Barrett's or no Barrett's

Hi,
I am a 39 yo male and a Clinical Psychologist by profession. I have Sliding Type Hiatus Hernia, GERD for more than 8 years along with Antral Gastritis. On 27th. April, 2013 my Endoscopy Repost indicated the follows :
1. Sliding Type Hiatus Hernia.
2. Barrett’s Oesophagus (Biopsy taken).
3. H-Pyroli negative.

In the Biopsy report, dated 3rd. May, 2013, it is clearly mentioned that the features of the Microscopic findings are consistent with Barrett’s Oesophagus (Section shows one bit of tissue having hyperplastic squamous epithelium. Other bit of tissue having columnar metaplasia and chronic inflammatory cell infiltration into the stroma).

On 12th. June, 2013, I have undergone a second endoscopy by another Gastroenterologist. This time the report indicates :
1. Normal mucosa except islets of columnar epithelium in lower esophagus without esophagitis or Barratt’s.
2. Presence of Hiatus Hernia.
3. Urease test : Negative
This time no samples were taken for biopsy.
During the period from 3rd. may till 12th. June, I took no medicines other then Ranitidine 300 mg. Now I am totally confused about what is the real problem in my abdomen. My doctor also increases the confusion by prescribing me Trifluoperazine which is normally used to treat Schizophrenia and Alzheimer’s. Please advise me.

I agree - Barretts can't be confirmed by naked eye. It's possible to have a very small area of Barretts and it's common to have a little "lip" of Barretts just above the valve, rather than full circumference of Barretts. If Barretts was definite on the first scope the recommendation is to have this monitored, with repeat biopsy done every 2 years. The risk of cell changes towards a cancerous condition are small, less than 1%, but catching it early is crucial so it's worth the monitoring even so.

If you are not convinced of the findings from the first scope you could ask your second GI cons to have a colleague in pathology review the slides to confirm the Barretts.

Barretts provides evidence that reflux has taken place, but not when. So further tests are sometimes required to confirm what is currently happening by way of reflux etc.

MMM

Hey Bill,

Whoa...scary. I didn't know about that.

I know that just hiding Barrett's under normal tissue was a worry for the ablation procedure...but the data seems like it was a non-issue and doesn't happen often if at all. But healthy tissue healing over Barrett's is another story...I had no idea. Pretty good that they found it afterwards with you :)

ARM-

It was a surprise to my GI as well. He was suspicious when an area that had been positive for at least 2 EGDs(not absolutely sure how many then) that it was just gone. This was my 1st recheck after I had mt 1st nissen redo, so the thought was that somehow without the reflux it healed over.

Take care,
Bill