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Barrett's Esophagus Can it Reverse or Not?

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Posted 10/19/2013 8:33 PM (GMT 0)

I was diagnosed last year in October with Barrett's Esophagus 5mm. I had a 2nd endoscopy with same GI Dr in January 2013, came back possible dysplasia. My insurance company denied the ablation stating it was experimental. I went to 3 other GI doctors who checked on my Barrett's. All 3 said I do not have Barrett's. The consensus was I had Barrett's but it had healed over several times during the years. I had the Nissen in August 2013.

I saw my surgeon yesterday and he said even if it "reversed" my cells were exposed and they could go back to precancerous condition. He said the acid reflux had been stopped but genetics come into play in the future. 

I am confused by this surgeon's comment. Has anybody experienced a reversal? I would like to hear your story.

FlaCracker 

Posted 10/20/2013 3:27 PM (GMT 0)
hi I was diagnosed with b.e. in October 2012 went for my upper scope last Monday,was given biopsie results on Thursday, doctors exact words were b.e. has been resolved , gone. I was ecstatic as you could imagine. but he also said that it if where there once it can come back, like you. I don't have to see him for 3 years, I was on achiphex 20 mg daily. and I used a lot of my own natural remedies I researched on my own,, not sure if it were a combination of the two or what. I hope this helps . I know how much it sucks when you are told you have b.e.,,j
Posted 10/20/2013 4:11 PM (GMT 0)
FC,

Sorry you have been spending all your time trying to get the answer to your Barretts.

Barrett's epithelium is a term used to describe a change in the lining of the lower esophagus. Normally, the esophagus is lined by pink, squamous type epithelium (lining) and the stomach is lined by darker, reddish, columnar type epithelium. When the lower esophagus is damaged by acid, its pink lining can be replaced by the darker, reddish lining.

If the lining on biopsy appears more like the intestinal lining, it is called intestinal metaplasia. Intestinal metaplasia has been associated with the development of esophageal adnocarcinoma (cancer) of the lower esophagus. For all practical purposes, Barrett's esophagus and Barrett's epithelium are the same thing.

It is controversial whether Barrett's esophagus can revert to a normal lining (mucosa).

Currently patients with Barrett's esophagus are screened by endoscopy and biopsy every two years to verify that there has been no evolution towards malignant change of the mucosa.

I strongly encourage you to continue with your screening at least every 2 years and sooner if you feel you need.

Remember to be your own best advocate.

Kindly,

Kitt

Posted 10/20/2013 5:10 PM (GMT 0)
Thank you all for the information. I have seen my pictures and I couldn't see the darker color but again I am not a doctor. The GI doctor explained to me that the natural lining or ridges start to disappear with Barrett's. I guess that would be the epithelieum replacing it.

Is anyone with a reversal still taking their PPIs? I was told to take it anyway just as a safety precaution till the next endoscopy. I was taking 20mg of Nexium twice a day but I am down to 20mg once a day.

FC
Posted 10/20/2013 5:33 PM (GMT 0)

In my prior post I put the wrong amount for Nexium. I was taking 40mg. Now 20mg.

FC

Posted 10/20/2013 6:33 PM (GMT 0)
I've asked this to a few different GI specialists, and have gotten conflicting opinions over the years. I've had one tell me it's irreversible and it will always be there. I've had one tell me that it is possible for a reversal to happen, and it does happen to some people.

The most recent answer I've gotten is that they don't really know. The last specialist I talked to said there isn't definitive consensus in the medical community about whether Barrett's can reverse or not, and overall, the condition suffers from lack of comprehensive research. So, it may or it may not. If you do see a reversal, it's important to determine whether that has indeed happened, or if you're getting varying results due to correct/incorrect sampling.

