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Gastroenterology  (Expert Forum)
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Barrett's Esophagus
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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MedHelp Member's Question

Barrett's Esophagus

by Billy Caddell, Dec 15, 1999 12:00AM
I have had stomach/digestive problems sine 1956. About two years ago it was diagnosed as Barrett's Esophagus. I have been going to a local gastroenterologist in my rural area of Texas. The last three times the endoscopic biopsies were "inconclusive" according to the gastroenterologist.

I have altered my diet trying to eliminate "problem" foods. However, sometimes everything I consume bothers me. I used a wedge to sleep on for about two years until I started having leg and hip problems. Several months ago I purchased an electric adjustable bed, which has helped in reducing the reflux. However, I still have erratic pain and reflux problems. I am currently on 20mg Prilosec twice a day and still I have some reflux problem.

I understand the nature, treatment and complications related to my condition. My wife and I are very concerned.

I am asking for the name of a HIGHLY qualified gastroenterologist in the Dallas, Texas area. I have little confidence in the treatment or concern by my current doctor. I live about 1 1/2 hours out of Dallas but am more than willing to travel to find the right doctor.

Bill Caddell, ***@****
Doctor's Answer

by HFHSm.D.-Gastro-rf, Dec 25, 1999 12:00AM
Dear Bill,

There are many outstanding sites at which you can receive treatment.  I suggest that you contact the gastroenterology section of any of the wonderful medical schools that ypu have in Texas.  



AS you know, Barrett's esophagus may undergo malignant degeneration causing an esophageal cancer.  Treatment consists of acid reduction.  It is also necessary to do endoscopic surveillance to exclude early malignant change.  The frequency of these surveillance studies ranges from every few months to every 2-3 years.  The degree of dysplasia (cellular change)is the determinant of endoscopic frequency.
Member Comments (78)

by Darlene Tuman, Dec 16, 1999 12:00AM
You know, I have been so interested in the Barrett's disease, because interestingly enough my mother's maiden name is Barrett. She and her twin sister have had the esophagus disorder described in the Barrett's disorder their whole life, but never knew there was even a disease or disorder named after them.. Is this just a coincidence or could they be related to the founder of this disease or disorder...?

by Peter Travis, Dec 18, 1999 12:00AM
I have had a somewhat similar experience. The main difference is that I have not had a definite diagnosis of Barret's Oesophagus.

I would ask for your medical records to find out for yourself exactly what they have and have not found. I don't know if your records are available to you: in Sweden the doctor MUST give you any records you request within a few hours. It is almost impossible to grasp what a doctor says in a few minutes. They are also lousy communicators since they never get any feed-back.



One thing I saw from my medical record was that the biopsies showed no intestinal metaplasi (which means skin changed into another plasma) or dysplasi (which means plasma that is different from what you normally have). The biopsies did, however, "show a picture which indicated Barrett's oesophagus..". As you see, I obtained a much complete picture of my situation with all the nuances than a bald statement that 'it was diagnosed as Barrett's Esophagus'. Let's face it, very few will be able to afford the type of advice from doctors you would expect from any other profession in a few years so we are going to have to find out for ourselves anyway. I took a science degree and did Latin at school so at least I have a chance of being able to read what they say. Do you read Latin in the schools in Texas? Might not be a bad idea if you want to live for a while.



Apart from that and having trawled the net (there is a very good site in Finland called http://www.gastrolab.net with pictures: I thought the healthy bits were the sick bits so that goes to show you need to see the pictures and the text to understand what your doctor is talking about)and if you do have Barret's Oesophagus then taking medication is a very good option. I am on something called Losec in Sweden. An operation seems to give pretty ineffective results and is very painfull afterwards. The site doctor said that and if a doctor said it is painful, boy is it painfull. Most of the studies seem to show that the problem returns after a while.



The reason they try to get rid of Barret's is, as far as I can make out, that it often turns into cancer. Actually, what has happened is that the skin in the entrance to your stomach stops being proper skin and that gives cancer a chance to get going, as far as I can see. If you or I do get cancer then I can't find out what they do.



I would not think going to see anyone else would give you any very different results. As far as I can make out getting a gastropy done every six months at least lets you know where you stand. Since the doctors can't do very much they don't seem to recommend this, but that is seeing the matter from their point of view rather than yours.



One thing that struck me about your tale was that you take Prilosec which may be a name for Losec in the USA. Otherwise I think you may have been put on that since Losec is so expensive. It costs about $5 a tablet here (20 mg) but since we have a government health service that is not an issue and the doctor prescribes the drug he thinks is best for you. I take 2 a day.



