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What Does This Endoscopy Report Indicate?

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Posted on Fri, 10 Jul 2015
Question: Dear Doctor, My daughter is 11 week pregnancy. Due to frequent vomiting and stomach pain my doctor recommended for endoscopy. The report is Fundus: Normal ; Body : Normal: AntrumL umblicus like polyp antrum ,Gist biopsy done., Pylorus: Normal; Duodenum D1; Normal D2 Normal;

The biopsy report is yet to come. Doctor what is the treatment for this kind of symptom.
doctor
Answered by Dr. Sameer Kumar (2 hours later)
Brief Answer:
emesis gravidarum with possible GIST..

Detailed Answer:
Hello,
Thanks for the query to hcm,
It is to be understood that increased vomiting and nausea is usually common in early 1st trimester due to the growing hcg levels and hence should be managed conservatively with antiemetics like TAB DOXINATE 10mg thrice a day ( safe in pregnancy). Now that your doctor has gone ahead and done the endoscopy and has detected a lesion near the antrum of the stomach which they suspect as GIST( Gastrointestinal stromal tumour), well it may be a possibility , yes but has to be confirmed by accidental reports.
But the lesion is not because of pregnancy per se and likely to be present before the pregnancy was established. If there were no symptoms before pregnancy with regards to vomiting and pain , it is unlikely that present symptoms are because of the lesion. So firstly, the nausea and vomiting has to be controlled. Increased stomach acid production is also a feature in 1st trimester if the woman is unable to eat something due to nausea and keep empty stomach, which acts in a vicious cycle and causes increased gastric acid production which irritates not just the gastric mucousa but also the ulcer like lesion in the antrum causing pain.
Gaviscon is an antacid and can be taken twice a day. But TAB DOXINATE should be started with immediate effect thrice a day for a week to control nausea and vomit. Then further treatment can be decided based on the biopsy report.

If the report is GIST,then the lesion has to be removed surgically and can be done endoscopically in experienced hand. But if its a gastric ulcer then it has to be managed conservatively through out pregnancy.
I hope i have answered your query in detail,
Wishing her safe pregnancy,
Regards
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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Sameer Kumar

OB and GYN Specialist

Practicing since :2002

Answered : 1782 Questions

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What Does This Endoscopy Report Indicate?

Brief Answer: emesis gravidarum with possible GIST.. Detailed Answer: Hello, Thanks for the query to hcm, It is to be understood that increased vomiting and nausea is usually common in early 1st trimester due to the growing hcg levels and hence should be managed conservatively with antiemetics like TAB DOXINATE 10mg thrice a day ( safe in pregnancy). Now that your doctor has gone ahead and done the endoscopy and has detected a lesion near the antrum of the stomach which they suspect as GIST( Gastrointestinal stromal tumour), well it may be a possibility , yes but has to be confirmed by accidental reports. But the lesion is not because of pregnancy per se and likely to be present before the pregnancy was established. If there were no symptoms before pregnancy with regards to vomiting and pain , it is unlikely that present symptoms are because of the lesion. So firstly, the nausea and vomiting has to be controlled. Increased stomach acid production is also a feature in 1st trimester if the woman is unable to eat something due to nausea and keep empty stomach, which acts in a vicious cycle and causes increased gastric acid production which irritates not just the gastric mucousa but also the ulcer like lesion in the antrum causing pain. Gaviscon is an antacid and can be taken twice a day. But TAB DOXINATE should be started with immediate effect thrice a day for a week to control nausea and vomit. Then further treatment can be decided based on the biopsy report. If the report is GIST,then the lesion has to be removed surgically and can be done endoscopically in experienced hand. But if its a gastric ulcer then it has to be managed conservatively through out pregnancy. I hope i have answered your query in detail, Wishing her safe pregnancy, Regards