BS: Barrett's oesophagus

Subject: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 10 Jan 19 - 05:36 AM

Late last year I had a CT scan for anything liver, kidney or pancreas related. That was a bit of a worry but it did not find anything sinister. It did, however, find a thickening of the lower oesophagus. Not being prone to needless worry it was not a great concern but I could not help have the odd dark thought :-( I had a gastroscopy to investigate yesterday. That was fun... Anyway, they allayed my fears and confirmed that the thickening was as a result of a hiatus hernia, which I already knew about. They did find some patches of Barrett's oesophagus which is likely related to reflux, worsened by the hernia. The oesophagus can recover and in an endevour to help I will loose weight and cut down on the booze!

I am of course much happier now and although I know it will need to be monitored I also know that, given the right treatment, it is very unlikely to develop into anything more serious.

Wish me luck and share any hints, tips or anecdotes that may help.

Cheers

DtG

BTW - I shall be learning Barrett's Privateers :-)

Subject: RE: BS: Barrett's oesophagus
From: Senoufou
Date: 10 Jan 19 - 01:58 PM

I too have a hiatus hernia Dave. And have had a gastroscopy (agree - not at all fun!) Reflux like yours, exacerbated by the hernia, has caused thickening of my oesphagus, ut nothing sinister.

I was prescribed a proton pump inhibitor (Lansoprazole) which I took for a few months. But having consulted my GP first, I tailed off the PPI, (it has some alarming effects long-term) which resulted in awful reflux. But I battled through and the reflux eventually abated after a couple of weeks.

I now eat nothing at all after about 5pm, and go to bed with a fairly empty stomach. This has reduced the reflux at night.
I also swear by Gaviscon. Just a teaspoonful instantly calms any indigestion.
I've learned which foods cause reflux and avoid them. I don't drink any alcohol.
And I have lost a bit of weight (never a bad thing)
The GP has never said anything about monitoring my oesphagus though.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 10 Jan 19 - 02:12 PM

I've had the hernia for at least 25 years, Sen, and do use a PPI. Omeprazole in my case. I stopped taking it regularly about 5 years ago because of a low haemoglobin count which may have been related. Other than that, which may have been a red herring, I had no PPI side effects. I have uped my does again until I see the doctor in about 3 weeks when I will get more advice. Thanks for the advice anyway and I like the idea of not eating late. I don't eat too late anyway and it may fit in with a weight loss plan too.

Subject: RE: BS: Barrett's oesophagus
From: Donuel
Date: 10 Jan 19 - 02:56 PM

I used to have those symptoms to the point I tilted my bed. It must have healed since its been over a year without any back flow or discomfort. No more red sauce after 7PM.

Subject: RE: BS: Barrett's oesophagus
From: bobad
Date: 10 Jan 19 - 03:05 PM

Yup, raising the head of your bed at least six inches is effective against the upward creep of gastric acid into the esophagus as you sleep.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 10 Jan 19 - 03:27 PM

used to sleep on my right side but now sleep mainly on my left. As that results in the opening to the stomach pointing upwards it does help to keep the acid where it should be.

Daniel and Bobad, can I ask if you have partners and, if so, how do they feel about raising the bed head? We are due to get a new bed soon and I was thinking about one with different adjustment settings for each side but they are quite expensive.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 10 Jan 19 - 03:36 PM

Sorry Donuel. Spilling clicker strikes again!

Subject: RE: BS: Barrett's oesophagus
From: bobad
Date: 10 Jan 19 - 03:47 PM

Dave, I slept apart from my wife with the head of the bed raised for a while until my GERD abated. That, along with some lifestyle changes has, so far anyway, kept me relatively asymptomatic. When I feel symptoms coming on I take PPIs until they abate. This regimen seems to be doing the trick for me so far.

Subject: RE: BS: Barrett's oesophagus
From: Jack Campin
Date: 10 Jan 19 - 04:56 PM

One peculiar fact: Barrett's is worsened by vitamin A. I think you can actually improve it by restricting vitamin A intake or blocking its activity.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 10 Jan 19 - 05:01 PM

Thanks Bobad.

I never heard that, Jack. I'll look into it in more detail.

