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Upper endoscopy and duodenum biopsy normal. Experiencing sore throat, abdominal pain. Worrisome

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Practicing since : 1962
Answered : 693 Questions
Hi there
I had upper endoscopy and duodenum biopsy done 2-3 months ago due to digestion problems, reflux, belching, shortness of breath. I have wheat flour allergy and histamine intolerance.
Endoscopy results: "the esophagus and stomach macroscopically appeared normal.
Duodenum also appeared normal".
Duodenum biopsy results: "fragments of duodenal mucosa with focal mild increase in intraepithelial lymphocytes with normal villous architecture".

A few days after endoscopy I experienced sore throat. I don't remember feeling pain in my stomach.
But maybe 12 days after I started to notice some sensation in duodenal area and occasionally short sharp pain. And it's still there.
I feel sensation most part of the day. Sometimes is just discomfort, sometimes just a little dull feeling.
Once or a few times per day I can feel shorter sharp pain.
Usually pain occurs while sitting. I didn't find that is related to being full or hungry.
Also I can sometimes feel pain while lying in the bed on the side - sometimes right, sometimes left.

GI doctor said that is not related to endoscopy. But I didn't feel any sensation or short sharp pain in my stomach before endoscopy. I'm afraid that they damaged something :(

Any advice would be greatly appreciated.
I'm really worried.

Thank you in advance
Posted Fri, 10 May 2013 in Digestion and Bowels
Answered by Dr. Charles S Narasi 21 minutes later
Thank you for contacting XXXXXXX with your concern.
The endoscopy did not show any obvious ulcers
on visual examination. But the biopsy of the duodenum
did show some patchy inflammation , called "Duodenitis".
This is not ulcer but could turn into one if not treated.
I can safely say , the biopsy also ruled out "Celiac " disease
since there was no villous atrophy. You may have just an
intolerance to gluten but not a true celiac condition.
I want you to follow a diet as if you did have an ulcer.
Avoid tomato based products, excess caffeine, smoking
if you are one, alcohol and also excess dairy products such
as cheeses . Fatty foods also slow down the stomach
emptying and can aggravate the acid condition.
You should be on a PPI such as Prilosec, Aciphex, Prevacid,
Nexium or Protonix daily for 6-8 weeks.
Also avoid NSAIDS such as Ibuprofen, Naproxen and even Aspirin.
I don't think you have to worry about any damage from the
procedure to the lining of the esophagus,stomach or duodenum.
I wish you the very best.
Above answer was peer-reviewed by
Follow-up: Upper endoscopy and duodenum biopsy normal. Experiencing sore throat, abdominal pain. Worrisome 1 hour later
Hello Dr Narasi

Thank you so much for fast reply.
I will have some additional questions.

1)Do you think that gastroscopy and biopsy caused discomfort and pain that I have now?
2)Do I need some addtional tests like barium swallow test,ultrasound or CT scann to confirm if I have ulcer? I wouldn’t dare to have gastroscopy again.
3)I don’t feel pain when I touch my stomach. Is this normal if you have inflammation or ulcer?
4)Do you think I have ulcer or only inflammation?

Thank you once again
Answered by Dr. Charles S Narasi 44 minutes later
Mild discomfort like a slight sore throat sensation is
common but does not last long. Sometimes , mild
bloating can occur after endoscopy because we
introduce a little air to get a good look at the lining
of the stomach and intestine. Again , that is temporary.
I would not worry about any damage.
Inflammation is rather mild in your case. It is not an
ulcer. A person can have an ulcer , still not have pain
on pressing on the abdomen.
At this point I do not think you need any barium studies.
If you have not had a sonogram of your gallbladder get one
just to rule out gallstones.
Main thing is taking the PPI for 6-8 weeks, so that any
inflammation that is present can heal nicely.
I wish you the very best.
Above answer was peer-reviewed by
Follow-up: Upper endoscopy and duodenum biopsy normal. Experiencing sore throat, abdominal pain. Worrisome 20 hours later
Hello Dr Narasi

Thank you again for your answer.
Any idea why I started to feel this sensation and pain maybe 12 days after duodenal biopsy? Can this be maybe infection? I don't have fiver.
If it's some lining damage in duodenum done by biopsy, I'm worried that it can't be fixed. I have feeling that I would't had this problem If I didn't have gastroscopy.

I used to take Tecta (pantoprazole) medicine in November for 3 weeks as a try to see if this will solve my problems but I had reaction (I would wake up during the night with red rash and sweat). My assumption is that reaction came due to my histamine intolerance.

Answered by Dr. Charles S Narasi 5 hours later
When we take the biopsy of the duodenum , it is not
a deep one, mostly the surface and the lining underneath.
There are no nerve endings there to cause damage.
Again , I would not worry about it.
If you can't tolerate Pantoprazole , you can try other ones
like Nexium.
The area of the biopsy will completely heal without even a scar.
Please don't worry.
I wish you well.
Above answer was peer-reviewed by
Follow-up: Upper endoscopy and duodenum biopsy normal. Experiencing sore throat, abdominal pain. Worrisome 22 hours later
Hello Doctor

Thanks once again for nice words. I hope I will be able to fix my pain.
I’m just very worried that I got sensation and pain after procedure. I will see GP today for medicaments.

One last question if I am allowed.
Sometimes I have feeling that I don’t swallow food so smoothly, that I have to make some effort to swallow it. It’s kind of feeling that something is stuck in my throat in its lower portion just above “v” whole made by chest bones.
Since I was swallowing my saliva all the time during the gastroscopy, even though the tube was in my throat, is it possible that I damaged my throat by doing this? But I had urge to swallow saliva even thought the tube was there and I felt it every time I did swallowing.

Thank you once again

all the best
Answered by Dr. Charles S Narasi 1 hour later

The feeling that you experience in the throat area could be from acid reflux. You might have GERD (Gastro-esophageal-reflux disease) where the acid from the stomach goes back up into the esophagus. Sometimes, this happens at night during sleep, and in the morning you might notice this sensation.

Hope this answers your concern.
I wish you well.
Above answer was peer-reviewed by
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