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JimmyJ
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Quote JimmyJ Replybullet Topic: Quite worried
    Posted: 14 Feb 2020 at 11:57am
Hello.I have been reading this site since I was diagnosed with Barrett's 2014 and have found it very informative.Have now joined though as I am looking for advice.I went for my 3rd endoscopy yesterday,(after the other two being ok),and they used acetic acid this time. This is what the report says :"1 area at 38 cm 1 o'clock slightly irregular on acetic acid 2.5% staining , otherwise unremarkable.I understand he has not been taking PPI and this looks inflamed ." The Doctor thought the irregularity was to do with the inflammation and said it wasn't cancer. He also put in the report that no follow up required and no further investigation proposed and to rescope in 4 years dependent on histology.I am worried that it still may be cancer or LGD/HGD . Does anyone know if acetic acid would show inflammation or if it could be anything else other than cancer LGD/HGD . I have started taking PPI's again today but am blaming myself if it does turn out to be something bad;(I didn't take the PPI's as I was worried about liver damage as I used to drink heavily.Have now stopped last couple of months but really feel in need of a drink now).Any advice please.Thankyou.
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chrisrob
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Quote chrisrob Replybullet Posted: 14 Feb 2020 at 2:48pm
Hi and welcome.

Acetic acid is just used to make it easier to spot areas of concern whilst scoping. (There are many tricks that are sometimes employed, like different coloured lighting etc).
It helped the endoscopist see an area he/she thought worth investigating - ie take biopsies.

There was some inflammation (oesophagitis) seen, which PPIs would have prevented but there were no other concerns. Histology of the biopsies will just show "normal" non-dysplastic Barrett's.

PPIs don't cause liver damage. Any reports they do, are wrong. See this chapter on Controversies over long term medication in the Down With Acid encyclopaedia.

No need to deprive yourself of a drink either - though binge drinking (quantity) isn't recommended. (See chapter on Alcohol in Down With Acid.
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JimmyJ
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Quote JimmyJ Replybullet Posted: 15 Feb 2020 at 11:11am
Thanks for the reply Chris and the links.Can I just ask you why you think the biopsies will come back normal though.I'm a bit worried that although it's looking inflamed it could still be dysplastic. I know it's not often that changes occur but they still do happen and that's the worry.The thought of waiting over 8 weeks for the results is a bit daunting to say the least!
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chrisrob
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Quote chrisrob Replybullet Posted: 15 Feb 2020 at 11:57am
Did they ever find dysplasia?

It's very unlikely Barrett's will mutate. For the vast majority of us it just sits there doing its job of protecting us against acid erosion.
The risk of it mutating is small; even in UK with worst progression figures in the world, in only 1 in 400 will it mutate.
A good endoscopist can usually tell the difference as shown in these images (courtesy of Medtronic):



Edited by chrisrob - 15 Feb 2020 at 12:02pm
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JimmyJ
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Quote JimmyJ Replybullet Posted: 15 Feb 2020 at 1:02pm
Thanks for replying Chris.They haven't found any dysplasia on the two previous scopes I had but I'm a bit concerned because I didn't take the PPI.I'm certainly doing that now.Thanks again for the information.
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