Erosive Esophagus and Intestinal Metaplasia

[concerned22]

I just got the results from an endoscopy-- some ulcerations and positive blue stain of Intestinal metaplasia and erosive esophagus. I tested negative for H-pyloric which I treated 6 months ago.  I have been taken Prilosec and Sucralfate once and now twice daily-- I still have some burning in my throat and taste of acid, especially at night.

How serious is this condition and possibility of getting cancer?
What other homeopathic options for treatment do I have?

[Jaybay]

I think what you are describing is a condition called "Barrett's Esophogus".  My husband has this too.  Simply speaking, long-term reflux really irritates and inflames the esophogeal tissues.  The cells responds to this irritation by mutating into cells that more resemble those in the duodenum - below the stomach - which ARE capable of dealing with stomach acid.  However, this mutation can become dangerous over time.  Barrett's is considered a pre-cancerous condition, somewhat similar to a woman having an abnormal pap smear test.  

Your gastro doc will probably want to keep you on the PPI meds, and if Prilosec doesn't cut it, try Nexium, Protonix or Aciphex.   Your doc will probably also want to do endoscopy annually for a while to keep an eye on the amount of damage that may continue. He can biopsy the damaged areas of the esophogus and determine if any cell dysplasia is occurring.  After several degrees of dysplasia, you are then looking at higher probabilities of the cells turning cancerous.  Those Barrett's cells will never return to their normal state, but keeping the reflux under control will help prevent them from getting worse.  So, specifically ask your doctor if the pathology report mentioned any degree of dysplasia.  If there is none, you're in good shape and a long way from considering cancer.

If the medications don't stop this damage in its tracks, you could then consider surgery in the form of a Nissens' fundoplication.  The top part of the stomach is "wrapped" around the lower esophogus that completely prevents stomach contents from refluxing.  Some people have no problems with this surgery, and others do.  You really want to do your research before jumping into the OR.  Hope that helps clear things up a bit.  :-)

[concerned22]

Thanks so much for this informative response and taking the time to share this info. I didn't see dyplasia only metaplasia. Is this similar? The doctor said I'm not even near cancerous, but I wanted to know if there is any homeopathic way to treat this. I am taking also digestive enzymes and probiotics to maintain a healthy track.

[Jaybay]

The term metaplasia simply refers to the cellular changes that have begun in response to the stomach acid.  Once they've changed, they won't ever change back.  Dysplasia is more abnormal tissue development.  In the case of Barrett's esophogus, you start with metaplasia, and if it gets worse, there are several stages of cell dysplasia to move through before the cells become cancerous.  It's a condition to treat with meds and monitor with EGD every year or two, but it certainly isn't a death sentence.  

I don't know about any specific homeopathic treatments for GERD.  The enzymes and probiotics are great for your intestines, but don't really do any for the reflux.  It's the reflux that you have to keep control over, and PPI meds are the best thing going right now for that.  Of course, you should also try to avoid, or lessen the intake of, the usual acid-producing foods: very rich and spicy things, caffeine, and in particular - alcohol.  In other words, the more bland and boring the better.  PPI's will allow you to hopefully still enjoy many of the things you like without a major lifestyle change.  Don't eat more than 2 or 3 hours before you go to bed either.  Many people find reflux is worse when they're lying down, and elevating your head and shoulders slightly may help.

It sounds like you've got a good doc too.  Lucky you!

[concerned22]

Again, thanks. Unfortunately, I learned more from you than my own doctor so far. I've been proactive in learning about the care of this condition and my options. You were great! I'm doing just what you said. However, I'm a bit reluctant to take the Prilosec two times a day. I've been experimenting and taking it with dinner instead of breakfast followed later by Sucralfate, which I also take in the morning. I still have mild bitterness in my mouth in the late evening, but it's only been a few days that I'm **** the treatment this way.

What are the long term effects of Prilosec?

[Jaybay]

I'm not really aware of any, but you can always check with a pharmacist.  They're far better than doctors in the realm of medication effects, and people often forget to use this valuable resource.  I CAN tell you that my husband has taken aciphex for many years, twice a day, and has had nothing but spectacular results.  If you're still getting the bitter taste in your mouth, one prilosec a day obviously isn't doing the job for you.  Taking this medication is the best line of defense you've got against further esophogeal damage.  Do it!  :-)

Glad I could help explain some of this to you.  The gastro doc that both my husband and I use is great at spelling things out in laymen's terms, and I always do my own research when anything crops up as well.  Sometimes you just have to know the right questions to ask the doctor in order to have a meaningful conversation.  Even then, some docs are just not great at communicating and tend to simply throw out orders without explanation.  Oh well, they're still human aren't they?  (I think!)  :-)

[concerned22]

Thanks again. Great feedback and I'm starting to feel better with taking the prilosec just at night and the sucralfate during the day. So far this is working. If the bitterness comes back during the day, I'll take two.  I must say you sound just like a doctor, but with good communication skills.
Bless you.

[Lori707]

I've just read your conversation with concerned22. I can't believe that his concerns and questions are exactly what's going on in my mind! Same condition as his and have been completely confused. My doc just says "Don't worry" and I can't handle that answer. You have explained more now than ALL the many hours I've sat at the computer on google trying to make heads and tales out of this "intestinal metaplasia". I thought I was dying.
concerned22-please keep in touch and let me know what your status is.
Thanks!!!!!!!
Lori