Good news one year post- fundo!

[Helen]

To all those of you who suffer from Barretts, just wanted to share my good news. I had a Lap nissen 1 year ago as was found to have a large hiatal hernia, a significant area of Barretts and had been taking PPIs for years with mixed results. I have had no reflux since the day of the op and a fairly uneventful recovery apart from some problem with gas bloating which I can control by staying on a gluten free diet.
Last week I had a follow-up gastroscopy and the surgeon reported that the area of Barretts was significantly reduced and thought I needed no further follow-up if I remained symptom-free. He revised this however when the biopsy results came back indicating that the very small remaining area is still consistent with Barretts and suggests another check in 2 years and then if further improvement nothing after that.
So ... I really feel the surgery was a good choice for me although being a worry wart with a family history of digestive cancers I will probably choose to keep things under surveillance from time to time!! :D

[daw]

Hi Helen,
Thanks for posting such good news! I agree with you about continuing your follow-up...Barrett's needs to be watched even after having the surgery. Some believe Barrett's cells can continue to change even in the absence of acid reflux. Also when the Fundo is done some of the Barrett's area is pulled into the wrap and then the visual segment looks shorter. All that said, your doctor is the one who is the expert but I commend you on your prudent steps and wish you continued success.

[Buffy]

Helen - that is super news!! I bet you and your family are celebrating. I read somewhere that if you have Barretts your chances of getting esophageal cancer are about one in three hundred. In other words, if a doc saw about 300 baretts patients a year, only one would be diagnosed with esophageal cancer. And since you know you have it, if it were to progress (which I doubt, as it is actually regressing) you would catch it early enough to do something about it. Great news -- thanks for keeping in touch. b

[Mcx]

Hi Helen

That's great news TU)

I think it's wise to keep the follow up though, the slight discomfort every 2 years from the endo is worth it for peace of mind, especially as you say you worry.

Good to know as well that the Fundo as helped so much.

All the best

Mcx

[Helen]

Thanks for your replies Daw, Buffy and Mcx.

I am assuming that you are also ''owners" of Barrets esophaguses or is that esophagi ? :o and was wondering what followup you are getting for your conditions. With Mcx a UK resident and others of you from the USA it would be good to have a cross -section of ideas before I decide what to do in the future. I think I will definitely have some follow-up unless it disappears completely, for peace of mind and in the unlikely event that it went nasty at least it would get caught early.
Unfortunately after 3 gastroscopies which went like a charm ie. I was in 'la la land' and don't remember a thing, my last one was very different - lots of gagging and struggling and not so pleasant memories. No idea why it was like that as had same surgeon, same drugs etc. Maybe I'm developing a resistance!? :eek:
Daw, I did ask my surgeon if the barrets area could have just disappeared into the wrap but he said no, that he could look at the area from below as well as from above the wrap and that it had definitely reduced in size.

[Mcx]

Hi Helen

Yes I have Barretts, 3.5cm when I had my last gastroscopy in January this year. I was taking increasing levels of PPI's with break through symptoms, and it was this, the Barretts, coupled with my age (45) that led to the surgery option.

I am currently on a watch list with an endoscopy unit based in the Greater Manchester area and have endoscopy and biopsy every 2 years. I was diagnosed 5 years ago after having symptons for many years. My doctor at the time was treating me for anxiety and depression and put my symptoms down to that. It was only after changing doctor after I had a horrible time on a holiday in Dublin due to horrendous pain and some vomiting that I was referred at last to a specialist. I wasn't drinking Guinness just bottles of extra strength Gaviscon.

When I had my first gastroscopy I was told about the Hiatus Hernia and Barretts straight away, but told that it was inoperable and I would have to take PPI's for the rest of my life. It later turned out that the consultant was biased towards medical treatment and against surgery. After a couple of years and another change of doctor I was told about the fundo option.

It transpires that there is a long term NHS study going on to determine which is most cost effective, surgery or medication. It would appear that the treatment you are offered depends on which camp your consultant falls in. Is your health service the same in New Zealand?

I have read so much info on Barretts my head hurts :D I had read that once the cells change that they stay that way, so it's interesting that yours is reducing. I also read that sometimes normal cells grow over the Barretts. I think it is because of these factors that they keep taking biopsy, as this is the only way to be sure.

