Barretts esophagus

[patchworker]

My surgeon says my adenocarcinoma was caused by Barretts esophagus, and that is caused by digestive acids scarring the esophagus, and that is caused by indigestion, the acids not staying in the stomach where they belong.

But I never had indigestion, or any problems with my stomach, or any pain in that area. Before my op. I never had heartburn, I could eat anything, without any difficulty. The family joked that I had a cast iron stomach.

Surely Barretts esophagus must be at least uncomfortable for a while before it turns to cancer?

I'm just trying to understand.

I think I should have put this under Questions.

[chrisrob]

Hi Patchworker,

Almost half of those developing Barrett's Oesophagus do not experience heartburn. We don't know why. It is called "silent reflux".

Barrett's itself is asymptomatic: the changes in cell structure actually protect the epithelium and nervous system against acid attack. Those lucky enough not to have endured the pain of heartburn, may not recognise the other symptoms: hoarseness, cough, phlegm, difficulty swallowing etc.

Even though I had had extreme heartburn (like a blow torch down the throat) I was always being sent to ENT for my cough - until I pointed out to my GP I thought it was reflux related.

Chris

[2Chrissie4 in reply to chrisrob]

I had the oesophagectomy done back in 2004 with a gastric pullup which left me with about 2" of oesophagus left. Just lately i have experienced problems with hoarseness when i try to call out to someone which ends up with me coughing up a lot of phlegm. I also have difficulty swallowing more than 5-6 small mouthfulls of food and i often have problems with fluid backing up to my throat and going down the wrong way which ends with a cough. It is like a vicious circle. It just so happens that i have an appointment to see a surgeon tommorrow and shall mention this to him. I am seeing him because a have an abcess next to my jejunostomy stoma.

[2Chrissie4 in reply to chrisrob]

I forgot to mention that i am on Nexium 40mg times 2 daily and i am still having problems with indigestion/heartburn and reflux which is pretty bad.

[spike3]

Hi Patchworker,

I was diagnosed the same as you and like you never really had any problems except the occasional bout of indigestion, (dont we all) however i had an Ivor Lewis procedure (oesophagectomy) nearly six years ago and can only thank the consultant team who spotted that it was turning (nasty)

Since then i have had a slow recovery but mainly energywise, but after my oesophagus was removed they were able to tell me that they had removed all trace and following the biopsie that it had indeed turned cancerous. So looking on the bright side i'm still here!!! and intending to stay. Just remember that you get back to a "new" normal life again. i wish you all the best.hope this helps.

[medway]

I too never had reflux. What is of concern to everybody, and I mean everybody, is that Oesophugal and stomach cancer has no warning and anybody can get it without knowing it as there is usually no pain. When most people are diagnosed cancer has reached T3 or 4 and then drastic surgery is required. Reflux needs to be taken seriously by everybody and little is publically known about it and possible further cancer issues. This is why so many people are developing oesophagal & stomach cancer without knowing about the previous Barrett's condition.

My wife has been suffering from acid reflux and we are taking it seriously and she is now being proscribed Omeprazole.

Anybody who is diagnosed with Barrett's Disease only should be made aware of Halo Ablation which is taking the top layer off the Oesophagus. The only side effect I am aware of for this is the bleeding that occurs which can be controlled.

Sufferers should also be aware that Halo Ablation is being done on the stomach in other countries and as far as I am aware under consideration here in the UK. It can only be done when cancer is in the first layer of three in the stomach. The risk is it may be deeper.

Where Barrett's is diagnosed and pull up is suggested, Merendino Interposition is an alternative if only Barrett's or T1 is diagnosed. It is a major op and the advantage is no reflux after. I had this 15 months ago and no reflux now. Just the usual digestive problems which need care. Contact me through the OPA if you would like to know more about a patients observations.

Personally I am concerned with the lack of understanding by the general population of the possible serious effects of acid reflux.

[Hidden]

I agree. I think it is generally understood that the stomach (acid) reflux does cause Barrett's Oesophagus. Not everybody feels it, and for some they would have felt it some years ago, but then it appeared to have resolved itself, with the suspicion that it was the completion of the process of the cell changes that protected the patient against the pain of the heartburn.

So some might never remember the heartburn - or have different symptoms; and for some it might have been some time ago and they have not felt it recently.

It is quite right to say that persistent heartburn is something that should be taken seriously. Persistent heartburn and Barrett's oesophagus do provide an opportunity to investigate precursor conditions that are not present for many other cancers.

There is more detail on actionagainstheartburn.org.uk

[Mick]

In my case for years I suffered with indijestion and heartburn, after several visits to the doctors over a long perod. A new doctor listened to my symptoms and said `I`ll book you in for an endoscopy just to check`, in the meantime Take a 30mg table of lazoprozine once a day. For the next month I didnt suffer with indijestion or heartburn, eating and drinking what I felt like. After the endoscopy I was told I had `Barratts` and that I would be on the Lanzoprozine indefinately, and that I should have regular endoscopies, that was about 14 years ago.

I had no symptoms, ie difficuly swollowing etc, just felt perfectly normal.

In Nov 2011 after a endoscopy I was told I had cancer of the oesophagus, early stages. By Feb 2012, after tests I went in for the op. Now 1 year later, yes I`ve had the usual ups and down, (haven`t we all), slowly coming to terms with everything.

The one thing I have been told is although `Barratts` can be caused by reflux (acid) not everyone developes cancer, in my case I am grateful that a regular endoscopy check found it early. As Alan says persistant heartburn etc should be taken seriously and checked on.

[rubynolegs]

I go into hospital tomorrow for a few days. It has taken a battle of 2 years and 9 months and not a single tablet even though the GP knows that when I have a really bad reflux it comes up out of my mouth and often from my nose burning like hell. I have also lost 5st 2lb (now 6st 8lb) and have just been allowed a dietician, who took 3 months to write to me and the first appointment is 3 months from now.

If I sound upset/cross it is because my dad and sister died of Gastric Cancers young, Oesophageal and stomach, and although there is a lot to be said about early checks, in reality some NHS departments seems not to have that view. It meant a lot of research and finding a good Hospital, with great Consultants that either care a great deal, or are into Research. I doesn't matter which, just that you get investigations, and treatment as required.

My husband is at a different GP than mine, and he too has Reflux (18 months now) He was treated for a month then told to stop. It cleared then came back to bite much worse, so after the GP saying it wasnt anything to worry about, but gave him another box of pills, he finished those and went on Rennies saying if the GP wasnt worried then why should he??

I did remind him that he already had Cancer removed and he shouldnt take chances but the GP has led him to believe that it is a "Nothing" condition.

I see a great Consultant tomorrow who asked me why I was travelling so far from home.

I reminded him that the Hospital had excellent reports. I felt he listened to me and he promised to put my mind at rest once and for all, good or bad, and promised to treat me straight away for anything found.

He is giving me a general and keeping me at least 3 days for tests, so I can only think myself lucky and hope for the best.

Good luck to everyone else.

[gutlesswonder]

There is a growing body of research-based medical opinion which considers that Bile may be a co-culprit with Hydrochloric Acid ,or even the principal cause of GERD/Barrett's/Carcinoma.