I need some peace of mind

[dachsie54]

In January this year I was diasgoned with Barrets Esphogus. My GI said not too worry too much about it and come back for a followup in 1-3 yrs. But my PCP told me typically this can lead to cancer in 2-4yrs and I will die. I keep asking if there are other ways, surgeries,etc and they just say wait and watch. My GI said they found a very small spot and it was hard to tell if it was Barretts, but then he says it is Barrets, help!
Has anyone been through this?


This discussion is related to Questionable Barretts Esophagus.

[CalGal]

If you check any of the medical sites for information on Barrett's esophagus and cancer you'll find that Barrett's can proceed to a cancerous condition, however it's typically a slow progression in many people, so your PCP may overstating things a bit. However, knowing you have Barrett's suggests that you should try to take as much control of the situtation as you can.

Get the doc's written reports and the biopsy reports and read them. Find out how big the 'small spot' is. Then make sure you are doing everything you can to tamp down your acid reflux. If it can't be done by using meds, diet changes and lifestyle changes, and the situation progresses, depending upon where the Barrett's is located, check with the GI doc to see if you're a candidate for some form of either endoscopic procedure or something like the Nissen fundoplication technique.

Three years seems to be a bit long to wait to have it checked again, but another endoscope in a year doesn't seem like too short a  period of time.

[dachsie54]

Hi,
Thank you for the information, I did know I could get my reports and look at them. I did ask him for the surgeries but he said no. Just stay on the meds. I would rather he be more aggressive and offer some ways to get rid of this . Just so scared to death and do not if they are saving me from anxiety or telling the truth as he is so vague and very busy.
Chery

[CalGal]

I agree with you, but think about why your GI doc may be saying what he does. He's probably used to people who believe they want to get rid of Barrett's or other GERD-related problems, but the minute he mentions diet changes or weight loss or a number of other things, resolve goes right out the window. The compliance to meds, diet and weight loss in most people is depressingly low, and after seeing patient after patient with a lot of complaints but little wish to help themselves - other than asking for some pill that will 'fix things' - docs can get extremely jaded. If you think your GI may be reacting to that, and if you feel you can make any changes he suggests or really put effort into making changes, talk to him frankly and ask what can be done.

Surgery is not a quick fix, and it can have some appalling side-effects in some people. So it's not something to jump into unless all other options are exhausted.

[Lori707]

I had a scope done and pathology stated: Focal Intestinal Metaplasia
I looked on the web and it's very confusing. A couple places states: Intestinal Metaplasia(Barrett's) when other sites do not.

I have no idea if I have Barretts or pre-Barretts, if pre-Barretts exists.

My other doctors says he's a good doctor but all I hear from him when I ask questions is: "Don't worry about it".  Then he runs to another patient. I would like to go to another doctor, but first I am sleepless with worry. I have no idea what Focal Intestinal Metaplasia is.

Anyone have a clue?
Thanks!!

[CalGal]

Focal intestinal metaplasia is something that typically refers to the transformation of stomach mucosa (surface cells) into intestinal mucosa. So without a lot more information it would be hard to say anything. You'll probably find a word attached to this description somewhere that says cardia, body, pyloric or antrum - all of these words would denote that the FIM was found at a specific place in the stomach.

[Lori707]

Hi Chery,

FYI: I feel that I can talk to you more than I can talk to my own doctor! You're making sense in my brain fogged mind where as my own doctor tells me I only have one question he'll answer because he has other patients. Thank you!

Anyway..I'm going to type exactly what the pathology report wrote:

A- STOMACH,ANTRUM,BIOPSY:
    - Gastric antrum mucosa with reactive gastropathy, mild chronic inflammation and  FOCAL INTESTINAL METAPLAISIA.

    - Negative for dysplasia/malignancy.
    - immunostain for H.pylori is NEGATIVE.

B- POLYP STOMACH BIOPSY:
    - Gastric fundic polyp, benign
    - Immunostain for H.pylori is negative.
      (I had two polyps but they only reported on one).wondering why

C- EG (esophagus) JUNCTION, BIOPSY:
    - Hyperlpastic gastroesopageal mucosa with mild chroic inflammation.
    - No evidence of intestinal metaplasia or Barrett's changes (Aician blue stain).
    - Negative for dysplasia

Can you explain what "reactive gastropathy" means and also "focal"? (stomach).
Also, "Hyperlpastic gastroesopageal" in the esophagus?

Good thing I read this report again because I thought the metaplaisia was in the esophagus when it's actually in my stomach. Is it usually in the stomach?

Thanks again,
Lori

[CalGal]

Reactive gastropathy is the second most common diagnosis made on gastric biopsies. It's a fairly general term that means your stomach is reacting to something - not specified - but it could be bacterial, chemical, drug, etc.

Antrum - bottom of stomach.

Chronic - the inflammatory cells they're finding are of a type that suggest this has been going on for quite awhile.

Focal - a fairly specfic, circumscribed area. Not spread out a lot.

Hyperplastic gastroesophageal - at the interface between the esophagus and the stomach; you've got tissue that 'doing stuff' faster than it normally should.

Fundus - toward the top of the stomach/under the cardia area; a 'pouchy' section on the left of the LES.

Ask the doc about the other polyp.