Barrett's Oesophagus
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NeilC
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Quote NeilC Replybullet Topic: Another newbie to the forum
    Posted: 02†Mar†2009 at 9:45pm

Hi, Im new to this so i just thought Iíd write and say hi and let you know a bit about myself

 

Iíve recently been diagnosed with Barretts (confirmed in January) and have gone through what many others have mentioned in previous posts about researching everything that can be found on the web and then thinking the worst is going to happen.

 

I did this for a good two / three weeks and really got myself worked up about it, (did I mention that I suffer from Anxiety aswell) and to be fair it still scares the living daylights out of me but Iím sort of coming to accept it based on some of the words of encouragement given out by many on this forum.

 

My diagnosis was sort of stumbled upon almost by accident. I donít think that I suffer from any of the Ďnormalí symptoms mentioned in that I donít get heartburn, I get the odd bout of indigestion (but doesnít everyone) and I live a pretty normal life. I do however have IBS which Iíve lived with for 20 years (Im currently 37). Iíve since found out that one of the associated symptoms of IBS is GERD which I had no idea about until I read about it via wikipedia

 

When my Doctor confirmed that I did in fact have Barretts I was told to watch what I eat.....but I donít know what to watch out for as I donít feel that I have all the necessary symptoms that goes with Ďacid refluxí. Iíll obviously steer clear from spicy foods which I can understand. Iíve been told by 1 doctor that I can drink alcohol, but another said leave off it for a few months until the medication (Iím on 30mg Lansoprazole) starts to kick in. Iíve also started to eat early in the evening and also to started to sleep with 3 pillows to raise my head (not got round to actually raising the bed head yet). Whatís more frustrating is that Ive had to find this out all for myself as my Doctor never mentioned it at all. My doctor just said it was a nuisance that Iíd have to live with...

 

So, Im here and living with barretts. My only real side effectís at the minute are that I get a dry mouth / lips which does become annoying especially at bed time and I do have trouble staying asleep.

 

So questions to throw out to the forum:

 

1)      Should I be asking my Doctors to be referred to see a Consultant to discuss my barretts and discuss any options open up to me. As it stands Ive just been told to go for another endoscopy in a yearís time.

2)      What foods should I try to avoid or reduce? Ive started to eat smaller portions of food as per the recommendations.

3)      What are peopleís thoughts on drinking alcohol? Ive not been told to stop at all but I will reduce my intake.

4)      What are peopleís thoughts on drinking fizzy drinks, Tea, Coffee? Can I continue to drink these or again, should I watch what I drink.

5)      My Barretts segment is 2cm long. Is this long in the grand scheme of things. Should I expect this to continue to grow or should it stay at this level as Im now on these PPIís.

6)      Has anyone got any other Ďlifestyleí changes that I should consider.

 

Iíll try not to make any further posts as long and boring as this one if I do have any more questions. Which I suspect I will......and Im so glad that Ive found this forum Smile

 

Cheers

 
Neil
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chrisrob
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Quote chrisrob Replybullet Posted: 03†Mar†2009 at 8:14am
Hi Neil,

Glad you found us. Hope we can be of help.

There is much confusion as to what we can eat or drink and it's really down to experimentation. In my case that was easy as I used to get horrendous heartburn and oesophagitis but I guess if you have "silent reflux" you don't have that indicator.
I personally have a small glass of wine a day with my meal. I feel it helps me digest it. The PPi (I'm on omeprazole although I have been on lansoprazole) reduces acid but, perhaps we need a little boost as we eat? But see the post: "Barrett's and wine".
Fizzy drinks? I personally find I manage slightly sparkling drinks better than still ones. (Although I only sip small amounts and usually with food.) Still ones always reflux on me whereas sparkling ones just make me burp. I know they're usually frowned upon but in a recent paper from the top GI surgeon in my area, he says what I've thought - that it can help with dysphagia (where food sticks in the gullet); it seeps past the obstruction lubricating it and can cause you to burp to release gas from the stomach.

When you had your endoscopy, was the follow up with a GI nurse or consultant or your GP? I'm fortunate in having an excellent GI nurse though am not scheduled to see him until my next endoscopy in two years time. Your GP ought to be able to discuss options with you to some extent but could refer you if you pushed. The main options are lifestyle, drugs and surgery.
Lifestyle: Lose weight (if you're overweight). Stop smoking (if you do). Reduce alcohol. Eat small meals slowly. Eat a few hours before going to bed. No movements (eg lifting) that constrict the abdomen after eating.
Drugs: You're on a PPi and many people have been on them for many years.
Surgery: Two types - Fundoplication to prevent reflux and radio ablation therapy to remove damaged cells.

