Progression Of Gerds to Cancer?

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Hi all. My name is Curtis. Im 42 and I live in the U.S.,South Carolina. My first post so wanted to say hello before I bring up my issues and questions.

I have had reflux probably about 18 years. First signs of it were lpr symptoms pretty much outside a stomach burn when I was first put on gerds meds back then. Was put on protonix 20 mg and worked like a charm. Probably took it about a year and for the longest time didnt need it and was symptom free for years outside occasional regurgitation or very mild heartburn which an over the counter antacid took care of. My issues however started to get chronic after needing to take nsaids for degenerative cervical disk pain. My gerds got bad while taking them to the point I switched to tylenol instead. But by that time the gerds was here to stay. Was put back on ppi which has been changed up several times the last two years because they help for a while but then stop. Well in the last month I developed the classic lpr symptoms again along with what has now become daily heartburn. Actually it seems to alternate. Some days its the lpr and some its the chest pain of heartburn. Never had a scope for gerds. But have been set up appointment with GI doc to discuss if one is needed. Emergency told me I had esophagitis. My doc now has me taking 40 mg protinix and 150 mg ranitadine at night before bed. Just started that last week. Stopped coffee,cut way back on colas until I can boot them also. Scared of scope findings. Not really the scoping it self. My question is this. What has been studied to determine length of time from gerds to cancer in the general population? Im seeing many people who have had gerds for 30 plus years and no cancer even though they may have esophagus issues. Hoping I fall in to that catergory of people.

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  • Posted

    Did want to mention by symptom free that was a pretty long span of time probably 10 years. Also the nsaid use stopped around 2013. Havent touched them since. But that was the start of this gerd situation up until now. The progression was fairly slow to this esophagitis. Just last week put on the 40 mg protinix and ranitadine at night. Have elevated my bed and began cutting out the diet offenders. Probably to eatly to tell much yet on those changes. Ive read it can take upwards of 8-12 weeks to heal from esophagitis reflux. So looks like I wont know much until after being scoped. I estimate about two months out on that based on time to get to see gi doc from my lower gi scope last year.
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  • Posted

    Sorry I don't know the full answer to your question. But I can tell you I had 5 clear endoscopies then the last one showed + for Barrett's. I knew if the acid continued to back up bad things were sure to happen. So I guess the question you should have is can you control the acid and if so, you should be okay. If not, medication, live style changes, diet changes and possibly surgery might be needed.
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    • Posted

      I intend on doing my best to control it with lifestyle changes,plus medicine the docs give me. Not sure what the end result will be but I will do my part. I dont drink or do any drugs,intend on dropping a few pounds to get closer to my prime bmi and watch what I consume. Im just afraid to much time has elapased. I never knew reflux was a danger. Never had doctors tell me it was. In fact they always treated it like a stubbed toe. I feel they were neglegtful in their actions. If I were to have known the dangers years ago I could have stayed on top of it.
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  • Posted

    Please stop worrying Curtis. The odds of cancer are very low and many of us here have Barretts. You have in my view worked out yourself what you have to do and it is of course change your lifestyle. Just as an aside the Nsaids are more likely to give you ulcer problems than throat. There are dozens of non nasty ways out there to reduce pain. BUT please oh please get an endo so you know what you are up against. I dont know but it sure sounds like simple gastritus has triggered your flare up. Remember you are NEVER alone here!
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    • Posted

      Thanks Rex. And I am scheduled to meet with gi doc on the 22nd if a slot is open. Either way I am going to push hard for the scope.
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  • Posted

    Progression from GERD to cancer, if it is going to happen, takes the following route:

    1. GERD

    2. Probably about 1 in 10 with GERD get Barrett's Oeosphagus. About 1 in 500 with non-dysplastic Barrett's per year will get cancer.

    3. Next stage, if progression occurs, is Low Grade Dysplasia. Risk of progression about 1% p.a. If diagnosed with Barrett's with dysplasia have it ablated to minimise any risk of preogression.

