Couple of odd questions for Barretts/anyone...

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Hi,

I could put up with my symptoms if I had to - the only thing I'm intrested in is preventing Barrett's or worse. So...

1) I believe that it requires acid AND bile to cause Barrett's and OC? Shouldn't we focus on a diet that would cause little or no bile to be produced, or is that totally impractical?

2) Sucralfate (Carafate) sounds like it would be good for preventing Barrett's and OC. Has this ever been studied?

Thanks

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  • Posted

    Bile plays some very important fundtions in digestion but is not usually required north of the pyloric sphincter. It backflows into the stomach if/when neded. It was William Beaumont who discovered this in 1833.

    A diet that is low in fats will reduce the possibility of bile entering the stomach (but some fats are required in a normal diet). So we cannot guarantee to keep all bile out of the stomach.

    As you say, it requires reflux into the oesophagus from the stomach of acid and bile to cause the development of Barrett's Oesophagus. There are no effective drugs to reduce bile but there are effective drugs to reduce the acid.

    Sucralfate does form a protective extra lining in the stomach to defend the gastric mucosa from acid hyper-secretion. However, it does not remain long enough within the oesophagus as the peristalsis and gravity help the mucous produced there to wash it down into the stomach. Gaviscon acts similarly and, whether it is stickier or a different density, may stay a little longer, whilst also floating on top of the stomach contents like a blanket to help contain reflux.

    But to reduce risk of developing Barrett's, at least one of the elements of reflux, acid, bile needs to be kept in check.

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    • Posted

      Thanks for the very quick response, and the for the very informative answers. I guess I'll keep taking the PPI's!
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  • Posted

    Not actually sucralfate but a study on Gaviscon (sponsored by its manufacturers) from 2011 concluded; "In a general practice setting for patients complaining of moderate heartburn, Gaviscon® (4 × 10 mL/day) is an effective short-term treatment option in mild-to-moderate GERD, in terms of onset of a first 24-h heartburn-free period after initial dosing. It proved non-inferior to omeprazole 20 mg/day, and is thus a relevant and effective alternative treatment in case of moderate and episodic symptoms of GERD as managed in general practice."

    (Note the careful wording.)

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  • Posted

    I don't know if I mentioned this or not. But along with Sucralfate I also take one Dexilant 60mg before bed. Dexilant helps reduce the acid your stomach produces. Whereas Sucralfate coats the stomach and asist in preventing the acid from cominig back up. 
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