Since everyone seems to sue everyone in the US I should point out that I am not a doctor and these are only my personal opinions for which I take no responsibility.



Anyway, Good Luck, and maybe your Barret's won't get any worse. In many cases it doesn't as far as I can see on the web. Where would we be without the web?



Peter

by DENISE, Dec 20, 1999 12:00AM
Bill,



     I share in your concern.  I was diagnosed 2 weeks ago with Barrett's and my gastro doc began immediately to treat it aggressivly.  He placed me on 20mg of Prilosec 3 times a day and 10mg of Propulsid four times a day.  He wants me to call him in a couple of weeks to let him know how I am doing.  He also said that he would want to do another endoscope in 6 months.  I can understand your frustration and concern.  It has taken me 6 months to even find out what was causing all of my pain.  I only had reflux on occasion.  My main symptom was chest discomfort and pain.  I am starting now to feel some better.  I dont know which way you live from Dallas but I have a excellent gastro doc in Shreveport, La. which would be close if you lived in East Texas.  Anyway, I wish you luck.  Please continue to seek answers if dissatisfied with any treatment you are recieving.  Take care.

by bill, Dec 21, 1999 12:00AM
I've had antacid nearly every day for over 40 years. I've tried every treatment that I could find. It has not been until the past few years that they really had a treatment for Barrett's. The best thing I've ever done was buy the adjustable bed, I incline it every night before I go to bed. Then sometime around 4 am I position it with only a slight incline. Otherwise, I would have reflux every night. The constant reflux is what caused the Barrett's to begin with. Why did not doctors tell me that sooner?  Because I never went to a specialist. BUT I was never informed that I needed to go to a specialist. My father had stomach problems and it had always been thought it was hereditary. So, I assumed I would have to live with it.



I've been to numerous doctors over the years, but NONE every really treated me for the problem. None had EVER suggested I go to a Gastroenterologist. One day about two years ago I saw an public announcement ad on TV concerning GERD and offered a free video sponsored by the Gastroenterologists Association. I saw the video and immediately made an appointment with a gastroenterologist. I already had Barrett's.

by Joe, Dec 22, 1999 12:00AM
I've been on Prevacid for my Gerd/Barretts for over a year with pretty good results.  Although not confirmed by biopsy, the pictures clearly seem to show Barretts cells present.  I saw somewhere on the net that a promising technique was to "ablate" the Barretts cells using a radiofrequency probe much like cardiologists use in the treatment of WolfParkinson's syndrome.  The cells appear not to return.  Several treatments are needed to "burn" the cells and there is reported to be little or no after effects of the treatment other than mild discomfort.  Is anyone aware of this cutting edge treatment of Barretts?

by bill, Dec 22, 1999 12:00AM
There are several good articles on medscape.com. One in particluar is at

"http://www.medscape.com/medscape/cno/1999/DDW/Story.cfm?story_id=689". It duscusses the removal of Barrett's Esophagus tissue. One issue was pointed out - that this procedure sometimes leave

"residualislands ofspecialized intestinal metaplasia" wher eadenocarcinomas (cancer) may develop. The treatment, according to the article, is considered experimental and no where near being routine standard of care.

by Doug, Dec 22, 1999 12:00AM
Having fought with GRED my entire life, I was born with a defective sphinter, I was recently dig. with Barretts.  Prilosec helped for a short time although it was the first medication I had any success with.  Approx 2 months ago my annual scope revealed a tumor in the esphogus.  My gastroentrologist recommended seeing a surgen about the Nissian Fundroplocation (spelling?) I did , had it done on 12\10\99 and have had no reflux since.   It is very early I know but at this point I am very happy wiht the results.

It is my understanding that by bringing the reflux in to check the potential for esophogieal cancer is greatly reduced even in Barretts paitents.  I would recomment this proccedure as performed by my doctors.  As with any procedure the results are only as good as the physisians who perform the surgery so find someone who is familliar whit hte procedure and has a porven track record.  Good Luck

by joebarkett, Dec 22, 1999 12:00AM
I had the nissan wrap procedure about 5 years ago in Boston. I had a sliding hiatial hernia with barretts esophagus. The procedure (5 hours)  stopped the reflux by 90% but I still get the symptons which caused me to have the operation in the first place. symptons severe neck pain and left shoulder pain sinus congestion all after eating...since the surgery