    4. Next would come High Grade Dysplasia with risk progression of 6% per year.

    HGD used to be known as "carcinoma is situ" and may be graded on the cancer scale as Tis - which is below T1, neoplasia - the earliest stage of cancer

    Anything upto and including T1 can usually be removed by ablation therapy.

    Risks of progression over lifetime from Non-Dysplastic Barrett's gives  reasonable chance over 20 years so if non Barrett's, just GERD, risk is about 200 years.

    Your chances of getting cancer are, in other words, not worth worrying about. You're more likely to harm yourself through worry.

    I know I've had reflux problems all my life and can trace particular symptoms of GORD and extra-oesophageal reflux for over 60 years.

    For the last 21 years, Ive known I have Non-Dysplastic Barrett's and it hasn't changed in all that time and I am confident it will never change. (We're learning more about this every year and it seems, although I have the genetic potential to develop Barrett's, I probably don't have that gene combination to permit progression or it would probably have shown changes by now,)

    So discover your own particular triggers - the foods that cause you problems (and it may not be coffee). Make lifestyle changes to reduce reflux because it takes reflux + acid + bile to make the cellular changes to your oesophagus. And your acid suppressants will reduce the acid. Not a lot you can do about the bile except for reducing fatty foods and processed meats.

    (Figures quoted above provided by statistics unt of Cancer Research UK)

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    • Posted

      Thank you Barrets. I have visited your site the past week and it is very informative. I will be downloading the book available and look forward to the read. I do know for a fact that any carbonated cola is a trigger. As soon as I drink it I get warm feeling in chest the chest pain. Coffee I have not fully tested yet. But seeing as I have not drank it in a few days,no need to bother going back. I need to learn my foods and which give me issues. Im sure dairy products do. Always have. Issues at both ends lol. So thats my Starting point.
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    • Posted

      I am taking esomeprazole 20mg and ranitidine 300 mg daily for very painful throat and chest radiating through to my back.  I just dont know what to eat, even water is difficult.   Do you have any suggestions for me. I am also prediabetic, due to taking prednisolone, so have to be careful of carbohydrates.   Is there anything else which can help with the pain?   I would be really grateful for your help.
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    • Posted

      I think you'll need to discuss this with your doctor. Pain relief can be a problem for those of us producing too much acid. You're actually on quite a low drug regimen but I used to experince problems with ordinary plain water, too. (For me the fundoplication worked to reduce reflux and render me med free.)
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    • Posted

      Im taking one protonix 40 mg in the morning and ranitadine 150 mg at night and so far only partial results if any really. I think your dose msy be to low. According to what I have read people like us should be on twice daily ppi maximum dose. So even my dose is low. I am going to speak with my doc about it on the 22nd and see if everything merits a change. Some of us are refractory patients,meaning we dont respond well to the meds and may heal slower also. In some cases 8-12 weeks or longer depending on our ability to control the reflux.
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    • Posted

      Thanks for your prompt reply.  Did you find that there was any particular food or drink that didnt aggravate the acid?   I dont have a very good reaction to PPIs, so can only take a low dose.
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    • Posted

      Protonix (pantoprazole) 40mg is equivalent to 20mg Nexium (esomeprazole).

      You don't have to take the medication in 2 doses. It just makes it easier to assimilate. Best time to take PPIs is 30 minutes before breakfast but that's only to get into a habit and for the food to help ensure the tablet has reached the duodenum before dissolving.

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    • Posted

      We're all different in how our bodies react to food so it's a case of experimentation. I personally found one of the easiest things to enjoy is one which most people are told to avoid - ice cream. Not the full Cornish dairy cream stuff but the cheapest vanilla that probably has little or no dairy product in it. But I'm not offering it as a recommendation since dairy products can cause problems for so many.

      If you actually do find you react to PPIs, have you tried H" blockers, eg Ranitidine instead? They're not as effective as PPIs and you'd probably need 300mg dose.

