what does this mean?

[partyoffive]

I recently had an endoscopy done with biopsys taken looking for sprue in duodenal, dysplasia in barretts, the report findings said extensive barretts right up to the cricopharyngeus. The pictures i wa given have alot of white stuff on them. does this mean i have barretts of the esophagus? and if so what does that mean? And what is sprue?

[Kevin Pho, MD]

Barrett's esophagus occurs when the normal cell type that lines the lower part of the esophagus (squamous cells) is replaced by a different cell type (intestinal cells). This process usually results from repetitive damage to the esophageal lining. The most common cause of this is longstanding gastroesophageal reflux disease (GERD), a condition in which the esophagus is exposed to excessive amounts of stomach acid. Interestingly, the intestinal cells of Barrett's esophagus are more resistant to acid than squamous cells, suggesting that they may be an adaptation to the chronic acid exposure. The problem with this adaptation is that the intestinal cells have a small potential to transform into cancer cells.

Barrett's esophagus is normally diagnosed via a biopsy to be sure of the condition.

Celiac sprue is a condition in which the lining of the small intestine is abnormal but improves once gluten (a protein contained in wheat, rye, barley, and a multitude of prepared foods) is eliminated from the diet. People with celiac disease have an abnormal immune system reaction against gluten, the consequences of which cause damage to the lining of the small intestine. Celiac disease can occur in people of any age and affects both genders.

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.

Thanks,
Kevin, M.D.

Bibliography:
1) Kelly.  Patient information: Celiac disease.  UptoDate, 2004.
2) Spechler.  Patient information: Monitoring and treatment of Barrett's esophagus.  UptoDate, 2004.

[partyoffive]

i failed to mention i am a 38yr old female smoker since age 9yrs old. also mentioned in findings were barretts like changes in upper half Hiatus hernia sliding and patulous eG junction. also reflus larngeal changes and supraglottic was inflammed. please let me know soe thing my appointment is not until the 30th and im nervous.

[tessa0825]

Don't get nervous until you get the biopsies back (I know that's asking alot)..You need to understand that Barrett's cannot be diagnosed visually...It is possible for Drs. to think they see it during EGD only to have biopsies come back clean.If that happens then the diagnosis is no Barrett's...Barrett's is a change in the cells in the lining in the distal esophagus. It is caused from reflux disease and it occurs after repeated damage from acid and bile reflux...It is called "intestinal metaplasia or dysplasia".The cells change to look like those in our stomach and small intestines...It is a pre-cancer lesion and can become adenocarcinoma...It is a very small percentage of people with barrett's that progress to cancer and my Dr. tells me that at the present time there is no way to know who would be most likely to progress (there are many studies going on right now to try and answer that question).If your biopsies confirm this diagnosis you will want to get educated about this illness as it would require lifetime surveillance...It also requires lifestyle changes such as sticking to a strict diet, not eating for 3-4 hrs before bedtime, taking PPIs faithfully, elevating the head of your bed, AND even though smoking and alcohol is more directly related to squamous cell carcinoma it cant be a good thing for our esophagus...There are many programs available to help stop smoking if you are willing to get involved and you have reached the point that you want to quit.You could call your local hosp. and ask about smoking cessation programs or even call the American Cancer Society. They will give you advise about programs in your area...Dr. Pho will give you much better advise about the Barrett's than I have. Also, I dont know a thing about sprue....Good luck to you....Tessa