I've had a few different results with my biopsies over the years, and I'm still on PPIs. Mainly because for me, scopes were showing damage done to my esophagus other than just Barrett's - stuff like ulcers, bad inflammation, and strictures. IMO, if you are symptomatic when off PPIs, and if you have evidence of esophageal damage (not necessarily Barrett's), it's probably worth it to remain on them. But obviously, it's best to discuss with your specialist about your specific case and needs - and if you're not satisfied, request a second opinion.
Posted 10/20/2013 6:56 PM (GMT 0)
husjsjr-can you post what remedies were successful for you.

thx
Posted 10/20/2013 7:38 PM (GMT 0)
i am on 20mg aciphex daily. on my own I created a log of all the times I had a burn. cut all hot spicy foods out, along with sweets and chips,etc, I drank loads of aloe vera ,apples,fresh fruit and veggies daily, also blackberries, fresh and powder,basically almost every day a mixture of apple cider vinegar (braggs is the brand) and honey. way down on alcohol as well. but to me it was worth it. health is wealth. hope this helps. write anytime if I can help any more..j
Posted 10/20/2013 10:46 PM (GMT 0)

hujusjr,

I followed a special diet too when I was diagnosed with BE. I still follow this diet today. I was using DGL gum but I had to stop once I got the Nissen. I use Aloe Vera, high PH water 8.0 and over, low acid and high antioxidant foods. After my surgery, I am adding back into my diet low acidic vegetables. Someone at work told me to add a lot of omega 3, 6, and 9. I cannot tolerate any spicy foods, and I stopped my coffee habit.

I had to get the Nissen because I had a large hiatal hernia. My reflux is gone but I will continue to take the PPIs for now till the next endoscopy. 

Has anyone had the ablation with the Nissen? Or known of anyone? Interested to hear.

FC

  

Posted 1/1/2014 4:13 AM (GMT 0)
I was diagnosed with Barrett's 8 years ago and took a ppi for the first 3 years until my joints started aching. Soon I was taking pain meds to counteract the ppi's. I discontinued them and found alternatives on the net. I stopped drinking alcohol, eating highly acidic foods like meat and fish, consuming caffeine, sugar and fatty foods, wearing constricting clothes. I did eat a ton of food--all vegetarian and including tomatoes and spices.
I lost weight on the new diet and never felt hungry. Preparing great-tasting low-fat vegetarian meals became my hobby. I used slippery elm bark or licorice capsules if I felt a twinge of reflux coming on. I didn't eat anything within 3 hours of bedtime. I raised the head of my bed. In 5 years I dropped 3 dress sizes and 30 lbs.
In his office my doctor chided me saying that I could be experiencing reflux in my sleep and that I shouldn't have tossed out the ppi's. During this November's endoscopy I think he expected to find adenocarcinoma and was astonished when he couldn't find Barrett's. His report stated: 'If no Barrett's is found in 3 years, patient need not return.'
You might think this is a deprivation diet. But if I were forced to eat the way I used to, I would definitely feel deprived and depressed. I look and feel 10 years younger than I did 5 years ago. I will continue to eat this way for the rest of my life.
Posted 1/1/2014 10:44 AM (GMT 0)
Happy New Year!

Actually your logic is correct if there are no anatomical problems causing the reflux. I followed the same lifestyle and diet without the tomatoes for a brief period and my Barrett's reversed according to 2 GI doctors. Now on the other consensus there could be other locations not biopsied that were impacted.

Honestly, I am not going to worry about the Barrett's. I was concerned when the surgeon told me it was lifetime monitoring. Each doctor has their own educated opinion.

My father smoked 4 packs of cigarettes and drank hard liquor up until his death at 83 (diabetes). He never got scoped to see if he had Barrett's. My surgeon feels that the progression of Barrett's is sometimes hereditary. If that's the case, I might have luck on my side. :)

Michelle
Posted 1/1/2014 1:55 PM (GMT 0)
Excuse the earlier post of 2 surgeons stating reversal of Barrett's esophagus. It was 3 as I posted at the beginning of the thread.

Michelle
Posted 1/1/2014 3:02 PM (GMT 0)
Happy New Year to you! I'm pretty sure Barrett's is not in my hereditary picture. My parents lived into their 90's, and I have an aunt in Phoenix who will be 101 in April. I caused my own problem with excessive alcohol consumption and smoking. If you look up acid/alkaline food chart, you may be surprised at what you'll see.
Best wishes to you for continued health and a Barrett's-free life!
--M
Posted 1/2/2014 3:32 PM (GMT 0)
Barretts can heal over...meaning the esophagus can heal healthy tissue over the top of the barretts. Sometimes they can't find the barretts cells because they don't go deep enough to get the cells or they biopsy the wrong spot.

