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Gastroscopy Fail!

Printed From: Barrett's Support Forum
Category: Barrett's Support Forum
Forum Name: Barrett's Oesophagus
Forum Discription: Your Questions about Barrett's Oesophagus
Printed Date: 11 Jul 2020 at 9:16pm

Topic: Gastroscopy Fail!
Posted By: BobBelcher
Subject: Gastroscopy Fail!
Date Posted: 05 Feb 2020 at 9:38am
Has anyone ever been told after a gastroscopy that their Barrett's and dysplasia has "disappeared"?
Was diagnosed with Barrett's 5 years ago by a reliable endo department but then changed areas and had the worse experience of my life by an arrogant endo nurse who seemed to have decided in advance that I didn't have Barrett's and didn't even bother to take a biopsy. Angry that I went through that horrible experience for no good reason.
My GORD has barely been under control these past five years.
I can't find any cases online where Barrett's has miraculously been cured of it's own accord.
Have you?

Posted By: chrisrob
Date Posted: 06 Feb 2020 at 10:13am
Hi Bob and welcome.

Barrett's does not disappear. If you had it in the first place, you still have it. It is the permanent addition of "armour plating" cells to the base of the oesophagus to protect against acid attack.

Were you previously diagnosed with Dysplasia? If so, you need to discuss management of this. Dysplasia is the initial mutation of Barrett's cells that can progress to cancer. Although the cancer risk is very small - about 1 in 400 per annum in UK, if dysplasia is seen it can be ablated (under NHS) to remove that risk.

I'm sorry you had a bad experience with your recent endoscopy. You are entitled to request a referral for a second opinion.
Good endoscopists can readily identify visually likely areas of Barrett's. They are typically salmon pink colouration and found especially at the 3 o'clock position of the view down the endoscope. This identifies the area to be biopsied. However, if no suspect area is identified visually, there's nothing to guide where biopsies should be taken. Barrett's is then confirmed (or otherwise) by histopathology.

There are reasons why a subsequent scope fails to find Barrett's.
      1. The initial diagnosis was wrong. This happens. Because the suspect area is close to the z-line, where the oesophagus meets the stomach, it is easy for a biopsy to be taken on the stomach side where the cells are columnar shaped like Barrett's cells.
      2. New mucosal tissue can grow over the Barrett's, hiding it.

If you are still getting acid reflux symptoms, you will still have oesophagitis. (Barrett's has no symptoms.) You will need to continue taking PPI medication - I assume you're on omeprazole or lansoprazole? You will also need to manage reflux with - lifestyle modification . PPIs reduce acid not reflux - they just make it less damaging.

If you are still concerned, discuss with your GP about having another referral.

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