need information on metaplasia

Question

endoscopy one year ago. told I had two areas of inflammation, continue on the ACIPHEX which I discontinued after three months as I felt fine. Got recall notice for one year recheck, called, said I felt fine. Shocked. told no I am not fine, one area no concern, other area metaplasia, was I still taking the Aciphex. I have gone back on the Aciphex but am terrified after reading on websites that I did the wrong thing. Endoscopy only done originally because I had still unexplained/diagnosis following three days of diarrhea, cramping, dehydration. On antibiotiic, H pylori ruled out. History of GERD, hiatal hernia. Control symptoms with diet, OTC Gaviscon. I wish gastroenterologist Physicians Assistant had told me what the inflammation was, reason for Aciphex. Nothing I can do now - - I should have ASKED if o.k. to discontinue. Can you give me facts about what I have done with discontinuing. I am truly scared. appointment for endoscopy Aug. 6th, consult on July 23rd. thank you.

This discussion is related to Intestinal metaplasia.

CWattersMD · Answer

You are very kind. Hope all goes well at UConn. That's a little tough for a Duke guy to say!

ceil1946 · Answer

new to posting - unsure if my thank you reached you.  Lucky is perhaps another way to look at this - will post after endoscopy results.  thank you.

ceil1946 · Answer

thank you for taking the time to post - scared that I in my stupidity have done damage - kicking myself that I didn't ask, royally annoyed that inflammation was not insignificant and I got the information handed to me without more than "inflammation", repeat in a year.  Live in small N.W. CT area - Physician Assistant gave me the info. from the doctor.  Again, thank you.

ceil1946 · Answer

thank you! I  I just in June  took medical to Geriatric Dept. t UCONN - Gastroenterologist here in town and where I have been going - - will write to Dr. at UCONN today explaining what has happened and ask for his direction.He still does not have my medical records from former gnereal doctor but at intake we covered that I have reflux.    I feel I will get better care at UCONN as it is a teaching hospital and I have had great experiences with their orthopedics dept. 

My concern at the time I stopped taking the aciphex was for my bones.  

Again, thank you.

CWattersMD · Answer

My first advice is to find another gastroenterologist that explains their findings personally to the patient rather than deferring to some extender. If you have Barrett's esophagus you will require lng term followup with periodic screening endoscopies and need a GI doc that you feel comfortable with. Current evidence supportsthe theory that Barrett's is caused by the reflux of bile rather than acid. The bile first refluxes from the duodenum into the stomach and then into the esophagus. Acid might make the esophagus more prone to damage by the bile salts. Many patients with Barrett's have minimal symptoms but must still be followed because there is a 10% risk of progressing to cancer. Close surveillance should give adequate warning to allow intervention to prevent the degeneration to cancer. The key finding is whether or not "dysplasia" is seen in the "metaplasia." Symptomatic patients that are poorly controlled on medical therapy should consider anti-reflux surgery (typically a laparoscopic Nissen fundoplication). Work is currently being done looking at methods of killing the abnormal lining with the hope that it will heal as a normal esophageal lining. This may have been a lucky finding in you that didn't actually relate to your complaints at the time but finding it may save you some real misery in the future.

patient915 · Answer

Welcome to the gastroenterology community!  Most likely, stopping the Aciphex was no big deal.  It probably didn't cause any negative things to happen to you, but this would be good to ask your doctor about.