barrett's info

[apriori1957]

I was diagnosed w/Barrett's esophagus last summer. My specialist told me to come back in 3 years and be re-tested to see if it had returned to normal. Can your esophagus ever be normal again? I think my doc's a quack! He only prescribed Zantac 150 3x's a day, and told me I could continue to drink coffee all day long (I'm a 6 cupper) and drink alcohol at night (which I've been doing), My primary care dr. was shocked when I saw him last month and told him what my specialist did for me. He demanded I start taking Nexium and quit drinking coffee, liquor and a host of other things! I'm severely depressed by his orders. Nexium is very expensive and has side effects-specilaist told me there are prescriptions I could take, but in his opinion, they don't work any better than otc meds. I think this guy is not a good doctor. I have another appt. w a specialist Jan. 28 for a 2nd opinion, but I hate to avoid all my wonderful foods and drinks that I love if I don't have to. What do you think I should do?I also have a hernia, as well that I didn't know about. I didn't even know I had GERD until I went to an ear/nose/throat dr. about my hearing-he's the one who found it-said my tonsils were scarred!!! I've never had any symptoms (except extreme nausea the past year). Thanks for anyone's help in guiding me in the right direction w/this depressing condition! By the way, I also think they should fix the hernia-isn't this what caused the Barrett's problem? Acid is going to keep leaking into my throat-right? No matter what I do??

[Smiley2000]

Hi there,

I also think that 1st Doc was a quack!  The first thing he should have done is prescribe a strong PPI like Nexium - some GI's believe you can take dosages of up to 80mg of Nexium a day and it is a save drug to take long term.

Barrets Esophagus is a pre-cancerous condition, but as Flycaster said it only turns into cancer in a small number of patients and they still don't know why some people's Barrets never changes and some goes bad.  But this type of Adenocarcinoma is bad news and you don't want it to come to this.

It is good that you are going for a second opinion.  Take your 1st Endoscopy photo's and biopsy results with you.  It might also be necessary to do further tests:  i.e. 24hr Impedance study (I don't recommend the normal 24hr PH study as it only measures acid and misses the non-acid reflux episodes).

ENT symptoms are alarms going off that your GERD is not under control and the Barrets sells is also an indication for intervention!  The above tests can determine if you are a surgical candidate and if the Nexium alone can keep your GERD under control.

While you are waiting for that consult in Jan. please take your Nexium and avoid alcohol, fizzy drinks, acidic foods.  Eat frequent and small meals during the day and stop eating and drinking 3hrs before bed-time.  Elevating the head of your bed will also help, but is a bit of a mission if you share your bed with anyone.  Also:  DO NOT sleep on your righthand side as this also aggrevates reflux.

All the best and feel free to ask more questions and know that we are here for you.

[Flycaster305]

This post will probably result in a lot of different thoughts...
I'm also diagnosed with Barrett's Esophagus, and my diagnosis was based on scars on my vocal chords as well as erosion of tooth enamel.  I think the fact that you are getting a second opinion makes very good sense, you have two doctors with different approaches and a third opinion will help you sort it all out.  
Barrett's Esophagus leads to full-blown cancer in only about 4% of cases, from what I've read.  However, if it leads to cancer, it's a very difficult one to fix.  I had the cause fixed with a somewhat controversial procedure called a Nissen Fundoplication.  That might or might not help you, as acid reflux is caused from a number of causes.  
Until you meet with your 2nd opinion doctor, I'd follow the advice of Selma who mediates this board... raise the head of your bed about six inches with a 6 x 6 post, so acid won't drift into your esophagus at night.  Stay away from food for a few hours before laying down, avoid carbonated drinks or beer, and spirits like whiskey, rum, etc should be avoided.  White wine was suggested OK to me in moderation, but not just before bedtime.  Avoid spicy/acidic foods for awhile.  I made low-acid coffee by cold-brewing it.  I'd filter about a quart of water through a pound of ground coffee using cold water.  The resulting low acid brew should be kept in the refrigerator, and added to hot water, about 1 TBS to a cup.  
Keep us informed.