Awaiting biopsy results for diagnosis with questions.

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Hi all,

I'm a 37 yo male, non-smoker, non-drinker, coffee addict who is a non-symptomatic celiac and I recently had a followup endoscopy (six years after celiac diagnosis) to see how things looked. I was coming off of propofol when speaking to my doctor and will be following up in 1-2 weeks for biopsy results. They confirmed I have a medium-sized hiatal hernia (knew this) and had salmon-colored mucosa suspicious for short-segment (about 1cm) Barrett's esophagus.  

Other than having a friend with a diagnosis, I knew next to nothing.  My present understanding is Barrett's esophagus is an unlikely but possible side effect of GERD, which I knew I had, and in most cases does not progress to esophageal cancer, but they do repeat endoscopies to check for dysplasia and precancerous cells and advise you to make lifestyle choices and take PPIs and all that good stuff if you in fact have it.

My question is, I am assuming my biopsy results will either confirm Barrett's esophagus or not, and will confirm dysplasia or not if I have it at all? Is there the possibility it's already become cancerous, if I had it, or is that something that would have already been identified on the CT, blood labs, etc.  Do they tend to lean one way or another on the dysplasia front depending on how much damage they see on the endoscope?  Could this really be anything else but Barrett's esophagus and is the biopsy uncertainly just on how progressed it is?

I appreciate the feedback, now that I'm fully awake again!  smile

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  • Posted

    Actually, Barrett's does develop from severe and/or long term GERD. It used to be diagnosed mostly in middle aged people, mostly men, but that's not as true as it used to be.

    If you have Barrett's, it's unlikely that it would have already become cancerous, especially if the doctor wasn't even able to say 100% for sure that it's Barrett's, just by looking. Cancer would be diagnosed from biopsies done during the endoscopy. Dysplasia is ranked according to how close to precancerous it is, but I don't remember the details.

    Definitely follow the doctor's advice and don't neglect regular endoscopies. If the Barrett's does happen to turn cancerous at some point in the future, routine scans will increase the chance that it will be found at a very early stage when it can be dealt with fairly easily.

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    • Posted

      Thanks Becky!  

      I've never had classic GERD symptoms or experience much heartburn.  I was popping too many meds a few years ago during a bad flu/pneumonia combo and vomited blood.  They found the GERD scoping me to make sure I was alright, but it's never been much of a factor in my day to day life.  This was a second scope for celiac status, so I hadn't been expecting the news and was out of it when they were explaining post-procedure.

      It occurred to me today that perhaps they're testing it for cancer, or alternatively, like you said, if that was something that was more visually clear to them.  

      It's my understanding then that GERD is not incredibly common (1 in 5), BE is uncommon in people with GERD, and cancer from BE is significantly uncommon. 

      I suspect a lot of things are like you say.  I could have had this for fifty more years without problems, but get to worry about it now because we find these things so early.

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    • Posted

      Well, I suggest that you don't worry about it, but don't get lax in getting the scopes. My Barrett's did actually become cancerous (after 30 years) but it was found very early in a routine scan. I'm lucky that it could be dealt with swiftly and my life expectancy isn't really any shorter than it would have been before the cancer was found.

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