biopsy

[Gordon__0]

  A few months ago I began to have a problems swallowing food.  The piece of steak I was eating didn't seem to want to go down.  It took about a minute to finally reach my stomach.  About a month ago I was on my way to work eating a piece of bread and butter.  During the entire 10 minute commute the bread was stuck in my esophagus.  I kept trying to build up enough saliva to flush it down but it didn't work.  I could feel the muscles of my esophagus pushing downward but this lousy piece of bread wouldn't budge.  When I pulled into the parking lot I opened the door and immediately threw up.  The bread came out along with what looked like a cup of saliva.  After this incident I decided to consult my doctor.  This was about a month ago.  I told him that the swallowing problem was infrequent and at no time did I have any problems swallowing liquids.  He decided I should get an Upper GI done anyway just to make sure.  Well, I had my Upper GI done yesterday and this is what the Doctor told me after I woke up from the procedure.  He said that everything looked normal but he took a biopsy of some tissue that was the size of a pea.  Since I was so groggy from the drugs, I did not ask him any questions at all.  He said I would be contacted for an X-Ray appointment.  At present, I have not had ANY problems swallowing since the fateful "Bread" incident almost four weeks ago--NONE.
  I am afraid to hear what the results of the biopsy are and I wanted to prepare myself by having the following questions answered:
  1)  Is it possible that this is life-threatening?
  2)  If it's not cancer, than what could this be?
  3)  If it is cancer, wouldn't I still be having trouble swallowing?
  4)  If it is cancer, how can it be treated?
  Thank you for your help.
Dear Gordon,
Your symptoms are suggestive of a lower esophageal ring called a Schatzki ring or a hiatal hernia. These findings are often found in association with gastroesophageal reflux disease. It sounds like the procedure you had was an upper GI endoscopy with biopsy. This procedure is usually very accurate in ruling out a mass lesion in the esophagus. It is also a good test to rule out a lower esophageal fixed narrowing (stricture). The biopsy was probably performed to assess the lower esophagus for the presence of inflammatory changes (reflux esophagitis). Esophageal cancer usually presents with poor appetite, weight loss, difficulty swallowing (dysphagia) and blood in the stool. As you pointed out, if cancer is present the symptoms are usually persistent and progressive and do not usually abate. 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: dysphagia, gastroesophageal reflux, esophageal cancer