Esophageal Dysmotility May Have Caused My Barrett's. Can I Improve It?

Posted , 4 users are following.

Hopefully, I'm in the right forum for this. Apologies if not. First time posting. Sorry for the long note. And apologies for accidentally also posting in the Reflux Esophagitis area. 


I've been dealing with GERD for almost 20 years. I am 38 now. For 10 of those years, I've been on PPI's, mostly Esomeprazole (Nexium). In that time I've had 4 endoscopies:

- My first endoscopy, 10 years ago, revealed mild esophageal inflammation. I also had gallbladder dyskinesia. My gallbladder was subsequently removed. After removal, I was off PPI for about a year because no symptoms. GERD symptoms came back. 

- My second revealed mild eosinophilic esophagitis (EoE), with an hpf of 18. I was started on budesonide and kept on Nexium. 

- My third revealed the EoE was well controlled, but now I had an "Irregular Z-line." This was not biopsied, as in the US, standard procedure is to not biopsy the irregular z-line. 

- My fourth -- which I pursued as a consequence of getting a workup for fundoplication -- showed the irregular z-line again. This was biopsied and showed goblet cells. I'm now scheduled for a scope in a year, and scopes every 3 years thereafter. 

The z-line's tongues, it seems, extends only to about .5cm in my case. 

As part of the surgical workup, I also had an esophageal manometry test done, and a 24hr pH impedance.

- The esophageal manometry revealed that my esophagus was failing 60% of the time. 

- The 24hr pH impedance test revealed that I had the normal number of reflux events and esophageal acid exposure. My DeMeester score was around 4. However, my bolus clearance time was a little slow. 

The suspicion is that my Barrett's was caused by my esophagus's inability to clear acid during regurgitation. Indeed, I can feel stuff "sticking" there after meals. Warm water tends to help this some. 

It should also be noted that within the past 10 years, I've lost almost 120lbs (52.43kg). I was quite corpulent in my youth. I am 6'0" tall (183cm) and currently weigh 210lbs (95.25kg). I still have some to lose, particularly in the gut, but that's moving along -- mostly because I'm afraid of eating: every meal brings reflux. Every meal, in my mind, brings me one step closer to cancer. And it's all I can think about now. 


Is there ANY way to improve esophageal clearance, or to improve esophageal motility?

I've read that warm water helps, so I've started drinking warm water with meals and after, and it has indeed helped. 

Unfortunately, I've also read that impaired motility is more associated with not just the development of Barrett's, but with dysplastic changes. I realize the odds are low, especially given my length of Barrett's, but to say that this is like a dark cloud hanging over me would be an understatement. 

So while I've been told "there's nothing we can do", I refuse to accept that. There must be something. I just don't know what. And thus I come to you.  

Thank you for reading, and thank you in advance. 

0 likes, 6 replies

6 Replies

  • Posted

    Do you have a Hiatus Hernia?

    Keep losing weight - that's you best hope of curing the reflux.


    • Posted

      I have a 1cm Hiatal Hernia. It was initially spotted when I was 18, then never seen again (even on barium swallows) until my most recent endoscopy. Apparently, it doesn't misbehave all that often. 

      As for weight loss, thanks, although according to one surgeon, a person should start to feel a difference after about 25lbs. I'm about 95lbs past that so while there have been some improvements, I doubt I'll ever be rid of my reflux. But every little bit counts, so I'll continue the weight loss. My goal is to be at least at 205lb by year's end. 

  • Posted

    Can you please elaborate more on PPIs. How long have you been on them exactly, any sides, which brand, are you on them daily, have you experience any nutrient downsides (magnesium, calcium, iron)? Thanx in advance. I'm 26 and also on PPIs.

    • Posted

      I’ve been on them for about 10 years, daily. This is as exact as I can get. Omeprazole (as Zegerid, 40mg) and Esomeprazole (as Nexium, 20-80mg depending on need at the time) being the most used. Currently on Aciphex, as the Nexium stopped working. I did take a break for about a year, as noted above. 

      To help with additional symptoms, I also use Gaviscon Advance and US Gaviscon. 

      I have had no nutritional issues, due to these or otherwise, at least none that has shown up in any blood work, which has been at the very least annual. 

    • Posted

      I will add a piece of advice: PPI’s aren’t magic pills. Follow a GERD diet religiously. Pretend the PPI doesn’t exist. Take it anyway. Hopefully this will help you avoid progression. 
  • Posted

    Hi. I can totally understand your worry. Just diagnosed with barretts. Waiting confirmation on biopsy. i had an clear endoscopy at the end of Jan. " all clear". Prescribed nexium since then for Gerd. I am 41. Really worried about my acid reflux so went back for another endoscopy and voila....barretts. i am completely gutted. Seems like the end of the world to me. The worst thing about it all is that I cant stop the heartburn. The worry and stress seem to make it worse. Going to try and solve it naturally as these ppi are dangerous and not working whatsoever. I am nearly starting to think that they are part of the cause.

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