Grading of Oesophagitis.

[Lydia1960]

Had a endoscope done recently, after vomiting up some blood, and was informed that I had grade 2 oesophatigis. Spoke to my doctor who said there was inflammation there. Does this mean that there has been cell changes and if so, should I be worried? Prior to be given two Omprazole tablets to take for 8 weeks, which should have been reduced down to one, but they are controlling my symptoms, swallowing difficulties, burning in my throat, hoarseness, coughing, pain under breastbone... These seem like advance symptoms to be worried about, but the doctor suggests not. There was no suggestion of Barrett's oesophagus disease. So I am wondering how advance this condition is, and what the outlook is for it. Read that, although few people go onto to developing cancer, it is on the increase, and it is a lethal cancer, in that few survive it, or for very long after treatment.. Can anyone advise me on this?

[DavidP]

Hello Lydia, Grade 2 is a low grade inflammation (the scale is 1-5 with 5 being the worst). As you're getting treated and monitored try not to worry. As to your question about OC, as with many relatively "silent" cancers, OC has been associated with poor outcomes because many people are diagnosed with late disease. As many on this site wll testify OC can be cured if caught early enough. In your case, I'd be confident that they would have picked it up at endoscopy if there was anything there.

[Lydia1960 in reply to DavidP]

Thank you for your response, DavidP, as I had spoken to a nurse on the Macmillan line and she was suggesting this indicated that cells were changing, and that the grading was at the intermediate stage? Your reply has reassured me somewhat. I know my diet, exercise routine and keeping stress to a minimum, are factors. So I'll try and work on these...

[Hidden]

Oesophagitis really means that there is a degree of irritation of the oesophagus, and this is normally quite different from Barrett's Oesophagus, more details of which can be found at actionagainstheartburn.org.uk

It is normally cured or controlled with medication, depending on the underlying cause of the irritation, eg: webmd.boots.com/digestive-d...

[Lydia1960 in reply to Hidden]

So there are no cell changes, then, as the nurse I spoke to on the helpline seemed to think that there must be, and that I was at the intermediate stage? I'll check out those two links here..

[Lydia1960 in reply to Lydia1960]

Aren't symptoms such as difficulty swallowing, burning in throat after eating, coughing, hoarseness, pain under breastbone, all of which I had for quite some time, pre vomiting up blood, having an endoscope and being prescribed Omprazole, which was supposed to be reduced down to one tablet a day, from two, but very slight symptoms started again. Little bit of coughing, reflux coming up into throat. Mostly stopped now. Aren't these advance symptoms that indicate that there might be cell changes?

[Hidden in reply to Lydia1960]

If there is erosion to justify a diagnosis of oesophagitis, there must be something noticeable about the cells, but they may well heal over time with the right medication. If this counts as 'cell changes' the nurse is right. Which is different from cell changes that occur from Barrett's Oesophagus, that you have not apparently reached:

The Savary-Miller grading system is commonly used:

Grade 1: single or multiple erosions on a single fold. Erosions may be exudative or erythematous.

Grade 2: multiple erosions affecting multiple folds. Erosions may be confluent.

Grade 3: multiple circumferential erosions.

Grade 4: ulcer, stenosis or oesophageal shortening.

Grade 5: Barrett's epithelium. Columnar metaplasia in the form of circular or non-circular (islands or tongues) extensions.

[Lydia1960 in reply to Hidden]

On the comments on the form for the endoscope procedure were:- 'No evidence of active or altered blood. Grade 2 Oesophagitis. Continue high dose PPI for 8 weeks then reduce to maintenance dose.'.

I have continued to take two omprazoles as when I reduced it to one, the annoying coughing started a little. My GP said this was okay, but I am seeing a Gastro specialist soon about problems I have been having with discomfort in my stomach, which might be to do with IBS, so I don't think it is related to this condition...?

Am under a lot of stress, and have been for decades, which has had a profound effect upon my physical health and my GP advise me to try to keep this to a minimum as it is a factor in this disease, Oesophagitis..

[Hidden in reply to Lydia1960]

Following the recommended course of PPI medication (Omeprazole) for the eight weeks is a sensible thing and sounds like a normal sensible strategy which will be reviewed by the gastroenterologist, seeing whom is an excellent move.