Subject: RE: BS: Barrett's oesophagus
From: Steve Shaw
Date: 10 Jan 19 - 05:32 PM

I had terrible heartburn for years. Had that thing with a telescope down me throat. There was a touch of erosion around my cardiac sphincter (no, not THAT sphincter, you bastards). A bit of reflux going on. One 15mg capsule of lanzoprazole per morning has fixed everything. I can drink red wine and neat malt with impunity, and I even take max-dose voltarol every day for my bad bones. Don't fret about what you read about lanzoprazole. The side effects are rare and even rarer with such tiny doses. Life is all about risk-benefit at our age. Keep taking the tablets and be happy is my philosophy. On the other hand, I'm no doctor.

Subject: RE: BS: Barrett's oesophagus
From: Jeri
Date: 10 Jan 19 - 05:37 PM

I took PPIs for years. Has to stop when I started having chronic diarrhea. The stuff worked great for my stomach, but apparently, can cause problems with absorption of nutrients. , H43R='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110863/">Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications (National Institute of Health)

If it were all new to me, I think I'd take the PPIs, but stop them for a while every now and then. I don't know if that would be effective. I take Zantac (Ranitidine) now, but I seem to have less heartburn than I used to.

Subject: RE: BS: Barrett's oesophagus
From: Senoufou
Date: 10 Jan 19 - 06:00 PM

I believe there are various sizes of hiatus hernias. The gastroscopy chap gave its measurement in his report, and it was quite small. Larger hernias can be repaired, but this is very rarely done.

I don't regret coming off the PPI, although the couple of weeks of withdrawal were a bit hairy. I haven't needed it since.

I also believe that huge, heavy meals provoke reflux, and I now have small, simple meals.

Subject: RE: BS: Barrett's oesophagus
From: Senoufou
Date: 10 Jan 19 - 06:41 PM

Steve, I should get a different gastroscopist if he ended up poking his camera into your cardiac sphincter! Do you mean your gastric sphincter?

Subject: RE: BS: Barrett's oesophagus
From: Helen
Date: 10 Jan 19 - 06:44 PM

Thanks for scaring me about how much "fun" my gastroscopy is going to be in a week's time. I've been bricking it anyway, but now I'm feeling worse. The one good thing is that - apparently - it will be under general anaesthetic so at least I won't be awake to experience it.

Have any of you tried using Slippery Elm Bark powder? It puts a soothing coating on the lining of the stomach. I have used it, off and on, for about 40 years.

Just be careful when you make it up with hot water because it retains the heat. My method is to put a heaped teaspoon of SEBP in a cup. Add a third of a cup of boiling water and stir quickly to dissolve the lumps then add a third of a cup (or more) of cold water to make it a drinkable consistency. You can add some honey or lemon juice to mask the flavour a bit, but it doesn't have much flavour anyway. I am used to it now so I just drink it neat.

Subject: RE: BS: Barrett's oesophagus
From: Steve Shaw
Date: 10 Jan 19 - 06:50 PM

Nope. Cardiac sphincter top end of tummy. Pyloric sphincter bottom end of tummy. From Steve (20 years on lanzoprazole and deliriously happy)

Subject: RE: BS: Barrett's oesophagus
From: Tattie Bogle
Date: 10 Jan 19 - 07:40 PM

I went to my GP with something entirely different, but she took a very thorough history, including - any trouble swallowing? Well, yes, very intermittent, but if I eat too quickly, especially dry foods such as bread, it does get stuck, and I just have to wait a few minutes until it passes, before I can eat any more. Even drinking liquids doesn't help: you just have to wait...... Think my Dad had the same. Very occasional, and not progressive, so I didn't think it could be anything nasty. But, endoscopy showed that I had a hiatus hernia, and minimal oesophagitis and gastritis, tho not having been aware of any reflux symptoms. So that was it, 20mg omeprazole for life, tho it was later cut to 10mg in view of concerns re long-term usage. And about 5 or 6 times a year, I do get severe lower chest pain, enough to send most people phoning 999 for a cardiac ambulance, but as it disappears within minutes after 4 Gaviscon tablets, I think it is just oesophageal spasm due to acid reflux into the lower oesophagus.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 11 Jan 19 - 03:10 AM

It's not that bad, Helen. I have had 3 - all without anesthesia. The worse thing is the gag reaction (How did Linda Lovelace do it? :-) ) and that only occurs a bit. Overall, the whole procedure is only a few minutes. Not something you would do for fun but nothing at all to be frightened of.

