How do concerned should I be?
Posted , 7 users are following.
Hello! I have written on here a few times and it has been a great help!! Back in July of 2016 I had a endoscopy due to regurgitation issues. The GI doc took biopsies for susipicion of Barretts because of a salmon colored tongue that was a maximum of 1cm. The biopsy results came back as negative for specialized columnar cells (intestinal metaplasia goblet cells). Just recently been to a specialist for a second opinion and he said I have a irregular z line and that I did not need to be on ppis because I have no pain or symptoms of heartburn. Also said no diet restrictions, that I could have coffee and alcohol. Also said no followup endoscooy needed. This is a specialist in the field of Barretts. He said I am a woman in my 30s and under weight and is not worried. However I've done a ton of research on Barretts and my concern is the USA vs UK definition of Barretts. I am in the USA and wonder if I would have a diagnosis of Barretts if I was in the UK and therefore be monitored. How concerned should I be diet and medication wise and how proactive on getting further endoscopies.
0 likes, 14 replies
ajoy16607
Posted
Also wondering how often a "irregular z line" that has no goblet cells progresses to Barretts esophagus with goblet cells??
Guest ajoy16607
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ajoy16607 Guest
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Robert_Emmet ajoy16607
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Irregular z lines often test false-positive for Barrett's since some of the columnar cells are displaced. They are taken for biopsy and mistaken for Barretts. If your physician is a specialist in this area then he/she takes special precautions not to pass over the squamous epithelium. BE is an obvious and clear change and your physician would note that if it was present. I wouldn't worry.
ajoy16607 Robert_Emmet
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Barretts ajoy16607
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It doesn't sound as if you've anything to be worried about.
The difference between US & UK definitions of Barrett's are, in US there has to be Intestinal metaplasia (characterised by "goblet cell" ) whereas in UK, gastric metaplasia may also be counted as Barrett's. Both are columnar cells. With an irreguar z-line, it is quite easy to biopsy on the stomach side and find normal gastric cells whch may be mistakenly thought to be GM.
Are you still getting acid or reflux problems? If not, PPIs are unnecessary. Also, unless you identify any specific trigger foods, nothing needs to be banned (as far as causing acid or reflux is concerned anyway! ) .
ajoy16607 Barretts
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Hello! Thanks for your reply! I'm not sure if histology showed columnar cells, gastric metaplasia, my pathology report just says no specialized columnar cells or intestinal metaplasia. So I guess I need to find that out. Also I don't ever feel a acid burn but do still have burping and hiccups EVERY time i eat and a feeling that food wants to come up but I can control it with drinking water / breathing. My doctor mentioned possible remunination. In this case would taking a PPI give me protection if acid is coming up with the burps and hiccups and I just can't feel it?? I am trying to prevent whatever I have from progressing.
ajoy16607
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Barretts ajoy16607
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If your scope didn't show obvious signs of inflammation from erosive oesophagitis, nor permanent cellular damage, unless you get the relfux every day, you can probably mange without PPIs.
It does sound as if you can manage the symptoms by how you eat.
ajoy16607 Barretts
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Barretts ajoy16607
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if you find you are still having problems in a few years, ask for another endoscopy.
For a 1cm tongue, if it was Barrett's, advice is usually not to bother. See the attached graphic. It is from British Guidelines but the same as for US, AUS and EU.
ajoy16607 Barretts
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Guest ajoy16607
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dhimi29434 ajoy16607
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I couldn't agree more. Thank you barretts wessex n all the members of this forum.