Dr. Chia's stomach biopsy

[green52]

Hi,

So I had my initial appointment with Dr. Chia back in April, and I just got the results back from his testing of my stomach biopsies:

http://imgur.com/UxsI7Vm

I'm just a bit confused about how much stock to put in all this. The fact that he found enteroviruses in 20% of controls seems a bit high to me, I wonder if it's really the cause of my symptoms or the product of something else?

Also, he wants me to go on Equilibrant. Has that ever gotten anyone to a permanent remission?

 

[halcyon]

So I had my initial appointment with Dr. Chia back in April, and I just got the results back from his testing of my stomach biopsies:

Looks like yours was actually a colon biopsy not stomach. I don't believe he has looked at many control samples of colon tissue.

I'm just a bit confused about how much stock to put in all this. The fact that he found enteroviruses in 20% of controls seems a bit high to me, I wonder if it's really the cause of my symptoms or the product of something else?

It's not unexpected. Enteroviruses are constantly circulating and many people are totally asymptomatic while infected. Finding them in controls is definitely normal, but he finds them in like 82% of CFS patients so there is a significant difference there.

Did he order any serology tests to look at which enterovirus you might be infected with?

Also, he wants me to go on Equilibrant. Has that ever gotten anyone to a permanent remission?

His son has. I'm sure there are others. I wouldn't get your hopes up for a remission but it has definitely helped me improve. Did he want to try any other treatments along with it, such as inosine or an antiviral drug?

 

[green52]

@halcyon I was confused by the fact that it said "colon" as well, but I'm thinking that might be a mistake as these were biopsies from an endoscopy where they only looked at the esophagus and stomach.

As far as the serology tests, I had a bunch done which were all negative, but he said those can't test for all of them.

I'm still just very confused

 

[Hip]

@halcyon I was confused by the fact that it said "colon" as well, but I'm thinking that might be a mistake as these were biopsies from an endoscopy where they only looked at the esophagus and stomach.

If the gastroenterologist stuck the endoscope down your throat (as opposed to up your rectum), it cannot be a colon sample. Perhaps the gastroenterologist made a mistake, and put down "colon" by accident.

My understanding is that Dr Chia's lab requests gastroenterologists take a sample of the inflamed areas of the antrum of the stomach (this is what it says on the request form for Dr Chia's VP1 immunoperoxidase stain).

Also, he wants me to go on Equilibrant. Has that ever gotten anyone to a permanent remission?

It has indeed, especially males; although Dr Chia finds 50% of his patients do not respond to oxymatrine.

There is a transcript of one of Dr Chia's videos on oxymatrine treatment in this post. You can see the image at the end of that post which shows the significant reduction in viral infection of the stomach tissues after oxymatrine treatment.

As far as the serology tests, I had a bunch done which were all negative, but he said those can't test for all of them.

The enteroviruses associated with ME/CFS are coxsackievirus B and echovirus. There are 6 types of CVB, and 32 types of EV.

The ARUP Lab blood tests that Dr Chia uses can detect all 6 CVB, but the ARUP Lab test for echovirus only detects 5 out of the 32 EV types.

The stomach biopsy works by a different method, and detects enteroviruses by their VP1 protein, which is common to all these enteroviruses. So the stomach biopsy method has a wider scope, and is also more sensitive than the blood tests. The disadvantage with the stomach biopsy method is that it cannot tell you which type of enterovirus you have.

I wonder if it's really the cause of my symptoms or the product of something else?

It is not possible to know for sure. There are a number pathogens associated with ME/CFS, including enteroviruses, Epstein-Barr virus, HHV-6, cytomegalovirus, parvovirus B19, and some bacteria such as Chlamydia pneumoniae.

If you have ME/CFS symptoms, and your tests show that you have a chronic active infection with one or more of these pathogens, then that suggests the pathogen(s) may be causing your ME/CFS, and so you may then want to treat that infection with antivirals, antibiotics or immunomodulators.

If you had herpes infections such as Epstein-Barr virus or HHV-6, then the antiviral Valcyte might be considered, and studies show Valcyte can be effective. In the case of enterovirus, there are very few antiviral treatments, and oxymatrine is one of the only effective options.



There are also many other general treatments that can help your ME/CFS. Some of these are listed here:

Chronic Fatigue Syndrome — A Roadmap For Testing And Treatment

 

[green52]

Thank you for all the information!

One other thing that confuses me if the fact that I don't have PEM. In fact, the only times I feel good or normal is when I excercise. And I've been very vigilant, I don't have any crashes even into the next week. It's just that usually I feel so, so awful I can't bring myself to excercise

 

[halcyon]

@halcyon I was confused by the fact that it said "colon" as well, but I'm thinking that might be a mistake as these were biopsies from an endoscopy where they only looked at the esophagus and stomach.

I'm not a pathologist but the tissue looks like colon epithelium more than stomach tissue to me.

Usually the staining in stomach tissue is more diffuse as you can see above, while with the colon tissue usually the surface cells and the crypts are infected which looks exactly like on your report.

As far as the serology tests, I had a bunch done which were all negative, but he said those can't test for all of them.

That's true, the serology can only show 11 out of over 70 serotypes.