I have had this happen a few times. The only way I know of to remove the barretts cells is surgical removal or ablation. If the cause isn't fixed it can return though.

I have an EGD scheduled for tomorrow to check mine even though I have a functioning wrap and my last biopsies didn't show any my GI told me I need to still be screened because they are most likely there, just hidden.

I first had to be checked every year and when there wasn't any growth I was switched to every 2 years. Since my esophagus tear I now have it checked every 3 years.

Take care,
Bill
Posted 1/2/2014 6:17 PM (GMT 0)
Yes, I thought about that having read a few of these posts. I've had no reflux problems in the past few years and have no intention of changing my dietary habits. In three years I will mention your warning to my gastroenterologist, asking to be checked again in another 3 years. Thanks again and Happy New Year!
Posted 1/2/2014 6:35 PM (GMT 0)
Bill,

Why the push from some surgeons to get the Nissen for Barrett's esophagus if there is a lifetime of monitoring afterwards? My surgeon said the Barrett's would be gone in 2 years after surgery. Then after the surgery, backtracked and said he never made that statement. In my case it is a mute point, since I had hardly any diaphragm left and a large HH. Prior to all of this, my insurance refused to pay for an ablation. So I get the Nissen, what happens if the Barrett's does progress?

Michelle
Posted 1/2/2014 8:02 PM (GMT 0)
Bill and Michelle,

I'd like to add that I researched diet in relation to Barrett's and found several studies from NIH compiled by researchers from Kaiser Permanente. It was entitled, "Dietary factors and the risks of oesophageal adenocarcinoma and Barrett's oesophagus." The report noted: "The main aim of the present review is to consider the evidence linking dietary factors with the risks of oesophageal adenocarcinoma, Barrett's oesophagus, and the progression from Barrett's oesophagus to oesophageal adenocarcinoma. The existing epidemiological evidence is strongest for an inverse relationship between intake of vitamin C, β-carotene, fruits and vegetables, particularly raw fruits and vegetables and dark green, leafy and cruciferous vegetables, carbohydrates, fibre and Fe and the risk of oesophageal adenocarcinoma and Barrett's oesophagus. Patients at higher risk for Barrett's oesophagus and oesophageal adenocarcinoma may benefit from increasing their consumption of fruits and vegetables and reducing their intake of red meat and other processed food items."

I emailed one of the researchers about what I'd experienced, asking if any studies had been done of Barrett's sufferers who had reversed the disease. He emailed back that most people would not be willing to make such a radical shift in their lifestyles, so no such studies exist, but he has personally seen people who have suspended or reversed chronic diseases through diet and exercise.
Posted 1/3/2014 3:15 AM (GMT 0)
Michelle-

The reason to do the nissen is to stop the bombardment of acid on the esophagus tissue. Without it the barretts has a higher chance of advancing. If it advances it goes to dysplasia, short then long segment, which is the next step before cancer.

As with any cellular changes it needs to be monitored, but with the nissen it can be checked at longer intervals because the reflux is controlled. Barretts is the cells of the esophagus changing to stomach type cells due to the acid.

When I was first diagnosed with barretts I had to be checked every year for 2 or 3 years and then if there wasn't any advancement in size or to dysplasia I went to every 2 years. Since I had the esophagus tear my GI wanted to go 3 years because my wrap was working and I am at a high risk for it to tear again.

My esophagus had been damaged a lot from dilatations when my 1st surgery was done wrong and they thought it was just too tight. I had about 13 within a 6 to 8 month time frame. this is most likely why it tore during an EGD to check the barretts.

I am happy to deal with an EGD every 3 years just to be sure it doesn't advance. I had almost lost my esophagus when it tore and if it turns to cancer and gets too far, that's what I'd be facing again.

