1. Community
  2. Gut, bowel and stomach
  3. Barrett's Oesophagus

Has my Barrett's increased?

Posted , 5 users are following.

Barretts
Barretts

A recent study showed 20 years on most patients' Barrett's segment lengths remained the same as at initial diagnosis.

Thus it was with some confidence I approached my surveillance gastroscopy yesterday that my 3cm circumferential band of non-dysplastic Barrett's would show no changes.

Awake throughout the rather longer than usual procedure (unfortunately sedation has no effect on me), I listened to the doctor call out the distances to her recording nurse as she took 20 biopsies and realised this was longer than 3 cm.

"8 centimtres", she confirmed when I asked her afterwards. ""Full circumference lower down and patchy higher up."

I was astounded. With my Nissen fundoplication years ago and the Collis-Nissen revision last year reducing reflux, I hadn't expected that.

It took my wife to unravel the blindingly obvious.

"Doesn't the Collis procedure lengthen your oesophagus?"

"Yes."

"And what constitutes that increased length?"

Of course. The extended oesophagus is lined with gastric cells. And the length of that extension? - About 5 cm.

The biopsies for the bottom 5 cm will show gastric cells which, depending on histopathology, may be interpreted as gastric metaplasia but not intestinal metaplasia.

I feel sure my previous 3 cm of non-dysplastic Barrett's remains unchanged but has 5 cm of stomach cells lining the extended oesophagus below.

1 like, 7 replies

7 Replies

  • andyr0
    andyr0 Barretts

    Posted

    Well worked out, but I guess with your wide range of knowledge you were able to do this. Had a read of your ' Down with Acid ' website and it is excellent, in layman's terms, and gives much more information than any consultant has ever given me. The mucous coming up the throat, rhinitis, dry eye, dodgy ears all rings true for me but never explained by any medic. They should read this as well to learn a thing or two, particularly the nurses that carry out endoscopies. Many of them have very little knowledge of the disease.
    • Barretts
      Barretts andyr0

      Posted

      Thanks Andy.

      The regional patient support charity I chair (Barrett's Wessex) has 2 of our (Southampton) gastroenterologist consultants amonst its trustees. They have indicated the Down With Acid book is something they would like to be able to give all their patients. (They already give them our charity's contact details when newly diagnosed.)

      The national consortium of charities working to promote earlier diagnosis of oesophageal cancer, Action Against Heartburn, has produced a GP training module through BMJ from which they may gain CPD points but we are trying to increase awareness nationally and the other participant charities like the book. Just hope to get it finished and published in the next month or so and looking for possible grant to pay for the printing of first 500 copies (£2,500).

  • rex_44766
    rex_44766 Barretts

    Posted

    Congratulations on your brilliant labour of love so far on your website. I just wish that the poor old doctors got more than the miserly 18 hours on the importance of nutrition they get at med school. Something you might loke to think about adding is using a fitness bracelet to monitor your sleep activity. I put a post up tonight on the Alternative section. It really works and I'm amazed that my lovely wife get it all to work! Anyway - again congratulations. You can get a real buzz from helping people. I do talks on prostate for frightened guys at motorhome club meetings. The thanks you get make all the preparation so worth it.
    • Barretts
      Barretts rex_44766

      Posted

      Just returned from having a stall at a summer fete. (It's bank holiday here.)

      Although we made an insignificant amount of money, we did talk to a number of people who have Barrett's Oesophaus, including  GP (PCP in US as I'm guessing you are) who hadn't heard of it before he was diagnosed! And a nurse likewise.

      It was worth turning out in the rain this morning just for the contacts we made.

  • shaq26875
    shaq26875 Barretts

    Posted

    After suffernig from severe indigestion and feeling of trapped wind in my chest with pain radiating to my upper back for about a year with attacks increasing in frequency and lasting hours sometimes, I went to a gastroenterologist. After endoscopy was diagnosed with GERD and Barretts ..metaplasia cells and about 3cm in length. Prescribed PPI (Pariet) + Motilium+ Fixit + Duspatalin Retard ( cant remember generic names) + Gaviscon at bedtime and a wedge pillow for 4 months. The symptons subsided almost immediately ....Had another endoscopy and I was told Barretts reduced to insignificant length and I could stop taking the meds except Pariet as I have just started steroids and immune suppressants for suspected Sjogrens Syndrome (awaiting saliva gland biospy to confirm)  I needed to reduce the stomach acid ( also diagnosed with Pityriasis Rosea through a skin biospy and on prescription steroid cream) . i now seem to have the indigestion reaction to nuts I eat (almonds,macademia,brazil, cashews, pecans, peanuts) The gastro said I had become allergic to nuts and to stop eating them for 3 months. Incidentally  I never had heartburn ( though both daughters were born with hiatal hernias and 1 serious enough to under fundoplication surgery at the age of 2.) the Gastro said it was hereditary (I had GERD but not hiatus hernia) .It seems the PPI + other meds helped reverse my Barretts. My next endoscopy is in 1yrs time.
    • Barretts
      Barretts shaq26875

      Posted

      Hi,

      Glad you,ve managed to get your indigestion problems under control.

      Assuming your Barrett's was accurately diagnosed originally, it won't actually have diminished. Measurements are not very precise as they have to be estimated from marks on the outside of the gastroscope - usually at 2cm intervals, and the length may appear longer if the measurements are taken whilst the scope is being inserted than if taken during withdrawal (as the scope will tug slightly at the oesophagus). Barrett's often appears to have gone when in reality it may be hidden in corrugations of the mucosa or buried under a new epithelial growth. But non-dysplastic progression risk for microscopic incidence is almost neglible.

      Pariet (rabeprazole) is a good PPI to reduce acid production so if you do have more reflux, it's less likely to create more Barrett's cells.

      Motillium (domperidone) can help peristalsis.

      Duspatalin (mebeverine - also Colofac) is an anti spasmodic for the intestines and commonly prescribed to reduce symptoms of irritable bowel. (Sorry, I don't recognise "Fixit".)

      Patients with Sjogrens, frequently have Barrett's. The mucous production in the oeosophagus reduces the defense of the oesophagus against acid attack.

      Upto 40% of those who have Barrett's report never having experienced heartburn though they must have had acid and bile reflux to have initiated the metaplastic changes from squamous to columnar cells.

      Although there have been genes identified that provide susceptibility to GORD or Barrett's, being pedantic, it's not actually described as hereditary since that implies a certainty the condition will develop in offspring.

      Good luck and hope your problems have been resolved.

    • shaq26875
      shaq26875 Barretts

      Posted

      Thanks Barretts. ...I am now hpoing my 'burning' tongue sensation will also disppear soon..neither the Gastro nor ENT nor the rheumatologist have been able to tell me why I have this and since I stopped taking the other meds (except Pariet) the 'burning' is almost non stop (day and night)
Back to top

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.