Jack - I can't see anything about vitamin A affecting either Barrett's or GERD. Do you have a link for that?

I can confirm that there is a theory that PPIs may affect absorbtion which is why it was suggested I came off them when I was suffering from a low haemoglobin count. Other doctors I have spoken to have said it may not be related though so I will keep up with them until told otherwise.

Subject: RE: BS: Barrett's oesophagus
From: Backwoodsman
Date: 11 Jan 19 - 03:32 AM

Helen, I've had (I think) six of the 'camera down yer throat' jobbies - in my case they were looking at some serious pancreas/common bile-duct issues, and included placing stents in the bile duct and taking biopsy samples from my pancreas. The first was under sedation (awake, but in 'I don't give a rat's arse' mode!), the rest were 'straight down', no anaesthesia, local or otherwise. Dave's correct, as long as you give a big swallow when they tell you, going in is OK. I found coming out was where I got the gag-reflex each time, but it was fairly slight, and over quickly.

Don't be nervous - the medical staff are aware of patients' feelings, and they are very kind.

People I know who have had laparoscopies 'at both ends' tell me the the one going in from the top is preferable to the one going in from the bottom!

Subject: RE: BS: Barrett's oesophagus
From: Senoufou
Date: 11 Jan 19 - 03:41 AM

Well I never did! I'm so sorry Steve, I was completely wrong. You'd think I'd know better (did Biology O Level) Please accept my apologies.

I was sedated, and calm for the camera going down, but found the 'coming out' worse. I fought like a demon and four lovely (but burly) nurses pinned me to the couch. Surprising really, as I'm usually quite a placid person.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 11 Jan 19 - 03:51 AM

I have had both ends too and the other end was not as bad. At least it does not gag :-) The worse bit about that is the preparation as they have to make sure your bowel is completely empty. You know how it feels when the bottom falls out of your world? Well, it is the same but in reverse :-D

Subject: RE: BS: Barrett's oesophagus
From: Senoufou
Date: 11 Jan 19 - 03:56 AM

Was it Dulcolax Dave? My friend was given that, and the effects were just as you describe!

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 11 Jan 19 - 04:08 AM

Dunno, Sen. All I can add is that I am glad I had not eaten anything since the night before!

Subject: RE: BS: Barrett's oesophagus
From: Senoufou
Date: 11 Jan 19 - 04:32 AM

She said, "Oi thort oi woz a-turning insoid owt!"

Subject: RE: BS: Barrett's oesophagus
From: Jack Campin
Date: 11 Jan 19 - 04:32 AM

My wife had a gastroscopy yesterday - turned out she had a few small stomach ulcers, completely unsuspected. The procedure was not a big deal.

The way the clinic runs was ingenious. For hygiene reasons, they do down the gullet in the morning and up the bum in the afternoon, less cleanup required. My wife got hers done just before the watershed when the gastro patients in their day clothes were just making way for the colon queue in their hospital gowns.

Subject: RE: BS: Barrett's oesophagus
From: Backwoodsman
Date: 11 Jan 19 - 04:45 AM

LOL Dave! Reminds me of a joke my (ex-nurse) sister used to tell about someone who, due to bad record-keeping, had two 'clear-outs' in quick succession - when a nurse approached after the second one, the patron asked, "Who goes there, friend or enema?". :-)

Subject: RE: BS: Barrett's oesophagus
From: Helen
Date: 11 Jan 19 - 06:36 AM

Backwoodsman, that last bit of reassurance doesn't actually help because I am having both procedures on the same day.

Subject: RE: BS: Barrett's oesophagus
From: Backwoodsman
Date: 11 Jan 19 - 06:39 AM

Oh shit! (See what I did there?). ;-)

Helen, Dave seemed to think otherwise, I reckon you should trust his judgment.