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    • Posted

      Thats interesting. I always take the pantoprazole in the morning. But never followed up with a meal to ensure it is absorbed properly in the duodenum. Seemed to always work before but doesnt mean that is the case now for me. I will have a light breakfast the next few days to see if it makes a difference.
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    • Posted

      For the pain I take 2 500 mg tylenol around one half hour before bed,also have my bed elevated at the head to help keep the acid down at night. The tylenol does help. I sleep fairly well and usually pain free outside of an occasional night where I had already had heartburn before bed. Sometimes I take a dose during the day but not to often. Could give it a try. Works ok for me.
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    • Posted

      Just a heads up on tylenol. I absolutely swore by this stuff when it first came out but one does have to be very carefull with dicky stomachs. I ended up with an ulcer which isnt a whole lot of fun either. Many here take Melatonin for sleeping as it appears to be fairly safe and not addictive. I tried it with some success but didnt want to go down the path of using aids to get to sleep. I suppose this goes back years when I had a lot of trouble getting off long term Valium use. Slept like a log though!!! How are you going overall?
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    • Posted

      I take 20 mg omeprazole in the morning about an hour before breakfast, 150 mg ranitidine at lunchtime and 150 again in the evening before dinner.   I have read your book today, it is very informative and concise.  I have been suffering from stomach problems since I had helicobactor pylori about 13 years ago.  Had the triple therapy which didn't work, so had the quadruple.  My weight went down to 7stone 6, I was very ill with it.  I have had problems ever since, which flare up badly from time to time, as now.  Other medication I am on has contributed to it all.   

      I like your idea of low dairy ice cream.  I could do with a treat, so will try a small amount first.  At the moment I am going to stick to vegetables for a few days i think.  

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    • Posted

      I also elevate my bed which I am sure helps, and occasionally take some painkillers too.   I have been having stabbing pains in my ear which my doc says is also related to the reflux.  He has recommended  an inhalent.  My throat is very painful and my chest pain goes through to the back, so very u comfortable.  
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    • Posted

      The symptoms were stressful and a shock to be honest. I had always tbought I knew what real reflux pain was until this. Im managing daily like everyone else. Trying new things to lessen the reflux. I do believe the ppi meds are working. I think my issue may be reflux with bile and pepsin more so than the acid. I think those two things give me the issues I have with lpr symptoms and even the heartburn/chest pain. The chest pain I think may be errosion. The tylenol has been my main stay seeing as any nsaid just feels like a bomb exploded inside my belly that works its way through me. Cant take aspirin at all or any of the others either.
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    • Posted

      Hi Curtiss - do you have trouble swallowing when you get that dryness? I used to get chest pain wihen I had an ulcer at the beginning of the year. Does your pain move around? Got rid of the lump with DGL as many here have done.
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    • Posted

      Sounds like you sadly have the works. What bothers me most is we all seem to be running out of options and we are grasping at straws here looking for a way out. Even when you see your doc once a week its still a darn long time before you see him again. The other worry is the grief we are causing our partners and family. Even our dogs know something is up. Despite all the aids I use my throat is as raw as, had about zero sleep so I can 101% empathise with you.
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    • Posted

      Jan with the ear problem I have had a lot if luck with the saline sprays. Apparently you can use these constantly with no side effects as its only salt and filtered water. Had those stabbing pains going right thru to ones back. This went away with 8 weeks on Tazec but that stuff really knocked me around.
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    • Posted

      Not so much trouble swallowing. Everything goes down fine. Just sore with lumpy feeling. Goes away,comes back...tend to get it from the time I get up until about 10 am after some coughing and clearing the throat. The chest pain does move around some. Just right of center breast bone is usual location with it sometimes up higher and a little more dispersed across upper chest. It can be a real whopper at times also.
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    • Posted

      Thanks Rex will try that.   Do you ever have the feeling that your whole body is trembling?  I have it constantly at the moment.  I'm not sure if its the medication or the fact that my stomach is not right.
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