would start by doing a food intolerance breath test try and cut down on the stress.

Lack of seep and like I said poor diet and ot's of soda or carbonated drinks can also be a factor.

Just because it's not crohn's or not h-pylori or NSAID'S it can be a of other stuff as well you shouldn't get fixated on one cause try the breath test for food allergies and go from there.

Really? I thought it was a myth that food and stress cause ulcers. I will try the breath test I guess. I just assumed if it isn't NSAID and it isn't H pylori it MUST be crohn's. Is this the right line of thinking??

Edit:Not feeling too bad anymore but still am constipated. This is really depressing.

 

[badstomach]

Biopsy results:

Document info Result type: Histo-Cyto Report Result status: authenticated Report released: Jul 05, 2017, 09:14 a.m. Specimen collected: Jul 03, 2017, 01:57 p.m. Encounter Histology-Cytology Report Patient:

Preoperative diagnosis: Epigastric pain Clinical data: Postoperative diagnosis: Gastritis, duodenal ulcers, hiatal hernia, GE junction stricture Special instructions: Specimen source: A. Gastric bx, B. GE junction, C. Upper esophageal bx A. In formalin labeled "gastric bx": 4, 0.2–0.5 cm tissue piece(s). Totally submitted, 1 block. B. In formalin labeled "GE junction bx": 2 0.3-0.5 cm tissue piece(s). Totally submitted, 1 block. C. In formalin labeled "upper esophageal bx": 2, 0.4-0.5 cm tissue piece(s). Totally submitted, 1 block. AMR

M.D. A. STOMACH, MUCOSAL BIOPSY: GASTRIC ANTRAL AND BODY TYPE MUCOSA WITH NO SIGNIFICANT HISTOPATHOLOGIC ABNORMALITY. B. GASTROESOPHAGEAL JUNCTION, MUCOSAL BIOPSY: SQUAMOGLANDULAR MUCOSA WITH MODERATE REFLUX ESOPHAGITIS. NEGATIVE FOR GOBLET CELL METAPLASIA. C. UPPER ESOPHAGUS, MUCOSAL BIOPSY: SQUAMOUS EPITHELIUM WITH NO SIGNIFICANT HISTOPATHOLOGIC ABNORMALITY. A., B., C. Microscopic examined.

 

[Ozboz]

@badstomach GI'S also used to say diet doesn't affect crohn's when I was first diagnosed they said diet doesn't affect crohn's, how crazy is that a digestive disorder isn't affected by diet so I asked him why do certain foods flare my crohn's and other's out right put me in agony, again his answer was diet doesn't affect crohn;'s.

Now 10 years later they are coming round to the idea that diet does affect crohn's and are doing food allergy breath test's and actually send you to a dietician in the IBD clinic.

So food causing ulcer might not be that much of a myth anymore.

 

[Jabee]

Hmmm. The duodenal ulcers could be caused by excess acid from your stomach. The Protonix and carafate should help with that. I wouldn't worry to much about crohn's at this point. Can you make an appointment with your GI to talk about the biopsy results and possible causes of your ulcers? Inflammation can result from infections as well. The most important thing is that you are feeling better!

 

[eleanor_rigby]

It used to be thought that stomach ulcers may be caused by certain lifestyle factors, such as spicy foods, stress and alcohol, and a genetic predisposition to excessive stomach acid secretion.
However, there is little hard evidence to confirm that this is the case and this line of thinking has been outdated since the 1980s. Although these factors may make the symptoms of ulcers worse.

I am not sure when I started with duodenal ulcers - I have had Crohn's since 2006 and only had my first endoscopy in 2016, whereas I had my first colonoscopy in 2011.

 

[badstomach]

It used to be thought that stomach ulcers may be caused by certain lifestyle factors, such as spicy foods, stress and alcohol, and a genetic predisposition to excessive stomach acid secretion.
However, there is little hard evidence to confirm that this is the case and this line of thinking has been outdated since the 1980s. Although these factors may make the symptoms of ulcers worse.

I am not sure when I started with duodenal ulcers - I have had Crohn's since 2006 and only had my first endoscopy in 2016, whereas I had my first colonoscopy in 2011.

It's absolutely agonizing emotionally not knowing why I have the ulcers. Haven't felt like my self since the ulcers.

