Barrett's Oesophagus
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Yaya
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Quote Yaya Replybullet Posted: 06†Jun†2019 at 1:21pm


Hi Jeff

Im the mother of a 19 years old daughter with 1 cm of barrett and wouldlike to find a surgeon in USA to eradicate it! By any chance do you know a surgeon in USA? Thank you so much for your help!

Yaya
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chrisrob
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Quote chrisrob Replybullet Posted: 08†Jun†2019 at 4:18pm
Hi Yaya,

I can't tell you anything about surgeons in US. However, I am concerned about your view of eradicating Barrett's.

Barrett's is the addition of acid protective cells to the lower oesophagus. Think of it as armour plating, if you like, or consider it as a friend as in this story.

There is a very small risk it may mutate to cancer (about 1 in 1000 each year in US but the risk actually decreases the longer you've had it). That's why those with Barrett's are recommended to take PPI medication daily, as it reduces that risk, and to have regular surveillance scopes every few years.

Your daughter is young and, being female, not the usual demographic but it's quite possible to live a normal life with this condition and not having to think of it. I know I've had my own Barrett's at least 25 years and probably much longer and will probably still have it when I die - of something unrelated.

If she experiences reflux symptoms, she may need to adopt some lifestyle modification as described here.
Apart from that, food and drink should not cause any problems - though if she has some oesophagitis, it may be irritated by certain foods which she can avoid whilst it heals.

P.S. 1cm Barrett's is really very small. Some doctors won't classify anything less than 1 cm.

If she were to have the Barrett's ablated, there is a high possibility of it reforming. She would still need to remain on PPI medication and have regular surveillance.


Edited by chrisrob - 08†Jun†2019 at 4:20pm
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Yaya
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Quote Yaya Replybullet Posted: 08†Jun†2019 at 5:04pm
Hi Chris,

Thank you so much for your answer!
I ve forgotten to tell you that my daughter has a small hernia hiatal around 3 cm ! Im wandering what do you think about the surgery ( fundo, stretta, linx, tif, ...) because she doesnít want to take PPI ( 20 mg per day omeprazol and gaviscon )all her life with the side effects and because she is so young!
Thanks again and have a great weekend
Best Regards

Yaya
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chrisrob
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Quote chrisrob Replybullet Posted: 09†Jun†2019 at 10:08am
Most, if not all, of us with Barrett's have a hiatus hernia, it is the usual reason the lower oesophageal sphincter doesn't work properly and permitted the reflux of acid and bile that contributed to the development of the Barrett's cells, as described here.

There are various reflux reduction surgeries, described in this section of the Down With Acid encyclopaedia, she may have but why would you or she wish to go through that unnecessarily?

All surgery carries risks that may, in your daughter's case, outweigh any benefits.
Laparoscopic Nissen Fundoplication (LNF) is the gold standard of anti-reflux treatments. I, myself, have had this twice. For me it was the best thing I ever did but that was because my problems were reflux causing chronic cough (with coughing fits lasting 2 hours until I practically passed out).

Although heavily promoted, I, personally, would not recommend Linx. It would not permanently manage the hiatus hernia, make surveillance scoping more difficult and can erode the oesophagus.
Stretta is, at best, a temporary stop gap - if it works. I haven't yet met anyone for whom this was an effective treatment. Even the manufacturers, Mederi, confessed to me it is not a log term solution.
TIF and MUSE have failed to prove themselves over long term.

Anti-reflux surgery will not remove Barrett's. LNF has been shown to probably reduce any risk of progression towards cancer as much as PPIs. However, with your daughter the age she is, it would not be recommended as it is likely she would need it redone at some stage.

Although I have had fundo, like many others, I do continue to take PPIs - now just 20mg omeprazole instead of the 80mg I was taking for years before the operation.

True side effects of PPIs are fairly insignificant. Some people may experience headaches, diarrhoea or constipation on one or other of them; if so, they should be able to find an alternative one that works. (See this section.)
If taking very high dose for a long period, there is a possibility induced hypochlorhydria may result in malabsorption of some minerals. If that is the case, as determined by blood tests, supplementation may be prescribed.

But there is much scare-mongering about other possible effects. Most of these are due to misreporting and confusion by the popular press between the terms causality and correlation. Studies supposedly showing a possible link between PPI usage and serious health issues are retrospective correlations and in most cases, subsequent investigatory research have disproved and causal link. (eg People with kidney problems may be more likely to take PPIs. They did not cause the problems.)

Read this chapter in the Down With Acid encyclopaedia for the actual findings of research: Controversy over long term PPI medication.
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Yaya
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Quote Yaya Replybullet Posted: 09†Jun†2019 at 12:44pm
Hi Chris,
Thank you so much for your answer ! I appreciate your help!
Sorry but l have a another question. My daughter complains often to have some pain on her left arm and chest and l donít know if it can be her heart , hernia hiatial or the vagus nerf. Do you have experience if this can of symptomes?
Thank you so much again and have a great sunday

Best Regards

Yaya
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chrisrob
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Quote chrisrob Replybullet Posted: 09†Jun†2019 at 1:53pm
Could be referred via vagus nerve but better to have it checked out by a doctor.
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Yaya
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Quote Yaya Replybullet Posted: 09†Jun†2019 at 6:02pm
Hi Chris,
Thank you so much! I will see the doctor!
Also by any chance do you know if there is a barrett forum in USA?
Have a great sunday

Yaya
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chrisrob
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Quote chrisrob Replybullet Posted: 09†Jun†2019 at 10:17pm
This is probably the oldest forum specific to Barrett's Oesophagus in UK but with members from all over the world.
There jave been other attempts that have failed but Facebook seems to be taking over instead.

There is the Facebook group @Barrett's Esophagus Awarenesswhich has nearly 5000 members from all over the world, a majority of them from USA, which you may wish to join?
I can sign you up, or just apply.

All the best
Chris
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Yaya
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Quote Yaya Replybullet Posted: 09†Jun†2019 at 10:34pm
Hi Chris
Thank you so much! Yes if you can sign me up it will be so kind. I love your forum but it is just to finf more people not to far.
Have a great night
Yaya
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