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Dr. Andrew Rynne

Family Physician

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Are low serum gastrin levels in a test indicative of stomach cancer?

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Dr. Saddiq Ulabidin

General & Family Physician

Practicing since :2011

Answered : 1623 Questions

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Posted on Thu, 26 Jul 2018 in GERD
Question: Hello,
I requested a test of serum Gastrin levels because I wanted to rule out Zollinger Ellison syndrome as a cause of my histamine issues. I just got my results back and my levels are actually QUITE low(< 15). I looked up low gastrin levels on the internet and found Pubmed articles that said it's indicative of extensive gastric damage(chronic atrophic gastritis) and high risk for stomach cancer. In addition, I have daily stomach pain(especially after eating), signs of poor digestion: progressive weight loss down to 130lbs at a height of 5 11', loose mushy stools, acidity after eating. My doctor ordered an endoscopy at my request.
My question is: does a low Gastrin level ALWAYS indicate chronic gastritis? I wonder, because on the test the reference range only indicates that if it's < 100, it's normal.
Thank you very much, XXXXXXX
doctor
Answered by Dr. Saddiq Ulabidin 2 hours later
Brief Answer:
It doesn't necessarily indicate chronic gastritis

Detailed Answer:
Hi! Welcome to Healthcaremagic. Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all it's sad to know what you had been going through lately.

Based on the history you have shared, your symptoms does correlate with gastric issues and that may include gastritis as well but low gastrin levels doesn't allways indicate gastritis as usually extensive damange to inner linning of stomach can produce low levels with gastritis but acute Inflammation may also give such levels and are reversible after the wear and tear is over.

Also that gastritis is a risk factor for cancer same as ulcer, H.pylori and other are. For reassurance, You may also need stool antigen for H. pylori and biopsy during endoscopy should also be performed. Meanwhile antacids like omperazole before meals can be continued.

Wishing you a speedy recovery. Hope this has answered your query. If you have any questions please feel free to ask. Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Saddiq Ulabidin 2 hours later
Hello again, and thanks for your answer.

I should add that I've had this stomach pain for over 5 years,
so maybe I do have chronic gastritis with extensive damage.
Scary to think so. Another thing is that I did have an H Pylori infection
back in 2013, and was treated for it. Several followup stool and breath
tests showed it is no longer active. But the blood test always shows
positive for this. Is it possible I might still have an H Pylori infection?

I had an endoscopy about 5 years ago and it was basically normal.
Is 5 years enough time to cause extensive damage to the stomach?

If my stomach is that damaged, is there any way to reverse some of it?

Also, what are the odds that it will develop into stomach cancer?
What can I do to prevent this from happening?

Should I take antacids? I currently don't because I read they can
cause stomach atrophy and actually increase risk of stomach cancer.
Is this true? If so, does this apply to H2 blockers as well?

Thanks for your patience in answering all these questions,
XXXXXXX
doctor
Answered by Dr. Saddiq Ulabidin 1 hour later
Brief Answer:
The repeat endoscopy and biopsy is next best step

Detailed Answer:
Hi! Thanks for the detailed feedback. Blood tests for H. pyrlori may still remain positive but for eradicatiom of H. pylori and treatment effectiveness stool antigen is more reliable. However as you are undergoing repeat endoscopy you can have the biopsy of stomach lining done and it can reveal both extent of damage to stomach walls and M pylori persistance. Meanwhile you can continue using antacids till the biopsy reports arrive and as far as risk is concerned such risks attributed to antacids like omperazole are after extensive usage upto months to years and not with short term or few weeks therapies. You should stay relax as nothing of this signifies that you are having such extensive damage before the endoscopy and biopsy results arrive. Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Saddiq Ulabidin 6 hours later
Thank you for your followup answers.

Regarding the endoscopy and biopsy: I requested it be done without sedation because last time I went into anaphylactic shock from it. How painful and difficult will abiopsy be without sedation? Is a biopsy absolutely necessary? If I had to use sedation what measures could I request before the procedure to prevent anaphylaxis? Eg. Antihistamine Iv?
Lastly, do u know the odds of developing stomach cancer if I do have extensive damage and can I improve those odds (say by taking antacids)?

Thanks so much for all your help!
XXXXXXX
doctor
Answered by Dr. Saddiq Ulabidin 13 hours later
Brief Answer:
You can have it without much sedation and prohylactic anti histamines

Detailed Answer:
Hi! Thanks for the feedback. Yes you can have endoscopy without much sedation and usually local anesthetic gargles can also be sufficient though discomforting but not very painfull. Still prophylactic anti histamines can be given as well as a steroid shot if needed.

For biopsy you don't need any kind of anesthesia and it's through mucos layer and is not very painful and only a small amount is taken. Regarding the chances if healing or reversibility is concerned, it will depend upon extent of damage on endoscopy or biopsy. Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
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