It is also true that the chances of the Barretts developing on to cancer is low as Buffy points out, as long as you reduce risk by treating the reflux, and make lifestyle changes.

Sorry to hear about the endo experience. I had a bad one the second time I had one and broke a crown on a tooth as I bit down on the mouth guard so hard :eek:

I wasn't offered sedative the first time I had one, and didn't know there was that option, that's the NHS for you. When I had my third one they gave you leaflet pointing out that you could have the medication, however I have got 'used' to it now and just like to breeze in have it done and get out as quick as poss :D It helps as they now play classical music, and I learnt to use visualisation during my anxiety treatment.

So there you are - that's my story. It's really good to hear your Barretts is reducing and shows that they are still learning about this condition :)

[daw]

.....I have read so much info on Barretts my head hurts :D I had read that once the cells change that they stay that way, so it's interesting that yours is reducing. I also read that sometimes normal cells grow over the Barretts. I think it is because of these factors that they keep taking biopsy, as this is the only way to be sure....
Same here.

I was diagnosed with 0.5cm Barrett's after only 9 months of mild to moderate heartburn. I have a feeling I was dealing with silent reflux for many years and didn't know it. After two more endoscopies failed to find Barrett's, I sent my original biopsy slides to a Johns Hopkins GI pathologist for a second opinion and they could find no Barrett's. I am still being cautious and my next endoscopy is in the fall (2 years since the last). I also developed LPR so my medications are currently double doses of Nexium and otc Ranitidine (Zantac)at bedtime.

The last endoscopy I had, I was sedated by an anesthesiologist and given Propofol. Post procedure I woke up faster and was much more alert than when I had been given the Demerol/Versed combo in the past.

I would talk to the doctor about the sedation given if you were uncomfortable and aware of what was going on during the procedure. Some people prefer no medications but others have difficulties and need to be properly sedated.

[Mcx]

Hi Daw

Actually I have never had any sedation at all, just the spray on the back of the throat to stop the gag reflex.

I think however that sedation is a good idea if the thoughts of it get too much, and I think the thoughts are worse than the actual procedure.

I elected last time not to have the sedation after not having been offered it the first two times on the basis that I thought I could cope with it, and actually the music really helped.

It's good that your Barrett's has gone but also wise to get that second opinion.

It's interesting you had access to your slides, we don't have that level of access here in the UK or at least not in the health region I am under.

[daw]

...It's interesting you had access to your slides, we don't have that level of access here in the UK or at least not in the health region I am under.
Hi Mcx,
Yes, many people in the US don't realize they have access to biopsy slides, xrays and reports of all kinds. You call the facility that has done the tests and, providing your doctor or an in house doctor has reviewed the results, they are either handed to you or sent where ever you want. More recently they have you sign a waiver. One time I actually picked up some xrays from the hospital and looked at them myself at home with a tracing table. Where there is a will, there is a way. Sometimes it just takes a little assertiveness, tact and a lot of thank yous. :D

[Helen]

A belated thankyou Daw and Mcx for your replies and also Daw for the very informative info/ studies that you have been posting about Barretts. It seems that it is an area of medicine that is getting lots of attention. My surgeon said that Adenocarcinoma of the esophagus is one of the fastest growing cancers in the western world and there is some thought that bile may be just as important in Barretts as stomach acid therefore PPIs on their own may not be enough to protect a Barretts area from further damage. I am just very relieved that the fundo worked for me but I do intend to continue with checkups every couple of years.
Buffy in case you happen to read this thread, I hope your recovery continues to go well and you are soon able to eat all the foods that you most enjoy. One year ago I was in your situation, sick of eating baby foods, hanging out for pizza and beer and wondering if I had done the right thing in having surgery,. Last weekend I celebrated my son's 21st with beer, red wine (which I had not been able to drink for years) pizza, and lots of other yummy rich and spicy foods and was then able sleep what was left of the night - FLAT ON MY BACK!!!! I'm not sure what age you are but I am 49 and the one thing I would say if you are around this age is don't expect to bounce back from the surgery like a youngster would. Fatigue was the biggest problem I had especially when you are not eating a great deal but as Thistle says, be patient and all should come right.