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Husband with Barrett's Esophagus won't keep up on tests

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Posted 7/5/2012 3:39 PM (GMT 0)
Hi, I'm usually on the fibro forum, but I'm here for my husband.  He's had Barrett's for years, but it's like he doesn't remember.  I keep telling him how important it is to be checked (he was supposed to have an endoscopy and colonoscopy almost 2 years ago) but he keeps saying we can't afford it.  cry   True, our 2 daughters and I have all had necessary surgeries in that time, and that's sucked up so much money that we're having a hard time financially.  But some things can't be put off! nono

When his GERD first reared its ugly head (about 5 years ago) he had terrible vomiting episodes.  But as soon as he got on generic Prevacid and Pepcid AC, and changed his diet a little, he feels fine.  It's not that he minds the tests, I think he really believes they're not that important. 

He also has a medium-sized hiatal hernia that he keeps forgetting about.  This man is totally out of touch with his body!

So what I'm wondering is, am I just overworrying?  The literature I've seen says otherwise, but I'd like to get some real people's viewpoints.

Debbie  

Posted 7/5/2012 6:36 PM (GMT 0)
Hi,

I'm a stickler so I would say he should try to get it done asap. That is just me and the type of person that I am. I also understand that there are people in the world who are more easygoing, and it looks like your husband is one of them.

Be that as it may, it is tough to really say. Different doctors say different things. It depends a bit on his past results. If he had dysplasia it would require much more frequent endoscopies, but I imagine he didn't have it during his last scope. How often did the doctor say he needed to get scoped?

What makes Barrett's turn cancerous is unknown, and for most people it never will. On top of that, the usefulness of using endoscopies to check for changes to cancer is not clear. It is often cited that frequent endoscopies do not increase the chance of finding cancer early, likely because the cancerous changes are difficult to recognize as different from regular Barrett's. This has some doctors against using them entirely from what I understand.

Remember, a number of things seem to lower the risk of cancer in Barrett's patients, including (to my knowledge), fish oil supplements, brocolli sprouts and olive oil. Brocolli sprouts really aren't expensive if you buy a bag of seeds and grow them yourself.

If I had to choose to use these or get frequent endoscopies, I'd choose to take these because IMHO the evidence for their benefit is much clearer. However, given that in real life that restriction is not imposed I would probably try to do these things and get the endoscopy.
Posted 7/5/2012 8:58 PM (GMT 0)
Hi there

You may find the Barretts thread interesting ("for new members worried about Barretts") - as ARM says they really don't know what sets off the changes that lead to adenocarcinoma of the oesophagus, but Barretts is no longer considered the main culprit. For most people with Barretts the chances are they will die (eventually!) of something else. There's a link to a really good pie chart on the other thread - on that you can see that when you look at deaths from all causes in people with Barretts, the biggest killer is actually HEART DISEASE!

I'd watch out for "red flag" symptoms - weight loss, anaemia, difficulty swallowing, any worsening of the original symptoms etc

You could also point out there are some long term side effects with ppis and suggest that perhaps it's worth getting reviewed from time to time to see if a lower dose might be more appropriate or whether, thinking very long term, surgical repair of the hernia might actually be best, or even cheaper overall!

As ARM said, the jury is still out on the value of screening people with Barretts. They don't even know who the most at risk people are, so they can't agree on a screening protocol! For me, if gastroscopy didn't completely terrify me (I have serious issues with this test!!), I would want to be reviewed every 5 years, so long as my symptoms stayed exactly the same.

However, if you are going to be proactive with cancer prevention, don't let having Barretts draw your attention away from the other far more common cancers - prostate and large bowel in particular for men, or lung if he's ever smoked. Why not suggest an overall health screen with the primary carer, when he could have age appropriate screening for other things and if you went with him you could drop in some hints about monitoring the Barretts!

MMM
Posted 7/5/2012 11:34 PM (GMT 0)
Hello there,

From what I have read, the American Society for Gastrointestinal Endoscopists recommend patinets with Barretts  should be scoped up to 3 years but most people in US decide to be scoped every year. I think the best you can do is to let him know he should be following up with his scopes and if he chooses not to then he has made the decision. 

Many people are just afraid of what they might find out and therefore stay away from the Drs. until they are very sick. As a wife I know how difficult it is to stand by when you feel they are making a mistake but there is no way to make someone see there Dr. until they are good and ready.

My hubby has had Crohns for 36 years and when he is feeling good he avoids the Dr. but when he is so sick he can hardly stand up in we go to the clinic.  He has had 4 major surgeries and other problems so he has earned he right to feel afraid but to me check ups on a regular basis are important.  When his GI Dr. sends a letter for him to schedule an endoscopy he listens to her.  smhair

Good luck and keep on supporting him. 

Kindly,

Kitt

 

Posted 7/6/2012 9:48 PM (GMT 0)
Thanks, everybody. You've all given me some food for thought, and it's very true, in the end it's up to him.

Debbie
Posted 7/7/2012 1:55 AM (GMT 0)
Not sure if it is true but I have always heard that married men live longer on average. It is because their wives are doing what you are doing. Maybe it doesn't matter in relation to Barrett's, but don't feel bad getting on him about it. When my wife does similar in my life I have learned to really take it into consideration.
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