 

[halcyon]

One other thing that confuses me if the fact that I don't have PEM. In fact, the only times I feel good or normal is when I excercise. And I've been very vigilant, I don't have any crashes even into the next week. It's just that usually I feel so, so awful I can't bring myself to excercise

Have you had EBV serology done?

 

[green52]

I'm not a pathologist but the tissue looks like colon epithelium more than stomach tissue to me.

View attachment 16047

Usually the staining in stomach tissue is more diffuse as you can see above, while with the colon tissue usually the surface cells and the crypts are infected which looks exactly like on your report.


That's true, the serology can only show 11 out of over 70 serotypes.

Interesting, so is it more or less significant that this is a colon cell versus a stomach cell?

 

[green52]

Have you had EBV serology done?

I have, and it was negative

 

[halcyon]

Interesting, so is it more or less significant that this is a colon cell versus a stomach cell?

Well I would wonder how Chia's lab got a hold of your colon tissue if you only had an upper endoscopy first of all. Perhaps there was a sample mix up at your pathology lab or Chia's lab. Have you ever had a colonoscopy?

 

[halcyon]

I have, and it was negative

What are your main symptoms and which CFS or ME criteria do you fit into, if any?

 

[green52]

What are your main symptoms and which CFS or ME criteria do you fit into, if any?

I have pretty intense fatigue, GI pain, bloating, loose stools, sore throat, and blood tests showing both autoimmunity and immune deficiency

 

[green52]

Well I would wonder how Chia's lab got a hold of your colon tissue if you only had an upper endoscopy first of all. Perhaps there was a sample mix up at your pathology lab or Chia's lab. Have you ever had a colonoscopy?

Yea, I actually had a colonoscopy during the same time I had the endoscopy, but I was very clear about what was to be sent. Of course there could have been some confusion. Is it less important that there was an enterovirus found in my colon as opposed to my stomach? Maybe they are there in many normal people? Or maybe just not enough is known about that.

 

[Hip]

I actually had a colonoscopy during the same time I had the endoscopy

A colonoscopy is an endoscopy. An endoscopy simply means you use an endoscope.

 

[green52]

A colonoscopy is an endoscopy. An endoscopy simply means you use an endoscope.

Well I had cameras down my throat and up my rectum at the same time

 

[Hip]

Well I had cameras down my throat and up my rectum at the same time

As if street CCTV surveillance is not enough invasion of privacy these days!

 

[Jonathan Edwards]

Yea, I actually had a colonoscopy during the same time I had the endoscopy, but I was very clear about what was to be sent. Of course there could have been some confusion. Is it less important that there was an enterovirus found in my colon as opposed to my stomach? Maybe they are there in many normal people? Or maybe just not enough is known about that.

I don't think there is really any solid information on this. As far as I know these are not tests of generally recognised value. Having spent several years working with immunostaining of this sort I would be concerned about staining patterns in areas like this, which are often due to non-specific binding. I personally don't think I would base any clinical decisions on these findings.

 

[halcyon]

I don't think there is really any solid information on this. As far as I know these are not tests of generally recognised value. Having spent several years working with immunostaining of this sort I would be concerned about staining patterns in areas like this, which are often due to non-specific binding. I personally don't think I would base any clinical decisions on these findings.

This has already been brought up and verified by several parties including Dr. Chia. As far as I understand, the 5D8/1 antibody is very likely to only be reacting to enterovirus VP1, especially in stomach tissue. The same tissue samples stain positive for dsRNA with J2 antibody and lysates of the tissue can infect mice.

http://www.ncbi.nlm.nih.gov/pubmed/24190581
http://file.scirp.org.sci-hub.cc/pdf/OJGas_2015040916050357.pdf

 

[halcyon]

Yea, I actually had a colonoscopy during the same time I had the endoscopy, but I was very clear about what was to be sent. Of course there could have been some confusion. Is it less important that there was an enterovirus found in my colon as opposed to my stomach? Maybe they are there in many normal people? Or maybe just not enough is known about that.

The pathology lab probably just sent the wrong tissue samples then.

There is no test that will show with certainty that an enterovirus infection is the exact cause of your symptoms. Some healthy people will have an infection in their GI tract as well and will be asymptomatic. Dr. Chia does believe there is an association between chronic infection and chronic GI symptoms though. I will say that Equilibrant considerably cleared up my GI symptoms. It may be worth trying out to see if it helps you.

Did the pathology report from the gastroenterologist show anything interesting?

 

[green52]

The pathology lab probably just sent the wrong tissue samples then.

There is no test that will show with certainty that an enterovirus infection is the exact cause of your symptoms. Some healthy people will have an infection in their GI tract as well and will be asymptomatic. Dr. Chia does believe there is an association between chronic infection and chronic GI symptoms though. I will say that Equilibrant considerably cleared up my GI symptoms. It may be worth trying out to see if it helps you.

Did the pathology report from the gastroenterologist show anything interesting?

The pathology report was pretty normal. They found mile gastritis and esophagitis, but said that comes up on many, many people. I was actually able to improve my GI symptoms pretty considerably through other means. Did the Equilibrant not help at all with symptoms outside the gut?