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Gastroenterology  (Expert Forum)
 | 
Do I seem to have Barrett's Esophagus, Schatzki's Ring, or what?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
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.

Do I seem to have Barrett's Esophagus, Schatzki's Ring, or what?

by mistergutcheck, Jun 16, 2006 12:00AM
I'm freaking out that what started out as a little furball feeling in my throat 2 yrs ago is now something horrible, like esophagol cancer, since I looked up the symtoms on the web and,  "eeek!"  



My Internist thinks it's probably Schatzki's Ring, but will defer to the GastroGuy who's doing an Upper GI Endoscopy in a few days.



So I'm just hoping you can give me a few things it might be besides "that."



I'm male, 55, 6-0, 198 lbs, physically active, drink moderately, and have never smoked.  



I first felt a little furball feeling in my throat about 2 years ago.  I was hoarse in the mornings and couldn't find my voice and had a persistent shallow cough.  The ENT took a polyp off my larynx 18 mos ago and the hoarseness went away.



The ENT told me the polyp was probably caused by GERD.  I started taking prilosec, but not religiously, just before bed.



My symptoms have fluxuated over the past year but in the past three months, particularly the past couple weeks, I've really been bothered by them.  The "lump" seems to always be there. It aches in a spot south of my adam's apple, as low as my sternum.  The ache seems to penetrate to my back, in a spot between my shoulder blades.



So what can be causing this rather persistent aching?

I do experience some difficulty swallowing.  I'm getting over a cold and have had sticky (yellow-green) mucuos that seems to come up when I cough, like it's stuck in the area my esophagus is strictured or whatever.  This is especially in the a.m.



That's about it.  Would Schatzki's Ring result in a persistent ache?  What does the pain in the upper back relate to?



A brief history of my meds, etc:



I took Prilosec intermittedly until about 3 months ago; now I take it in the a.m. and p.m. as per the ENT's advice?  Before that I took it right before bed.  The aching can keep me awake, anxiety, too, so I take ambien abouot 3x's per week.  Could an undissolved pill create a problem?  



Some web info indicates that taking prilosec more than 6-8 wks in a row can actually increase the risk of esoph. cancer.  Is this founded?  The ENT has told me to keep taking it!



Could my latent chest cold be exacerbating the back ache and the tight spot in my sternum?



What exactly will the Endoscopy tell me?  What will it eliminate and illuminate?  



Finally, I've felt a nervous urge to clench of my esophagal muscles for awhile now.  I think it increases when I'm stressed.

Could this result in the ache?



Thank you!



by Kevin Pho, MD, Jun 17, 2006 12:00AM
I am not aware of Prilosec leading to esophageal cancer.  



The upper endoscopy is a good idea.  In addition to Schatzki's rings, any other upper GI abnormality can be looked for - included masses or strictures.  It will also look for GERD as well as stomach pathology.  



I would also consider post-nasal drip leading to irritation.  An sinus CT scan can evaluate for sinusitis causing this symptom.  Appropriate antibiotic therapy can be considered if this is the case.  



Any number of reasons can lead to the "tight spot".  I agree with the upper endoscopy.  Cardiac concerns can be considered - and ruled out with a stress test.  



If the testing remains negative, then stress can be considered as a cause.



These options can be discussed with your personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

kevinmd_
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by goldygirl, Aug 03, 2008 01:30PM
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