Oesoph C .. tell tale signs?

[Garysreflux]

Hi ..

Just read tommys post about being diagnosed with OC. Personally, its my worst dread. Im med/ high risk.

This post was originally a reply to tommys post obut after reading several of the fantastic replies you guys provided him it was obvious my situation fell short on equalstanding. So my thoughts, bestvwishes go out to tommy and ive created this new post.

ive got an oesophagus narrowing around join with stomach. Back in jul17 i had the narrowing ultrasounded and thankfully no C. The narrowing , im advised, is due to scarring tissue arising out of years of reflux. Had HH nissen360 op sep17 .. no more reflux .. but still got swallowing difficulties due to scarring and they suspect poss alchalasia or maybe nissen too tight. Still have funnel shaped oesoph and foods .. particularly those with low mass .. bread, salmon etc .. lodge in my oesoph. Food residue in my oesoph has meant recently ive had 2 failed endoscs and a failed mammometry. Ive just been advised i have a ct scan booked later this month and i believe the plan is to gather info for me to undergo an op for an incision to increase size of junction opening.

That aside, Im concerned of my condition developing into barrets or full out C and aware that early diagnosis is crucial. As i say im a higher risk for OC and i wondered if there were any tell tale signs i should look out for. 61yr old . Male .. fit . Bmi 22 .. feel good in myself.

Kind regards, good health and recovery to all.

Gary

[Alan_M]

If the Heller's myotomy is too tight, causing you swallowing difficulty, it may well be that this in itself stops the reflux coming up into your oesophagus. It is possible for these fundoplications to be adjusted but it is not something to be undertaken lightly and without good reason.

The risk of oesophageal cancer developing, especially adenocarcinoma that is linked with prolonged reflux, almost invariably entails Barrett's Oesophagus, where the lining of the oesophagus gets damaged by the reflux and is normally clearly visible during an endoscopy. So if you have not got Barrett's Oesophagus I would not worry about the cancer risk as such (and even then it depends heavily on whether there is high grade dysplasia).

In relation to the food residue it would be prudent to avoid food accumulating in your oesophagus not least because passage of food through your system is essential for good nutrition. You may wish to avoid certain foods with a stringy texture, or with difficult skins, or food that congeals like bread and rice.

[Mauser1905 in reply to Alan_M]

Alan

I never had Barret's oesophaegus, some research statistics I read showed less than 1% of the sampled patients with Barret's oesophaegus went on to develop adenocarcinoma.

[Alan_M in reply to Mauser1905]

It may well be that Barrett's Oesophagus is a side issue that is irrelevant; but in some cases it can be relevant. The issue for you may well be sorting out the swallowing issue and how food passes through into your stomach, and this should probably be your priority.

Incidentally, one needs to be careful about how the risks of Barrett's Oesophagus are described. It is quite often presented as 0.3% per patient year, ie less than 1% as you describe. But this is per patient year, and as years pass by, that risk increases. It is still low, but it is significant when a person aged 30 years with newly-developed Barrett's oesophagus may have a 12-25% risk of adenocarcinoma by the time they reach 80 years. But having an endoscopy, which you appear to have done, establishes very easily whether you will have Barrett's oesophagus or not

[Mauser1905 in reply to Alan_M]

Agree with you Alan on the BO being a irrelevant issue. From my personal experience I had had Adenocarcinoma at the age of 39, while the LES not functioned properly for long time.

Its a very good point you made about the sampled patients whole life span rather than just diagnosed span.

[Mauser1905]

Gary,

Sorry to know your struggle. Believe this is one of the after effects of the NF360, as the theme is more subjective than objective and very difficult to achieve 100% accurate and precise result. LINX was never discussed in the process as an alternative for the surgery?

As for the tell tale signs, the OC being one of the most fatal types, simply because its very stealthy till its much late into discovery, suggest frequent endoscopies and perhaps annual PET scans? If difficult to get on the NHS either going private in the UK or when on holidays in the sunnier places will be more cost effective option.

[Garysreflux in reply to Mauser1905]

Thoughtful reply. Thanks. Lynx was never mentioned and is limited on nhs as i understand it. Due to food residue in oesoph recently ive had 2 failed endoscs and a failed mammometry. Nhs have promptly got me in for a ct scan this friday .. ive got no feedback about ct from hospital (its in cancer unit) but im surmising to adjust my wrap doctor needs info and the ct scan is next best thing as other sources of info failed. Fingers xg. Cheers. G