Trying to understand endoscopy and pathology results.
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Hello. I recently decided to go to a GI specialist because for the past 8-10 years I have experienced regurgitation of food after eating large meals. This never caused any pain or burning, it was just gross and embarrassing. It also only happened occasionaly so I just kept dismissing that this was something to really worry about. Well my GI doc ordered a endoscopy and I was shocked, laying in recovery, to hear that he found one tongue of salmon-colored mucosa was present at 39cm that was a maximum longitudinal extent of 1cm in length. He said he took biopsies because of mucosa suspicious for short - segment Barrett's esophagus. Well lets just say my world was rocked. My doctor gave me a prescription for Protonix and said well it looks like you have reflux and well see what pathology report says. I went home and researched everything and anything I could find on GERD and Barrett's esophagus. My head is spinning with all the different information I am finding. And I had convinced myself I had Barretts Esophagus due to the way the salmon colored mucosa looked on the endoscopy picture. My pathology report came back and my prayers had been answered. My doctor said I have mild gastritis and mild esophagitis, no Barrett's. I was relieved and so happy. I requested for a copy of my pathology report and it reads.....Fragments of esophago - gastric junction mucosa with chronic inflammation and reactive changes. Specialized Columnar Intestinal Epithelium (Goblet Cell Metaplasia) , which is neccessary for the diagnosis of Barrett's Esophagus, is not identified. No dysplasia or Malignancy identified. Alcian Blue Pas Stains confirm the absence of specialized columnar epithelium and fungal organisms. All controls stain appropriatley. The question I have now is what exactly are the Reactive Changes mentioned on my result. Does this mean that the next step is for the tissue to eventually change into Goblet Cells?? My doctor said nothing about a followup endoscopy, but it worries me not to followup. Also how strict should I be about diet. I dont experience heartburn but since having the endoscopy and paying close attention to my body, I have noticed I burp and hiccup alot after eating anything or drinking even water. Also i have extra phlegm that causes me to clear my throat. I am currently taking Protonix 40mg once a day, have raised the head of my bed 4" , dont eat 3 hours before bed and am a pretty healthy eater.I have started eating more frequent smaller portions and have not had regurgittation since. I am in great physical shape and am very petite and under weight if anything. Since I dont feel heartburn it is hard to know what my triggers are when it comes to food. I love coffee and drinking red wine and having a beer or 2 when out with friends. But I am terrified of this spot developing into something more. I am only 33 years old and have 3 young daughters. I know this post is long but want to be proactive and try to get some answers. I have been very anxious since my endoscopy and this spot that was seen is always in the back of my mind. If anyone has any advise I would greatly appreciate it!!!!!
0 likes, 11 replies
mike1954 ajoy16607
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ajoy16607 mike1954
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Thank You so much for your response! It was very comforting!!
And really eased my mind!
Barretts ajoy16607
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Sounds like a good report.
No Barrett's. The colouration was mild inflammation.
It was a warning call and you are taking appropriate action.
Don't worry about strict diets. Unless you identify any particular foods that cause problems, you don't need to omit it from your diet - but eat carefully, upright and small amounts so as not to overill your stomach.
ajoy16607 Barretts
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ajoy16607 Barretts
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ajoy16607 Barretts
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Barretts ajoy16607
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It sounds as if the endoscopist has biopsied the suspect area and the pathologist has found nothing to report.
Of course, it is possible any Barrett's cells were missed but probably not; the red colouration was probably just due to oesophagitis.
See the page on "Biopsies" in the Tests & Diagnosis section of the www DownWithAcid org uk book.
If you do develop Barrett's, it's not really anything to worry about. It is your body's defence against it digestng itself. It's very unlikely to progress but if you are worried, or if Barrett's is diagnosed, you can have another surveillance scope in a year or two to make sure all's well. If you were to be one of the few unlucky ones to develop Barrett's and then have it mutate, they would see it at a dysplastic stage when it is possible to ablate it to prevent it becoming cancerous.
ajoy16607 Barretts
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Thanks again so much for your advice!! My doctor has now scheduled me for a barium swallow test since I expressed to him that I still have burping and hiccups after meals and a pressure that feels like food is going to come back up but doesn't. My question is, is this test with barium safe. If the spot I have is Barretts or in fact esophagitis can the Barium irritate it or affect cells in anyway??
Barretts ajoy16607
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ajoy16607 Barretts
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Ok Great! Thanks so much
rodrigo2023 ajoy16607
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Salmon colored mucosa is not always barret's Esophagus. I had an upper endoscopy done January 13, 2023. They ran biopsies as standard procedure with ALL patients. They did Esophagus, Stomach, duodenum. Long story short, Doctor said everything went well, no ulcers found, no polyps, just stomach inflammation. He said he was not worried about cancer. He gave me a copy with pictures of my esophagus, where it showed an island of salmon colored mucosa. also showed other pictures of my stomach. My mistake was to go on google and search for salmon colored mucosa, and EVERYWHERE it said it was Barrett's Esophagus. It rocked my world as well when i read it was associated with cancer, plus I had no idea what Barret's esophagus was. After extensive research, I was convinced that I had Barrett's Esophagus. Nonetheless, when the biopsy results came in, i was healthy, no Barrett's, NOTHING. The biopsies did show I had H Pylori bacteria, which most likely caused my stomach inflammation. I travel the world for fun, so I must have caught the bacteria in some continent, considering that half the world population has this bacteria, most without symptoms.
In conclusion, the doctor told me that it is pretty common to find salmon colored mucosa in esophagus during endoscopy due to irritation, caused by GERD. Gastro doctor said it should go away over time, once irritation is gone and with proper diet. My lesson learned was NOT GOOGLE anything medically related as you unecessarily stress yourself out with wrong assumptions. Also please note that Barret's esophagus is something people should not worry about, as most people never develop cell changes, and only like .5% of people get diagnosed with cancer, caused by barrret's every year (doctor's words). number is super low, and those that unfortunately develop cancer is probably because they did not follow any diet, weak/compromised immune system, etc.
i had this endoscopy done by a top rated doctor in the USA, he was super knowledgeable. Doctor said A good way to prevent Barrett's esophagus is taking Omeprazole, and a good diet avoiding caffeine, alcohol, fried foods, fatty foods, citrics, mints, smoking, etc. I told him I do not want to take Omeprazole for the rest of my life haha so he suggested a good diet then. Hope this review helps other people freaking out about salmon colored mucosa, as I myself did not find anyone giving this type of information i just shared. Peace out everyone! exercise and stay healthy!