Barrett's - but don't know the cause - help!
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Really hoping someone can help. My nearly 70 year old father has been diagnosed with barrett's (and a hiatus hernia) and he's having life-debilitating symptoms - terrible chest and back pain and shortness of breath. Up until this point he was strong and fit. But these symptoms over the past year or so have taken their toll - and he's a changed man. He has lost a lot of weight, is in constant discomfort and finds sleeping very difficult.
He has had a lot of tests. The doctor has diagnosed Barrett's but says the test don't prove that this is being caused by acid reflux.
We've ruled out achalasia (problem swallowing) - and my father's done a barium swallow - all fine, and when they tried to induce reflux by turning him almost upside down - nothing came back up.
He's starting to get very depressed as no one seems to be able to tell him definitively why he's getting these symptoms - yet the cells on his oesphagus have been changing - hence the barrett's diagnosis.
Can anyone shed some light - please.
He's been on PPIs - which seem to have minimal impact - and has tried changing his diet - smaller meals etc - but nothing seems to make a real change to his symptoms. The shortness of breath in particular is really worrying him.
Thank you.
0 likes, 6 replies
m17579 greengrass2017
Posted
First off.......I feel your frustration.
Secondly, the barium swallow test is not the gold standard in determining swallowing problems. I had 3 barium swallow tests, and all three were negative.
Your father needs a 24 hr ph test, this will determine reflux. The other test he needs is a motility test, they put a thin probe up the nose, down the throat and have you drink very salty apple juice in a quick progression. This is the gold standard for determing swallowing problems. Unless you have the "classic" achalisia symptoms, your not going to see the "birds beak" presentation on a barium test. And from the sounds of it, I dont think your dad is suffering from Achalsia. My opinion.
I have nut-cracker esophagus, it doesnt show up on barium tests. And when your dad says he has "terrible pain" in his chest and back - thats exactly what i go through on a daily basis.
Achlasia is not the only esophageal problem, there is nut-cracker esophagus and diffuse esophageal spasms.
Let me tell you, when my nut cracker esophagus is acting up- it feels as though I am having a heart attack in my chest - and being kicked in the back at the same time, its terrible. I have botox injected into the lower esophageal sphincter to reduce attacks, and reduce pain. Other medications given for this are: calcium channel blockers and nitro glycerin spray.
I definately think your dad needs more investigation.
I think nut cracker esophagus, and diffuse esophageal spasms get the back seat when they are investigating - beleive me, they can make your life misreble on a daily basis.
m17579 greengrass2017
Posted
m17579 greengrass2017
Posted
Barretts greengrass2017
Posted
Hi, I'm a nearly 70 year old man and have known I have Barrett's for at least 23 years. I sympathise with your dad's plight.
Most of us with Barrett's have a hiatus hernia, that usually is the reason for the reflux that he will have had that originally caused his Barrett's - whether or not they can detect the reflux now. And the PPIs will have minimised any acid. (See the attached graphic which describes the genesis of Barrett's. )
Barrett's can take 20 years to develop and, being asymptomatic, is ofetn not noticed.
?It's difficult to provide a diagnosis not knowing his particular medical history but despite the findings of the tests, the chest and back pains can be attributable to acid reflux and it's the shortness of breath could be attributable to aspiration of extra-oesophageal reflux.
The tests your father has received are not necessarily the final evidence. He does need to have further investigation. He may be producng acid or reflux at times outside the parameters of the tests he's received. A 24hr pH manometry or a 48hr Bravo test will ascertain whether any excess acid does reflux over a sufficient period to know.
Guest Barretts
Posted
You say that Barrett's takes 20 years to develop, then how did I get it at 19 years of age, after experiencing acid reflux for 6 months? After 6 months I went for an endoscopy and they found Barrett’s under the microscope which wasn't seen with the endoscope. I have no family history of gastrointestinal diseases and am healthy young man with no other issues other than hiatal hernia, gastritis, GERD and Barrett’s. Still getting this at 19 is really rare I believe. I do experience daily heartburn from the age of 19 because of excessive burping which is caused by my hiatal hernia I believe. I burp more than 100x times a day especially when I change the position of my body.
shellj greengrass2017
Posted