Barrett's Oesophagus
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Quote chrisrob Replybullet Posted: 27 Mar 2019 at 4:17pm
Hi Irish & welcome to the forum.

Most people haven't heard of Barrett's before they're diagnosed but there could be as many as 3 million in UK with it, though only 100,000 diagnosed.
Although it requires reflux of acid to trigger the formation of the protective cells, about 40% report never having experienced the pain of heartburn. We don't really know why but one theory is it has something to do with oestrogen providing a protection - which would make sense as women will be prone to reflux during pregnancy. (And the majority of those who say they've never felt the acid reflux, are women.)

Trigger foods are very subjective and "banned foods" lists propagate mythology which has been largely superceded.
We know so much more about acid reflux now. Previously, everyone immediately assumed it was the food (and acidity thereof) that caused acid reflux. Doctors compiled lists of what patients said bothered them. These lists have proliferated (and lined the pockets of many selling acid reduction diet books).

The acidity of the stomach is controlled and regulated by acetylcholine, histamine and simatostatin as described here.
Even the most acidic of foods won't make the stomach more acidic and alkaline drinks won't reduce the acidity either.
When people say a certain food causes them heartburn, it's not that food that's at fault but how it interacts with any existing inflammation:
Pour lemon juice over the back of your hand and it just feels wet. However, if you have scaring from a burn and pour lemon juice over it, it will burn.
Strong stomach acid refluxing can cause scaring to the lower oesophagus ( = oesophagitis). Lemon juice passing over this may produce a burning sensation, but it's not the lemon juice that caused the problem.

The other myth is that acid causes reflux. Reflux is caused by a malfunctioning lower oesophageal sphincter, most frequently occasioned by a hiatus hernia, as described here. Acid suppressant medication (eg omeprazole) will reduce the stomach's ability to make acid and therefore make any reflux less damaging. However, medication does not reduce the reflux itself which has to be managed by lifestyle or surgery.

So. Bottom Line. Only avoid foods that you find affect you. How we eat is more important than what we eat when it comes to reflux.

There is a small risk that Barrett's cells may mutate to cancer but those of us diagnosed are the lucky ones. The acid suppressant medication reduces that risk and regular surveillance scopes every few years will check it's behaving itself. If any dysplastic changes towards possible development of cancer are ever seen, we can have it ablated to obviate that risk.

Lastly, be very careful how you use Dr Google. There are far too many charlatans and snake-oil salesmen out there. The Barrett's UK directory has links to all Barrett's specific support groups in UK and links to reputable sources of information.
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Quote Guests Replybullet Posted: 27 Mar 2019 at 5:58pm
Chrisrob - thank you for that post, it is very helpful. My husband is still at the stage of being told “probable” Barrett’s so we still don’t know exactly what we are dealing with. But ever since the word was mentioned and I googled it, I’ve been keeping a food diary for my husband and it’s been really frustrating as the only trigger so far has been tomato (which he is soo ragin about as he does like baked beans, and pizza occasionally!) His daily fluid intake rarely strays from fizzy juice and milk and neither of these cause him problems. Curry/spicy foods cause him no bother either. He has been told he has a hiatus hernia, and I do wonder if he has had this from birth, as we met as teenagers and he had been suffering from heartburn already. He is carrying weight now and so I think this is the main thing we need to work on, rather than eliminating food from a very fussy eater if the “bad” foods aren’t actually causing triggers.

Edited by WorriedWife1983 - 27 Mar 2019 at 5:59pm
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Quote nasdaq Replybullet Posted: 29 Apr 2019 at 8:34am
Nearly same situation ... doesn´t matter which food I eat - I feel no regurgitation nor heartburn. I have 3-4 controlled burps after a meal and sometimes clearing my throat. But those symptoms disappear after max. 20min. and are very low - fellow man don´t realize this.
My cough which leads me to a GI last year also disappeared (Short Barrett, about 3cm HH - 20mg PPI).

"My Problem" is that I don´t feel anything pain or symptoms that I can find out which food trigger my reflux... I can eat all and have no problems.
(The only thing which I take serious is no alkohol, raising my head when I sleep and eat no meal 4-5 hours before sleep).

This is my dilemma - I don´t know how I can find the right way managing my Barrett/Reflux.
Yes - I like to have two cups of coffee over a day or have a chocolate or eating a steak - I can do this without getting problem - but I have always a guilty conscience doing that - also not a good situation.

Maybe somebody experience the same situation or can give me an advice.

Best Michael

Edited by nasdaq - 29 Apr 2019 at 8:35am
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