Barrett's 8 years post op

[liz_crisp]

Hi I am 8years post op and have developed Barrett's, wondering if anyone else has Barrett's following Ivor Lewis op.

Also if you do have Barrett's how often do you normally get followed up?

Cheers Lizzy

[kiddy]

Hi get acid reflux and bile reflux which is quite normal also inflammation in my oesphagus when I had a endoscopy 2yrs post op. I don’t think many people get rid of it,If like me you had part stomach part oesphagus taken away. I take Lansoprazole , Gaviscon advance and sucralfate.

Best Wishes

Debbie

[Alan_M]

Hello Lizzy!

I can remember this being talked about as a theoretical possibility, but being judged by surgeons to be a very small risk - but that is not much comfort is it!

There are some guidelines on management of Barrett's oesophagus issued by the British Society of Gastroenterology bsg.org.uk/resource/bsg-gui...

but the gist of it is that they assess people according to risk, and the interval between endoscopic surveillance is between 2 - 5 years. But this is meaningless in your case because it is so unusual.

Did you originally have adenocarcinoma? or squamous cell carcinoma?

Depending on where your surgery was located and how much of your oesophagus remains, there could be a feasible chance that there was some potential Barrett's remaining that did not happen to get removed in the original surgery, but this seems unlikely.

The other side of it is that the Barrett's has developed since your original surgery, perhaps as the result of exposure to reflux, acid or bile. The significance of Barrett's is really the potential for developing adenocarcinoma but it is otherwise not much of a problem. The risk of cancer is heavily dependent on whether dysplasia is found or not. There is some information on actionagainstheartburn.org.uk but it is primarily addressed to those who have never had cancer before. So they will probably take biopsies with a view to determining whether dysplasia exists or not.

A person aged 30 with newly developed Barrett's may have a 12-25% risk of developing adenocarcinoma by the time they reach 80 years of age, but with low grade dysplasia there is a 5% risk in the following eight years. With high grade dysplasia the equivalent risk is 50%. But these are general statistics of course.

Radio frequency ablation (RFA) can remove dysplastic Barrett's oesophagus cells with a good success rate, and it would be worth asking whether RFA would be possible in your situation if things developed in that direction. The oesophagectomy is a major complication, and it may be that they have little experience of trying it. It might just depend on the precise details of where the surgical joint is located. RFA is not available everywhere.

I imagine that they would perform endoscopies to keep an eye on it, and if it is stable, the periods between endoscopies would lengthen. It would also be worthwhile to review whether anything further can be done with medication to reduce the reflux risk.

I hope it goes well for you

Kind regards

Alan

[liz_crisp in reply to Alan_M]

Thanks Alan, the surgeon did say it was unusual and showed me a photo of my remaining stomach which has a very red area coming up from the remaining valve or at least that is what it looked like. He mentioned a few polyps. I am definitely going to take my PPIs forever now. I tried cutting down about three years ago and was obviously not a good idea.

Enjoy the sun

Lizzy

[Alan_M in reply to liz_crisp]

And just a thought, check that it really is acid reflux rather than bile. But if the PPIs combat it, it would seem more likely to be acid. Take care.

Alan

[liz_crisp in reply to Alan_M]

Thanks Alan. I have asked if it could be bile as I do take a large dose of PPIs

[Horses444]

My cancer started with Barrett's , I would be sticking to a low risk cancer diet to minimise chances of return of cancer. No strong or excessive alcohol. Low red meat consumption, high amounts of raw veg plenty of antioxidants and low sugar and carbs. It was excessive alcohol that caused my cancer, I am only four months out and doing well apart from a bit of dumping causing low blood pressure. Good luck and stay healthy

CJ Australia