EGD Results neither negative nor positive for Barrett's. Help!!

[pearl77]

I am a 28yo female and had a EGD on 02/01/06 for trouble swallowing/lump in throat that started approx Aug. 2005. Everyone thought this was due to my panic attacks and just some Post Nasal Drip. I was told that it looked like Barretts. I freaked out b/c I’ve never had heartburn and wasn’t expecting anything to be wrong. They started me on Achiphex 20mg qd. I went for my f/u on Feb. 22 and was told that the results were “questionable” as to whether or not I had Barretts. That it was neither positive nor negative. How can that be? I met w/ an FNP/RN not the Dr. She told me to up the Aciphex to b.i.d. Are those typical results? Should I seek a second opinion? If they can’t determine Barretts should I be concerned about dysplasia or even malignancy? Could they miss that too? Or does this mean that maybe there’s a chance that by taking the meds and diet changes my esophagus can heal? I immediately took proactive steps w/ diet, wedge pillow, etc. but am scared. I feel like I am so young to have this. I drank and smoked heavily for about 10 yrs and quit two years ago. Could that be why I have this? I also quit caffeine approx. 2 yrs ago b/c my panic attacks.  I have always burped A LOT.  Is there is correlation between belching and a weakening of the LES? I have still been struggling w/ the lump in throat. Is there additional testing that I should undergo? Forgive the abundance of questions, I am very overwhelmed. Can I expect to live a LONG and healthy life even if I have Barretts? Also, in re: Chocolate, is it OK to have low fat frozen chocolate yogurt or chocolate cake or chocolate milk? (I’m a chocoholic can you tell?) or am I supposed to stay away from everything choclate? Since I can’t eat at least 3 hrs before bedtime (sometimes that’s impossible b/c my schedule) is it OK to have a meal replacement shake and other beverages before bedtime? One last question, does this make a pregnancy dangerous since I’ve read that GERD worsens w/ pregnancy? Thanks for your time in responding.

[Kevin Pho, MD]

Barrett's esophagus is sometimes difficult to diagnose, even on an upper endoscopy.  

Based on studies, the frequency of Barrett's esophagus ranges from 1-4 percent of the general population.  Variability of the upper endoscopy results can be due to some of the subjective nature of the diagnosis.

If there is a question of dysplasia or other suspicious looking biopsy results, a second opinion with another pathologist is recommended.  If the diagnosis is confirmed, a regular schedule of surveillence endoscopy is recommended (ranging from every 3 months to yearly based on the severity of the dysplasia).  

Barrett's esophagus should be carefully monitored, since it is associated with esophageal cancer.  

Another test to consider would be a 24-hr pH study to definitively evaluate the presence and severity of GERD.

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_b

[celine149]

Hello, Most of us with Barrett's esophagus do get our slides read by one of the large training hosp. I know that John Hopkins offers this service. You don't have to go there just call them and send your slides. I'm thinking that your path. report certainly didn't show Barrett's but that your Dr. thinks he saw it there. That isn't good enough, it has to be either proven by biopsy or most likely you don't have it. JH, can atleast put your mind at ease or give you a definite "Yes, you do have barrett" There have been MANY MANY people who were told by local GI that they have Barrett's only to send their slides to JH or some where and find out that they do not have it..If you can get a copy of your path report it will tell you if there was any dysplasia noted. Also, another thing to look for on a path report is the presence of "Goblet Cells." If they aren't there then there is no Barrett's

[pearl77]

celine, thank you for the response. I have ordered a copy of my chart from the dr. and am also seeking a referral to a different GI in my area for a second opinion. I am still struggling w/ my swallowing and lump in throat even as I'm trying to drink some tea right now. I'm thinking also that I may need some additional testing. Thanks again. I appreciate any and all feedback. I'm new to this and feel very scared.

[myproblem]

The swallowing problem you describe sounds like esophageal dysmotility. Look it up.

[Dr J]

For diagnosis of Barrett's, location of biopsies and the pathologist reading is crucial. Also, don't panic. The risk of cancer in a patient with it goes up 0.5 % a year. Belching and a sensation of a lump in the throat are frequent symptoms of GERD.Close follow-up with your gastro is needed.

[Deseree]

Hi everyone! I am a 57 year old "recovering" bullimic woman. I have always been slim & I am quite sure that I will not binge & purge again! I am on Lexapro (antidepressant) & have gained about 15 lbs. I would like to lose this weight, so I have purchased an ab lounge & a hip, bun & thigh machine. I want to do things the right way, but I have done damage to my throat & probably my esophagous! I am experiencing minor acid reflux & I have a hiatal hernia. My main concern is that, every once in awhile, I will get a "bloody taste" in my mouth. I will then spit out pink saliva. Usually, when this happens, my throat will feel slightly swollen. I cannot believe what I have put my poor throat through! My gag reflux DISAPPEARED over a year ago! I then had to get "creative." I figured out that if I wrapped several bandaids around all four fingers, & stuck them way down my throat, I could then vomit. I had to press real hard & do some serious manipulation to accomplish this! I was bumping into my VOCAL CORDS & my UVULA everyday with my fingers. It is a wonder i'm still here to talk about this. I probably should be DEAD! I have to say that at this stage of my life, I am embarrassed & ashamed at my stupidity. Thanks for listening!