Subject: RE: BS: Barrett's oesophagus
From: Donuel
Date: 11 Jan 19 - 07:42 AM

We got a tilted bed and I made a manual one. The reflux thing was terrifying for my wife since the acid would autonomicly shut off my breathing as to not enter the lungs. So I would wake up and have to force myself to breathe. This sounded awful and take another minute or two to breathe again. I never took drugs for it. Water reduced ph and natural popcorn makes for a good acid proof plug.
No more incidents = no more late nite acid snacks.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 11 Jan 19 - 07:51 AM

I occasionally wake up coughing terribly and it takes a while to get my breath. Probably something to do with reflux but as I have both asthma and sleep apnea it is difficult to tell. I am a right duffer! Luckily the coughing thing is only once every blue moon. I'll try the popcorn though.

Subject: RE: BS: Barrett's oesophagus
From: Steve Shaw
Date: 11 Jan 19 - 07:55 AM

I had two colonoscopies within months due to an administrative cock-up (shut up over there...). Whilst the travelling to the hospital was inconvenient and the procedure somewhat unusual (mind you...), it did afford me the pleasure on both occasions of not only being able to fart freely and loudly into another human being's face but also to be actually encouraged to do so. The nurses were very nice and I did feel a bit guilty about it. I hope they got bonuses...

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 11 Jan 19 - 08:49 AM

The doctor gave me a course of suppositories once. For all the good they did I may have well as stuck them up my arse...

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 11 Jan 19 - 09:25 AM

I've just written the chorus

God damn them all! I was told
I'd drink no more Whitbread's gold
Keep off the curry, though it's delicious
No more fish and chips, just asparagus
I've got Barrett's oesophagus

Subject: RE: BS: Barrett's oesophagus
From: MikeL2
Date: 11 Jan 19 - 09:59 AM

Hi Steve

" lanzoprazole" ?? I have been prescribed Lansoprazole for indigestion
problems' ( are they the same??)   I was referred to have " both ends scoped and even had a date fixed for the top job sic. But the lanzoprazole cleared it all up. So I cancelled the appointment well before the date. The hospital were not too pleased that I cancelled.


Three months later I don't have the problems - except for some ocasional wind at either end but never both at the same time. If I am having a large meal and with alcohol with it I sometimes take a lanzoprazole a couple of hours before I eat.

Tonight for instance It is my wife's 80th Birthday and we are going out,
We don't know where as no. 1 son and his wife have organised it all.

All we know is to be ready for 7.30 tonight and a taxi will pick us up and return us at mid-night. So I will be taking a lanzoprazole just before we go out.

On a similar theme I had throat cancer some years ago and had to have many cameras pushed down my throat. Obviously not as deep as the other scopes but they went down my nostrils. No sedation etc but they sprayed something down to open the route down. The doctors called it " jumbo - jet fuel.!!
On ocasions I felt like gagging but I was " a brave boy" as the nurse always said.

It worked though.

Cheers

Mike

Subject: RE: BS: Barrett's oesophagus
From: Tattie Bogle
Date: 11 Jan 19 - 10:55 AM

The stuff what they give you to clear you out works osmotically: usually "Klean-prep" or "Movi-prep". Never been so "Klean" - or empty - in my life - yes I had both ends inspected all in the one day too!
Ingredients: Macrogol 3350, Sodium Sulphate, Sodium Bicarbonate, Sodium Chloride and Potassium Chloride, Aspartame and vanilla flavour.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 11 Jan 19 - 10:58 AM

Movi-prep sounds familiar.

Subject: RE: BS: Barrett's oesophagus
From: Manitas_at_home
Date: 11 Jan 19 - 11:12 AM

I had picolax last time and ended up being ferried by ambulance to A&E as my blood pressure dropped so much I was unable to walk and passed out. I still had to have the endoscopy the next day.