Barrett's doesn't normally develop quickly. At your next endoscopy, you'll find out if it's growing or shrinking. If the underlying cause (acid attacking the oesophagus) is removed, it is possible Barrett's can slowly heal itself apparently.

Don't worry about long questions. We try to help answer all concerns the best we can. You'll usually find someone here who has been through the same as you're going through who may be able to offer help from their own experience.

Chris

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NeilC
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Quote NeilC Replybullet Posted: 04†Mar†2009 at 6:00pm
Hi Chris,
 
Many thanks for the comments.
 
1) Following the endoscopy Ive had no interaction with a consultant or anything. If im being perfectly honest, Ive had little support from my Doctors. Other than to say that I have got Barretts and to try and watch what I eat. Ive not been told of any of the options open to me. However is this because my segment is only 2cm long and I guess that as Ive not been told there were any issues with the biopsies that were taken they arent going to give it much cause for concern...
 
2) The Surgery that you mentioned. Is the Fundoplication only carried out on poeple that are suffering quite badly with their symptoms. Given that I have relativley no symptoms Im guessing that I dont stand a chance of getting anything carried out. Additionally, Im guessing that they wont 'remove' the barretts via the Abalation therapy unless things start to progress.
 
3) Is it really possible that Barretts can shrink? wow......and also, you state that Barretts doesnt 'grow' quickly, therefore Im assuming that my Barretts has been growing for a long time...would this be months or years...any thoughts
 
4) Thanks for the 'Lifestyle' tips....Im there with most of them (I dont think Im overweight but according to my Wii fit it says IamSmile). However since Ive found out about this condition the changes in my diet and drinking habits (I do like (did) the odd pint or two) Ive lost half a stone and Ive never smoked so im ok there...I'll just have to keep on going.
 
Anyway, Thanks for you help once again.
 
Cheers
 
Neil
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susan333
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Quote susan333 Replybullet Posted: 04†Mar†2009 at 7:04pm
HI
LIKE YOU I DONT GET TYPICAL SYMPTOMS, NEVER HAD HEARTBURN, BUT SOMETIMES HAVE A HOARSE VOICE, WHICH WILL NOT CLEAR BY COUGHING, AND IS JUST ANNOYING. I GET VERY SLIGHT TWINGES IN MY CHEST, WHICH CANNOT EVEN BE DESCRIBED AS PAIN. HOWEVER, DESPITE RESEARCHING SINCE BEING DIAGNOSED A YEAR AGO, I DIDNT KNOW THERE WAS A CONNECTION WITH IBS. THIS IS INTERESTING TO FIND OUT, AS ALTHOUGH I DONT GET IBS NOW, I HAD IT FOR SEVERAL YEARS ABOUT 7 YEARS AGO. NOW MY DIET IS BETTER, DUE TO EATING MORE HEALTHILY, I DONT GET THE SYMPTOMS OF IBS, WHICH WERE TEN TIMES WORSE THAN MY SYMPTOMS OF BARRETTS. AS MANY MENTION ON THIS SITE, WE ARE THE LUCKY ONES. WE WILL BE MONITORED FOR ANY CHANGES.
I FIND THAT CHOCOLATE IS MY WORST ENEMY, BUT AS MY SYMPTOMS ARE SO MILD I FIND THAT I STILL EAT IT IN SMALL AMOUNTS, BUT DO WORRY THAT IT MIGHT MAKE THE BARRETTS WORSE. ITS A MATTER OF STRIKING A BALANCE REALLY. WHEN I WAS FIRST DIAGNOSED I LOST A STONE IN WEIGHT JUST BECAUSE I WAS FRIGHTENED TO EAT TOO MUCH. HOWEVER, MY APPETITE HAS RETURNED, BUT I FIND THAT I DID NOT PUT ANY WEIGHT BACK ON. AS I WAS ONLY 9 STONE AND AM NOW 8 STONE, I WOULD LIKE TO PUT A LITTLE BACK ON, BUT CANNOT SEEM TO MANAGE MORE THAN AN EXTRA POUND OR TWO.
BEST WISHES
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juju
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Quote juju Replybullet Posted: 05†Mar†2009 at 10:05am
hi i'm trying to find out more about barretts i got diagnosed with it only yesterday!!!!! and i'm worried and confused i'm only 28 and she said that she hasn't seen anyone my age with it like i have!!! she told me that its 37cm and there are also small islands above that and took three biopsies and that i've got to go back once a year to have it checked and i also have a hiatus hernia i don't really know where to start to look to find out information! i have suffered from heartburn since i was 15 but i just got on with it i couldn't eat most fruit i couldn't  drink coffeei kept asking my doctor about the heartburn and just got given gavaston and other things  i've never been over weight i feel ill alot of the time after eating and many times i'm sick i don't sleep well at night and go though 20 rennies a night and thats not counting the day i was given OMEPRAZOLE but it didn't work!! thats when my doctor decided to refer me i have two children and i'm always lethargic or not well and its hard on them because i can be moody sometimes  if anyone can help please thanxConfused

