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Dysplasia - I'm confused

Printed From: Barrett's Support Forum
Category: Barrett's Support Forum
Forum Name: Barrett's Campaign Website
Forum Discription: This is for ideas for the Website
URL: http://www.barrettscampaign.org.uk/forum//forum_posts.asp?TID=1384
Printed Date: 20áSepá2020 at 4:08pm


Topic: Dysplasia - I'm confused
Posted By: Barb
Subject: Dysplasia - I'm confused
Date Posted: 01áJulá2014 at 10:53pm
If dysplasia means that cells lining the oesophagus have changed, surely everyone with Barrett's has dysplasia? My notes don't use the word but say 'non-circular Barrett's epithelium'. I am assuming I have dysplasia. But I only have to have checks every 2 yrs.
I feel quite weepy when I start reading around the topic and wondering what the outcome will be. And if I'll have to put up with the bad guts forever. (Thanks Chris for advice on that btw). I'll phone the clinic and see if I can talk to someone and find out more. But part of me wants to stick my head in the sand and try to ignore it.
BTW I very rarely get any heartburn these days, almost never. I guess the Lanzoprazole sees to that. I have read that Barrett's reduces sensitivity to reflux tho'.
I'd be grateful for info re dysplasia, tho I am frightened of what you'll tell me.



Replies:
Posted By: jcombs99
Date Posted: 02áJulá2014 at 3:50am
Yes your a Newbie no you don't have Dysplasia or the Doc would've TOAD you so LEARN what you have(just barretts)..Keep away from the Tower Bridge..
What your thinking is a common mistake so learn don't
panic.
Send a copy of your report to Chris and he will explain it to you.

Been There

HGD Jeff


Posted By: chrisrob
Date Posted: 02áJulá2014 at 8:37am
Hi again Barb,

The normal oesophagus of a healthy person has a lining made up of squamous tissue - pink and slippery made of cells lying on top of one another. Under attack from acid it will become inflamed (esophagitis).
Now add bile with the ability to dissolve animal fats and the lining (epithelium) of the oesophagus is under attack.

To protect itself, the cells mutate (metaplasia). This is the "normal" Barrett's that looks salmon pink down an endoscope. Think of it as the cells standing on end (like the Giant's Causeway) to provide a smaller surface area for attack. And the pain receptors are deeper inside the cells so are less likely to feel the acid burn.

This is the condition which most people who develop Barrett's live with for the rest of their lives.
So you may even think of Barrett's as a helpful friend but one that cannot be trusted. (There is a risk of it progressing to cancer of about 0.3% at this point.)

If you keep bathing the metaplastic cells with acid and bile, it may continue to mutate. (Even the slabs of the Giant's Causeway get eroded slowly.) Further mutation changes the cells again to Low Grade Dysplasia (LGD). Think of it as a few of the upright cells having toppled over and are leaning against one another. (There is a risk of it progressing to cancer of about 1% at this point.)

Further progression (High Grade Dysplasia) is the next step if progression is permitted to continue. This is where all the cells have "fallen over". (The risk of progression to cancer is now about 6%.)

IF progression continues, the next stage is neoplasia from which progression to Oesophageal AdenoCarcinoma (OAC) or cancer is inevitable.

The development of Barrett's and its progression relies principally on 3 elements: reflux, acid and bile (plus susceptibility risk factors). Removing any one of these elements reduces the risk. The easiest element to tackle is the acid. PPIs are the most effective way of doing this.

A couple of years ago, consultant Phil Boger delivered a really clearly explained talk about Barrett's which is reproduced https://sites.google.com/site/barrettswessex/JOURNEY - on these pages. If you have 20 minutes to spare, following "the Journey" will provide a useful primer for anyone new to this.

All the best

Chris

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http://www.barrettswessex.org.uk - www.barrettswessex.org.uk



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