Dear you all,

Two years ago I (37M) started to have tarry stools. Endoscopy confirmed two benign bleeding ulcers. Multiple autopsies were found to be “normal” as well as H. Pylori negative. I should mentioned that I have not taken NSAID or aspirin for over two years now. He was always consistently asking me if I was absolutely sure, which I am, I mean I know what I take. After three endoscopy sessions in fall of 2021 and consistently taking PPI esomeprazole (80 mg per day) it was obvious that the ulcers were not going away although they had somewhat gotten smaller. A CT scan without/without contrast of the abdominal region showed nothing noteworthy. I was put on 40 mg/day esomeprazole permanently. In summer of 2022, I still had persisent ulcer again biopsy showed no malignancy and again negative for H pylori. Futhermore, I had bloodwork taken measuring fasting gastrin levels to rule out Ellison-Zollinger disease, thw gastrin levels were normal. In the end of the year 2022 I went again for endoscopy and still same story. No malignancy and H pylori negative, there were still persistent small ulcers. This summer I went yet again for endoscopy for routinely checup, and again same story. Next for me is ultrasound endoscopy to look better on the lining of the upper digestive system but I dont know exactly the reason. My doctor seems confused and has no other answers than idiopathic gastric ulcer. Given these facts:

• Chronic stomach ulcers (I dont know the cause), no H pylori and no indication of cancer.
• I still to this day take 40 mg esomeprazole.
• I dont have much symptoms
• Not Ellison zollinger syndrome
• HOWEVER, I do have psoriasis ( could that be and factor?) and chronic gingitivitis.
• Otherwise healthy, in reasonable weight, I workout 3x a week, I drink little alcohol and I have a stable family life with good work/life balance. I dont smoke.
• I dont take NSAID or aspirin and havent done that for over two years.

Do any of you have any clue?