There is also the option to ablate it if it does advance and they are getting very good results with that. The chances of it advancing are very low, especially with the reflux under control, but there still is a chance. Usually it will heal over and not be an issue any longer once the reflux is controlled.


Take care,
Bill
Posted 1/3/2014 5:28 PM (GMT 0)
opnwhl4, Hi, there are some new advances underway in OCT. [Optical coherence tomography] that will be of great benefit to those with Barretts.

Using this microscopic technique, combined with endoscopy, doctors will be able to capture a three dimensional image on computer. This allows identification at a cellular level a few mm below the surface, of lesions and other problems not visible to the naked eye.
In time, the need for biopsy and the vaguaries of biopsy interpretation, will be redundant. ID of problems will be very fast, allowing for same-day progressive treatment, if required.

There are two companies currently trialling in the UK and US, NinePoint Medical and Cellvizio

I hope this gives readers some hope for the future.

All the best

Phil
Posted 1/3/2014 5:35 PM (GMT 0)
Phil-

That is great news! Thanks for sharing that.

Being able to image the problems vs hoping to get the right area biopsied is a huge step forward.


Take care,
Bill
Posted 2/14/2014 12:11 PM (GMT 0)
Hi to all,

I've just been diagnosed with BE and really appreciate the positive support offered on this forum!

B-E Gone Girl, I am really impressed with your accomplishment.  I have been trying to radically alter my diet also as I hate taking drugs.  I worry about the long term consequences on my body from the PPI's.  However, when I started reading about B.E. it scared me more than the drugs so I'm now looking for a "good" PPI to take.

My brother died of Esophageal/stomach cancer at age 46 so maybe I worry a little more than average :)

I am still altering my diet "big time" as I do believe that we are what we eat to a large extent.  As I tell my children, "your body will pay you back if you don't look after it".

Anyway, I would appreciate any diet recommendations (books, lists) available.

Thank you all and bless you on your path to health.

Barb

 

Posted 2/14/2014 11:07 PM (GMT 0)
ParrotSlave,

Sorry to hear about your brother. I take PPIs as needed. I am at the six month mark for my surgery and have noticed less and less reflux.

I would take the PPIs if you have Barrett's. Keep a food log to see what foods trigger your acid reflux too.

Michelle
Posted 2/17/2015 9:02 PM (GMT 0)
Great reading more positive than I have heard since being diagnosed with BE.
Its funny though I have never had any pain except when I fold and give in to Dr's drugs...
I have always enjoyed a good meal spicy but now since my endoscopy that is no longer an option : (
I am now taking PPI'S and feel sick to my stomach...
I never had problems eating...never had reflux...or heartburn...but thanks to PPI'S I now do.Lost of appetite some say it could be because I do not have BE and the drugs are causing me harm!
Posted 2/20/2015 4:33 AM (GMT 0)
Healing well is a great site. But, serious answers require expertise and barrettswessex is an incredible site for BE. It's small and based in the uk but it's run by a guy named Chris and he knows his crap. Your sure to get a very educated well researched and kind answer to your questions when it comes to Barrett's
BE is not fun but for those of us who have found out we are quite lucky to have been given a second chance in life. Many people will not take their reflux symtoms serious and avoid scopes leading to longer segments and perhaps LGD or HGD or unfortunately EC.
Chris can lead you in a good direction. Very unbiased researcher answers.
Now, I'm not Chris but to answer a few questions with out having read every post here it is: Barrett's just doesn't go away. It's more likely due to the surgeon who performed the biopsies . Human error.
And get ablated if you can! Piece of mind and showing great results.
Ppi's did make my digestion work differently but I've learned to eat for health 90 percent of the time. I do take a ppi daily. Not messing around with BE. Good luck.
Posted 2/20/2015 7:10 PM (GMT 0)
My Barretts was not present on my last scope after a more stable year on Zantac. So yes, it is possible and in some cases it spontaneously regresses for no reason that has yet been discovered.

It's important to have good symptom control, with or without Barretts. And I agree, those of us that have it aren't badly off as we get monitoring - the people most at risk are those that don't know they have it!

MMM
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