Can one get Barrett's oesophagus if one has no oesophagus? I know it's a silly question, but what is it that is burning (and getting damaged) when I get indigestion? And might that damage cause a new cancer?

I'm taking esomeprazole 20mg and I worry about osteoparosis etc., but equally I worry about the damage being done if I cut down on them.

I don't think there is an answer to this, it's just a matter of choosing between two evils.

5 Replies

  • Hello try cutting out the caffeine it makes a big difference it works for me 21years on. Give it a try and all the best. John

  • This is the very thing that I wonder about .

    ie is it necessary to take PPI to prevent any further damage or could one just put up with the acid reflux ?

    Was going to ask at my next clinic appointment but I think they ( not doctors ) won't really know and will err on side of caution and tell me to carry on with PPIs.

    I guess we have a new oesphageous ,fashioned out of our stomach . Presumably the stomach is designed to cope with acid ,so....presumably we're only taking PPIs for symptomatic relief ?

  • Whether one can develop Barrett's Oesophagus without an oesophagus is a bit of a conundrum.

    I imagine your new oesopgaus/stomach will be lined with cardial cells rather than squamous cells. Barrett's Oesophagus is metaplastic change from squamous to intestinal or cardial mucosa.

    As regards taking PPIs, however, this study recently published: "demonstrates for the first time that PPIs impact on tumour cell survival, metastatic potential and sensitivity towards chemotherapy in esophageal cancer cell lines" and demonstrates they may have a chemo-protective property.

    As regards osteoporosis concerns, 20mg esomeprazole is the minimal dose so unlikely to cause real problems in that respect.

    All the best


  • The oesophagectomy surgery may have left a stump of the oesophagus, which will still retain its original characteristics, so yes, it is feasible that one might eventually develop Barrett's Oesophagus in the remaining stump if you continue to have acid reflux. But the surgeons will have taken this into account when deciding where to make their incisions because they do make sure that they are not taking any undue risk over any possible future problems. And it is a theoretical risk which is very rare, and if your oesophagus stump is healthy, the long time lag before developing problems should still apply. And in any event the PPI medication does have a protective effect

    As far as I am aware it is only the stomach and intestine cells that withstand the acid properly.

    As you have suggested, you should not take this out of proportion. But, the issue may be why you are feeling a burning sensation with indigestion, and that is worth trying to sort out. Perhaps the dose for the esomeprazole could be increased for a while to see whether that makes a difference. Or a change of PPI. Some people find that when they take PPI medication during the day/evening makes a difference. And it might be bile reflux, which would need a different sort of medication because it is alkali rather than acid.

    The answer re the osteoporosis issue is to have your mineral / vitamin levels checked, consider a bone density scan as a baseline comparison, and to counteract any problems with iron supplements. Omeprazole is a very common medication taken by many thousands of people and the side effects, again, should not be taken out of proportion to the benefits.

  • Thanks everyone, you've been very reassuring. Perhaps, after five years, I should stop looking for trouble and stop waiting for the cancer to come back!!!

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