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GI questions?

About 2.5 yrs ago, all of a sudden had stomach pain and burping out of nowhere. To this day still, I have a burning stomach (not as bad as initially) and burping continues feeling like gas gets stuck in the chest area sometimes comes up easy and sometimes I get anxious and it takes a bit of moving around & relaxing to come up. The initial H pylori breath test negative, but often wondered if it was some other bacteria that I got called helicobacter heilmannii since I have cats and a dog and I pick up the poop/scoop the kitty litter. Finally, got EGD done a couple of weeks ago and just trying to make sense of the findings (attached pathology/biopsy findings and letter from the doctor who did the endoscopy).

- Can heliobacter infections other than H pylori be seen on the H&E stain of gastric biopsy? Would helicobacter heilmannii that can cause chronic gastritis to be seen on the routine H&E stain or does it require different staining or procedure to be seen?
- Distal esophageal biopsy showed squamous mucosa with chronic inflammation and increased intraepithelial eosinophils (up to 80 to 100 eosinophils per high power field). No columnar-type mucosa identified. Is that a super high number of eosinophils? Do I need to be super concerned with that high number of eosinophils? Mid esophagus showed focally up to 6 eosinophils per high power field.
- I'm not currently on any PPI but took a trial many months ago that didn't do much if anything for the burping.

Female | 37 years old
Medications: none
Conditions: congenital left ear deafness

1 Answer

A typical stomach biopsy cannot distinguish between species of Helicobacter, but heilmanii is quite rare in humans.
The esophageal biopsy has a large number of eosinophils so this probably is diagnostic of EoE or eosinophilic esophagitis. This should be treated by your GI doctor upon follow up.