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JohnMc
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Quote JohnMc Replybullet Topic: another member of the BO club
    Posted: 13 Sep 2012 at 10:33am
Hi, I'm 45yo, live in Preston UK and was diagnosed with BO last Friday. I have a small hiatus hernia and have had indigestion / heartburn for possibly 20 years. Rennie's have been my best friend during that time but I now see they've been my worst enemy as they stopped me taking the problem to the doctor.

About me: I'm married and have two young kids aged 8 and 7. I work as an Adoption Social Worker.

I've just spoken with my GP. The hospital have asked if I want to be placed on the monitoring program, which I have confirmed.

The GP told me that the term c2m3 was used to refer to the Barrett's, the GP was unclear what that means, would anyone here have any idea?

I'm getting my head around the diagnosis but feel I need more info. C2M3 ? My GP couldn't tell me the length of the Barrett's cell changes, and I'm unclear what the biopsy results are? I'm usually pretty laid back but am taking this seriously and want to know more. Does the C2 M3 code tell me all I need to know.

In terms of diet big changes are needed, I eat all the wrong things and love a drink (my preference is to excess). I've kicked vodka into touch, but how safe is a few beers (bitter)? I may now have to start eating vegetables, but am happy to replace red meat with fish.

Overall it looks like some fundamental changes to my lifestyle are needed, fortunately I took up cycling at the beginning of this year, have lost 1 1/2 stone and am doing approx 100 miles per week at an average of 16mph, so I'm fitter than I've been for years.

I'm sure the above is all over the place but I suppose most if not all members of this forum will understand where I'm currently at.

Thanks for reading, and if anyone can offer advice re: c2m3, or suggest questions I need to be asking my doctors I'd be grateful.

Cheers all...

John

Edit:- C2M3 - finally found an article with accompanying diagram that shows the C2 means 2cm of complete coverage and M3 is 3cm of partial coverage. So 3cm of my oesophagus is damaged.



Edited by JohnMc - 13 Sep 2012 at 11:45am
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Sandra W
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Quote Sandra W Replybullet Posted: 02 Oct 2012 at 3:44pm
Hi John,
 
It's good you have found this site, and sorry you haven't had a reply yet.
 
You have asked about this C2M3, and it's a type of classification system for grading Barrett's, which gives circumferential and maximal measurements - it's basically how long the area is and how far around the oesophagus it is.  This link http://gut.bmj.com/content/60/Suppl_1/A178.1.abstract explains it properly and in detail. Do read it - next time you see your GP, you can give him training (LOL!).
 
As to diet, it makes sense to avoid any foods or drinks that you find make your symptoms worse - experiment and find what works best for you.  Other than that, make sure you have your regular scopes, follow you doctor's or consultants's advice as regards this and medication, keep checking this site and ask any questions either here or at your GP's or consultant's clinic.
 
Hope this helps, and don't forget you can google anything you're not sure about (sounds like your GP should try this, too!!!  Ha! Ha!).
 
Take care, all the best,
 
Sandra.
E-mail: swilliams888@hotmail.co.uk
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chrisrob
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Quote chrisrob Replybullet Posted: 03 Oct 2012 at 10:25am
Hi John,

Sorry not to have replied sooner. I've only just seen your post. I usually get notified of all new postings but for some reason many have gone past unreported recently.

Anyway, welcome to our forum and hopefully we'll be able to answer your questions between us.

Sandra has provided a good response which I hope has put your mind at ease.

Barrett's Oesophagus Campaign is working in a consortium with other charities under the banner "Action Against Heartburn" - before it's too late! to raise awareness - not only amongst the public but also with GPs, and are presently attempting to get funding for a BMJ accredited GP training module. - They can't be experts in all fields; the better ones know when to refer to those who are.

All the best

Chris
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JohnMc
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Quote JohnMc Replybullet Posted: 13 Oct 2012 at 7:21pm
thank you both for your replies...

The PPI's appear to be working well and I've had no heartburn / indigestion symptoms since I started taking them.

Dietary changes include... eating less, and trying to change my palette. I have a very immature range of foods I will eat... think kids eating chips and sausages and baulking at veg and fruit. My attitude has changed from viewing food solely as source of enjoyment and only eating what I really enjoy, to eating an increasing number of foods (especially fruit) for the benefits they give me.

I've been doing mad miles on my bike to help lose weight and am now 30lbs lighter than what I was 5 months ago, which is nice :) ...

I have my biopsy results on 30th October, I assume I would have had an earlier appointment if the news was going to be worse case scenario.

I will post my results after the appointment.

Once again, thanks for the replies, I hope I'll be in the position to help others in the future when they discover this place looking for support...

All the best to all on the forum...

John
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JohnMc
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Quote JohnMc Replybullet Posted: 30 Oct 2012 at 8:10pm
Finally had my biopsy results, and pleased to advise that there is no dysplasia. Booked in for another scope in two years time.
Have lost another stone since my first post in September and feeling really good. Lots of hard work put into the cycling and continued sensible diet.
I'd like to thank everyone involved in the forum, the information here is clear and not inaccessible medic gobbledegook. I'm sure lots of people have felt reassured and supported from their visits here.
Cheers all...

John
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chrisrob
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Quote chrisrob Replybullet Posted: 30 Oct 2012 at 10:18pm
Great news, John.
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Deano
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Quote Deano Replybullet Posted: 05 Dec 2012 at 12:10pm
Hello Chris,

I am new to this forum and noted your comments regarding RFA treatment. I was initially diagnosed with BO in 2005, aged 36, at my last re-scope July 2011 I have 2-3 small areas of BO, inflammed glandular mucosa with hiatus hernia, no dsyplasia.

I have researched cases in the US where patients without dsyplasia have been treated successfully with this method. I understand that in the UK this treatment isn't usually advocated until one progresses to HGD. At least under the NHS, I presume they may in a private practice?

However, do you know if it is possible to be treated with this method without dsyplasia, as I'd rather not have the Barretts at all, rather than go with the watch and wait as I am currently.

Regards
Dean
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chrisrob
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Quote chrisrob Replybullet Posted: 06 Dec 2012 at 9:49am
Hi Dean, welcome aboard.

You are right that NICE guidelines only recommend HALO RFA therapy for cases of HGD - though accepts its use for LGD in certain circumstances.

Covidien, who now produce and market the BARRX device, do say in some parts of US, RFA is used routinely at the first sign of Barrett's - but that does depend upon the patient's insurance.

The reasoning behind the NICE guidelines is that 99% of Barrett's patients will not develop cancer so the risks of undertaking the procedure are greater than leaving it alone. Indeed, as the percentage progression of metaplastic mutation through dysplastic stages is almost insignificant, the advisability of regular surveillance scoping is even being questioned. Except that it provides the patient with reassurance, it introduces risks each time it is performed.
Indeed, only a couple of days ago, the American College of Physicians published a paper advocating less scoping saying, "inappropriate use generates unnecessary costs and exposes patients to harms without improving outcomes." In UK the BOSS trial gives patients the option of receiving surveillance or not.

That said, HALO RFA may be obtained privately if that is your wish.
This page: www.barrettscampaign.org.uk/halo-system-location.html provides a list of doctors and contacts if you wish to investigate this further.

All the best

Chris
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Cropcircles
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Quote Cropcircles Replybullet Posted: 07 Jan 2013 at 12:11am
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Quote Cropcircles Replybullet Posted: 07 Jan 2013 at 12:13am
Hi chrisrob
Can you elaborate on the 99% of Barrett's patients will not get cancer please. I thought the that 90 - 95% didn't get it.
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