Edited by juju - 05†Mar†2009 at 10:32am
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chrisrob
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Quote chrisrob Replybullet Posted: 05†Mar†2009 at 10:41am
Hi Julie,
Welcome. Hope we can be of help.
The oesophagus (food pipe) runs through a hole in the diaphragm to the stomach. With a hiatus hernia (which is quite common), some of the stomach has been pulled up through that hole. This means the sphincter (valve) at the base of the oesophagus can't do its job properly and some of the acid from the stomach can reflux back up it. Whereas the stomach is lined to protect it from acid erosion, the gullet isn't. Acid attacking the gullet can cause heartburn and oesophagitis (inflammation). To protect itself, some of the cells of the oesophagus van mutate (dysplasia) to form a coating similar to that in the stomach. Unfortunately they may not know when to stop. Low grade dysplasia can become high grade dysplasia and this in turn can become cancerous in some cases.
Unless you're very tall, 37 cm sounds longer than your oesophagus. 3.7 cm would be considered quite large. But it isn't so much the length that's important as the grade of dysplasia.
Having found this, you will be monitored regularly to look for signs of degradation. If it becomes high grade, surgical intervention will be offered to prevent cancer developing.
Your condition will be managed by drugs. You will probably have been put on Omeprazole (or Lasoprazole or Pantoprazole or Esomeprasole or another new one I can't remember the name of). This is a proton pump inhibitor (PPi). It works by restricting the ducts that supply acid to the stomach. Many people have used these for many years and you may have to take them for life. However, since they have only been around for about 20 years, longer term usage studies don't exist. Large doses for many years can provide their own problems.
The other solution to preventing excess acid from refluxing and damaging the oesophagus, is surgery whereby the hiatus hernia would be pulled back down and a constriction formed at the bottom of the oesophagus to replicate the poor functioning sphincter.
Once the acid flow has been dealt with, the Barrett's cells can, rarely, start to slowly fall away. However they are better dealt with by "ablation therapy" whereby the cells can be destroyed via an endoscope.
So those are the present options and a drug regime may be all that is required / desired by you.

Now you have found us, please feel free to fire all the questions you like. There are many of us in the same boat and hopefully we'll put your mind at ease and be able to offer the help and advice you need.

Chris
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mikeg
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Quote mikeg Replybullet Posted: 05†Mar†2009 at 7:59pm

Hello Julie,

 

ChrisRob has provided some excellent info.

 

Also it is quite a shock to be told about Barrettís and it is quite difficult to initially deal with the anxiety.  It is very easy for everyone to say that you should not worry but hopefully you will find out more information that will put you at ease.

 

The most important point is that having Barretís does not mean that you will automatically get cancer.  This is one of the mysteries about Barrets that the medical profession are trying to understand.

 

Here is a link to an article that says ďSome studies demonstrate that the overall survival of patients with Barrett's esophagus is no different than that of the general population..."  http://easydiagnosis.com/secondopinions/newsletter25.htm

 

Most people with Barretts die from something else, so it does not make sense to worry about Barretts.

 

I can understand it can be very difficult having to deal with this and also looking after your children.  Prehaps you will be given PPIs like Chrisrob has said as these for most people are more effective than 20 Rennies.  

 

I am sure that you are searching the internet to find as much information as you can!

 

Finally you are in a better position now that the medical proffesion know about your condition there are lots of people who do not even know and these are the people who are at most at risk.

 

Hope this helps

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jcombs99
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Quote jcombs99 Replybullet Posted: 12†Mar†2009 at 8:08pm
NeilC

   Whats counts is the grade of DYSPLASIA you have , IF you have it . You have a short segment under 3cm ,I had a long one 8cm.I had HGD ( high grade dysplasia )and was told for 6 weeks that I may have cancer .SO CHECK ON YOUR GRADE THATS WHAT COUNTS .   

Edited by jcombs99 - 12†Mar†2009 at 8:56pm
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