Subject: RE: BS: Barrett's oesophagus
From: Steve Shaw
Date: 11 Jan 19 - 02:01 PM

A single 15mg capsule of lanzoprazole before breakfast every morning sorts me out for the whole day, including a glass or two of neat malt twelve hours later when required. No heartburn any more, ever. But we're all different and I'm no doctor. Lanzoprazole is a proton pump inhibitor, which means, in simple lingo, that it reduces the amount of acid released into your stomach by the oxyntic cells in the glands in your stomach lining. Your stomach has chemical mechanisms to buffer the acidity of the stomach, but if the acidity is a bit too high and your cardiac sphincter allows some of the fluids to leak back into your oesopagus at its bottom end you get heartburn. You need acid in your stomach to facilitate the breakdown of proteins in food and to kill any nasty bugs in your food. Antacids such as Setlers and Rennies simply neutralise somewhat the acid already present in the stomach. You shouldn't take them with lanzoprazole. If I forget to take the capsule, I'm in trouble by teatime. 15mg once a day is the lowest possible dose of lanzoprazole. You can be prescribed much more than that.

Subject: RE: BS: Barrett's oesophagus
From: Donuel
Date: 11 Jan 19 - 02:32 PM

A difference in UK and US drug names and procedures will once again cause some confusion.

Subject: RE: BS: Barrett's oesophagus
From: Steve Shaw
Date: 11 Jan 19 - 04:41 PM

Lanzoprazole is the generic name. Same your end as ours.

Subject: RE: BS: Barrett's oesophagus
From: robomatic
Date: 11 Jan 19 - 08:06 PM

No recommendagtions here, just personal experience:

I took Prilosec for a few years and then soured on the OTC medication when I discovered that if I stopped taking it for a couple of days I started getting regular chest pains which caused me to call a heart doctor. I stopped the Prilosec entirely and I moderated on foods with flour in them and seem to be more or less under control. losing some weight also helped.

Subject: RE: BS: Barrett's oesophagus
From: Steve Shaw
Date: 11 Jan 19 - 09:05 PM

Prilosec is what we call losec this end. I was prescribed it 25 years ago. It made me bounce from wall to wall in a long corridor. Weird. Never again.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 12 Jan 19 - 03:26 AM

Losec is omeprazole which I have been taking for years with no problems. Unless it did cause the anaemia I had. Funny how different bodies react to the same drugs init! I think I will ask about lanzoprazole though as it is a newer PPI.

Subject: RE: BS: Barrett's oesophagus
From: Jack Campin
Date: 12 Jan 19 - 03:51 AM

Long-term use of PPIs is a risk factor for dementia.

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 12 Jan 19 - 05:33 AM

Aye, I believe so. Conversely statins help prevent any vascular disorder, including dementia, and I am on them too! Maybe one will cancel the other :-)

Subject: RE: BS: Barrett's oesophagus
From: Steve Shaw
Date: 12 Jan 19 - 06:04 AM

Well the BMJ and the NHS don't agree with you, Jack. If anything it could be the other way round. Keep taking the tablets, folks!

Subject: RE: BS: Barrett's oesophagus
From: Dave the Gnome
Date: 13 Jan 19 - 04:05 PM

Interesting, Steve. I was under the same impression but following your comment I have looked it up and found that newer research has said that "there is no convincing evidence to support the suggestion that PPI use increases dementia risk."

Thanks for that. Trouble is, will newer research overturn it again? You scientists have a lot of confusion to answer for :-)

Subject: RE: BS: Barrett's oesophagus
From: Jack Campin
Date: 13 Jan 19 - 04:58 PM

You can guarantee that whenever anything that scary is suggested about a profitable drug, its makers will sponsor a shitload of studies in the hope that one of them will suggest the opposite. I would suggest a bit of skepticism about the exoneration.

Subject: RE: BS: Barrett's oesophagus
From: Steve Shaw
Date: 13 Jan 19 - 08:09 PM

Quite so. Very often, adverse research results are suppressed, but that is usually by the company that makes the stuff. Once a drug has been around for a few years, big meta-studies can be employed and they can be far more reliable. However, the philosophy of a biologist suggests that it's impossible to factor in lifestyle choices persuasively into almost all such studies. That doesn't mean they're useless, but it does mean that we shouldn't be necessarily thinking in terms of black-and-white Daily Mail horror stories.

Subject: RE: BS: Barrett's oesophagus
From: Rapparee
Date: 13 Jan 19 - 08:21 PM

When I first saw this I thought it was something like the song "Barrett's Privateers." I still think that when I see it.