 

[badstomach]

Short Version

http://exploitationnation.blogspot.com/2007/11/crohns-disease-conspiracy.html

Long Version

http://www.mad-cow.org/00/paraTB.html

I havent been diagnosed with Crohn's yet but I was a HEAVY milk drinker. Anyone here read anything about this?

 

[eleanor_rigby]

That's a controversial idea, it is generally thought that while MAP COULD be the cause of Crohn's for some patients, it cannot be the cause for ALL patients. There is loads of discussion about this in the research section of the board. As yet nothing is proven with the MAP hypothesis and studies are in trial stage.

You are jumping to massive conclusions. Coeliac disease could cause ulcers in the duodenum. There's probably other similar things that could cause them too that I am unfamiliar with. You need to take one step at a time. First step is colonoscopy, fecal calproctectin stool test and blood tests. You can then move forward there. Rather than panicking find out what you are actually dealing with. Even if it was Crohn's there is treatment and life goes on.

 

[badstomach]

That's a controversial idea, it is generally thought that while MAP COULD be the cause of Crohn's for some patients, it cannot be the cause for ALL patients. There is loads of discussion about this in the research section of the board. As yet nothing is proven with the MAP hypothesis and studies are in trial stage.

You are jumping to massive conclusions. Coeliac disease could cause ulcers in the duodenum. There's probably other similar things that could cause them too that I am unfamiliar with. You need to take one step at a time. First step is colonoscopy, fecal calproctectin stool test and blood tests. You can then move forward there. Rather than panicking find out what you are actually dealing with. Even if it was Crohn's there is treatment and life goes on.

Problem is the doctor hasn't even ordered a colonoscopy. GI specialist sent me to an eye doctor to check for williams disease. I also was sent on a 24 hour urine to check for copper again for williams disease. However,williams disease does not cause ulcers.I have no idea why they wouldn't order the colonoscopy right away. It just seems like my life is over. Why would they leave me hanging without a DX for so long?Everyday I wake up I panic not knowing what the heck is wrong with my body.


Edit:Eleanor thank you so much for letting me know about celiac disease. You have been a tremendous help and have eased my anxiety some,thank you.

 

[eleanor_rigby]

Problem is the doctor hasn't even ordered a colonoscopy. GI specialist sent me to an eye doctor to check for williams disease. I also was sent on a 24 hour urine to check for copper again for williams disease. However,williams disease does not cause ulcers.I have no idea why they wouldn't order the colonoscopy right away. It just seems like my life is over. Why would they leave me hanging without a DX for so long?Everyday I wake up I panic not knowing what the heck is wrong with my body.


Edit:Eleanor thank you so much for letting me know about celiac disease. You have been a tremendous help and have eased my anxiety some,thank you.

What country do you live in? Some places like the UK are very slow due to financial restraints and long waiting lists. Perhaps ring and leave messages with your GI Secretary / go and see your GP / request a second opinion / pay to see someone privately. You will get to the bottom of it eventually but it may take a lot of patience - think months if somewhere like the UK. You have to just keep going and go to the emergency department if you become severely unwell (I.e unbearable abdominal pain, high fever, dehydration whilst unable to stop vomiting etc).

 

[badstomach]

What country do you live in? Some places like the UK are very slow due to financial restraints and long waiting lists. Perhaps ring and leave messages with your GI Secretary / go and see your GP / request a second opinion / pay to see someone privately. You will get to the bottom of it eventually but it may take a lot of patience - think months if somewhere like the UK. You have to just keep going and go to the emergency department if you become severely unwell (I.e unbearable abdominal pain, high fever, dehydration whilst unable to stop vomiting etc).

I Live in USA and have private insurance. All that information I got was pretty much gathered within a 5 day time span.So far I havent been recommended a colonoscopy.Will talk to my GI and report back here.

 

[eleanor_rigby]

I Live in USA and have private insurance. All that information I got was pretty much gathered within a 5 day time span.So far I havent been recommended a colonoscopy.Will talk to my GI and report back here.

OK that's good you should be able to get a fast turn around then fingers crossed!

 

[badstomach]

Im still somewhat constipated. I go twice a day and the stool size is nothing like what it used to be(sorry for TMI) . I am suspecting crohn's in the small bowel.

 

[eleanor_rigby]

Lots of things can cause constipation, including non-digestive conditions so it would be impossible to say at this point.