Hiatus Hernia

Hiatus hernia is very common in the population. In most people it causes litlle or no problem but for those of us prone to frequent reflux, it's a common culprit. Some of the stomach has been pushed up (herniated) though the hiatis hole in the diaphragm the oesophagus passes through. But it is just where the muscles that form the Lower Oesophageal Sphincter reside.

The hernia can impede the normal function of the LOS eeacerbating reflux.

Reflux of acid frequently will remove the mucosal layer and cause scarring and inflammation to the oesophagus (oesophagitis). Lansoprazole will reduce the acid so reflux will be less damaging.

If bile refluxes along with the acid, the sub-mucosa or structure of the oesophagus may be compromised.

Barrett's Oesophagus is the body's way of defending itself from attack.

I liken the cells lining the oesophagus to dominoes lying on a table. Barrett's replaces these with "columnar" cells which are like dominoes standing on end - providing a smaller surface area for attack and moving the pain receptors further away from the surface.

But Barrett's is a bit like a mischievous friend that cannot be trusted.

The columnar cells are permanent and cannot be cured or go away by themselves (although they can be removed by ablation). For the vast majority of us with Barrett's we'll ahve it all our life and learn to accept it and forget about it. I've had my 3cm Barrett's for at least 21 years unchanged and expect to have it until I die of something totally unrelated.

But there is  the possibility that the columnar cells can mutate through stages of dysplasia to oesophageal cancer.

If they do find Barrett's, you'll take your lansoprazole for life and receive regular surveillance every few yeasr to check no dysplasia is seen. If it is, you'll be offered ablation to completely remove your Barrett's cells to minimise any risk of progression to cancer.

If you want to learn more, look for DownWithAcid org uk a FREE book I've nearly finished compiling or Google "Barrett's Wessex", the chairty I co-founded and chair.

Hi I was just reading your post and you said your endoscopy was horrendous' may I ask why? I'm scheduled to have one next week and am so scared, and might cancel. Don't know if I even really need it. So any information would be appreciated.

thank you