Question Title: Could bleeding be a symptom of Barretts?

I have Sjogren's Syndrome (approx 12 yrs), diverticulosis, and GERD (1-1/2 yrs). The acid reflux has been controlled well with Prevacid. Last year I had an episode of spitting up blood for a couple of hours. It was not coughing or vomitting, rather it was just a sudden warm flow of blood that came up my throat with no pain. I have had x-rays, upper GI, swallowing studies..and nothing was revealed other than some reflux. I had an endoscope performed several years ago, when I was diagnosed with the Sjogren's. This was extremely painful, which was surprising to the MD. I had severe throat pain for 2-3 weeks after this. My GI doctor wants to do another scope to r/o Barretts. I am very afraid to have the scope done again for fear of choking or it getting stuck. I have a very narrow passageway and a very dry mouth, which causes swallowing problems. I am unable to swallow most pills. I have a dull ache under the right breastbone area intermittently since the bleeding episode. Does this sound like it could be a Hiatal Hernia? Could this be a symptom of Barretts? Have you heard of this type of bleeding before? Are there any other types of non-invasive tests that could be performed in order to avoid the endoscope? The doctor I am seeing says there is really no treatment for Barretts. Is this correct? Thank you for your time.

Dear Bonnie,

Your symptoms are consistent with a diagnosis of gastroesophageal reflux disease and esophagitis (inflammation). Complications of esophagitis include bleeding from inflammation, narrowing of the foodpipe or a stricture and changes in the lining of the lower esophagus called Barrett’s esophagus. Barrett’s esophagus may lead to the development of esophageal adenocarcinoma. A hiatal hernia may be associated with gastroesophageal reflux disease. In most cases hiatal hernias are asymptomatic. Barrett’s esophagus is best diagnosed on endoscopy with biopsy. It is most often found in patients who have had symptoms of gastroesophageal reflux for at least ten years and it patients over the age of 40. It is very difficult to diagnose Barrett’s esophagus on upper GI x-rays. If Barrett’s esophagus is confirmed on endoscopy with biopsy, surveillance endoscopy is recommended every 2 years to look for dysplasia (glandular distortion which could signify the development of cancer). Once high grade dysplasia is confirmed by two pathologists, the current recommended treatment is surgery to resect the area. There are other treatments being studied to destroy the tissue in this area (in order to prevent the development of cancer), however, more research is needed before they are to be routinely recommended. I hope you find this information helpful.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.

If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians’ Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.

HFHSM.D.-ym
*Keywords: gastroesophageal reflux disease, complications

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