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Thread: Esophageal Polyp

  1. #1
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    Esophageal Polyp

    When I had an endoscopy on Friday because of chest pain and food "scraping" as it passed through the lower esophagus, the GI doc said she found esophagitis and a polyp during the scope.

    Has anyone had a polyp in the esophagus before? I haven't, so am not sure what it means. I did a search on the Internet, but feel confused.

    I was coming out of anethesia, so the conversation with my GI was short. I am assuming she did a biopsy of the polyp and that I will know more when they have the results in a week or so.

    As background information: This polyp had not show up in any of the 4 previous endoscopies I have had over the past 7 months...the first of which was in March. I was also diagnosed through biopsy with Barrett's Esophagus with the March scope, but the Barrett's has not shown up in any biopsys since then.

    She also told me that my nissen fundoplication wrap was loose and acid reflux was causing re-occurrence of the esophagitis...this is covered in a separate thread under Nissen Funduplication.

    Your comments are very appreciated!

    Joan

  2. #2
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    I don't have much actually helpfull info for you,,,, just to say that at my last endoscopy they said that the "mucosal views of the stomach including a retroflexed view of cardia and fundus, phylorus, duodenal bulb, and postulbar duodenum were REMARKABLE FOR MULTIPLE GASTRIC FUNDIC POLYPS". I don't remember the doctor saying anything to me about them, but don't remember anything really (except vomiting) until the next day.......... am thinking polyps don't seem to be something of concern. Hope someone knows more about them than that. Actually am wondering if I remember reading somewhere that PPI's caused them in lab animals,, really don't know
    cheri

  3. #3
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    Thanks, Cheri

    I can't seem to find out much of anything about polyps in the esophagus except that they are very rare. Fortuantely, everything I read online says the polpys are typically benign. Still, I am anxious to get the biopsy results just so I can stop worrying about a potential malignancy.

    From your post, it appears that your polyps were in your stomach...if I read it correctly.

    Joan

  4. #4
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    Joan

    Hi Joan You are the first person i beleive in this forum who has ever had an esophageal polyp. Quite a few have had stomach polyps though . You are right , they are much rarer , but it would help to know what kind of polyp it is to make any comment.


    You know most are beneign , so try not to worry Easier said than done i know. Are you sure it was biopsied ? Some types they don't biopsy due to ulceration etc. in case they need to remove them. It is odd that you had all of those endoscopies and none saw the poylp before.

    As for your loose fundo, most of the time that is due to surgical error , unless you lifted something exceptionally heavy or did some heavy duty vomiting.

    It could of been done too loose in the first place or become loose due to not closing the crura tight enough , or the surgeon mobilized too much fundus , .....or other technical aspects.

    Really you need more info . Fundos are supposed to be done really loose these days , has it slipped, misplaced, partially disrupted ? Was there a hernia pre op ? Esophagitis post surgery in even successful surgeries is not unheard of . It heals and it goes away .

    I hope things work out ok for you . If you do need a redo, make sure the surgeon has lots of experoence. Redos are a totally different ball game. Take Care

  5. #5
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    Hey Tricia

    Thanks for your input. I am working on getting more information about both the polyp and the loose wrap.

    The GI doc did do something with the polyp because the pain caused by food scraping past it is gone since the scope. I have asked for a copy of her report and biopsy results, and hope to have them soon.

    The surgeon's office is in the process of scheduling an esophagram to get more details on the wrap. My problems started shortly after I lifted a heavy suitcase about half a dozen times when I was on vacation Labor Day week. I was feeling so good at that point (about 7.5 weeks post op), that I totally forgot about lifting restrictions after surgery. So, I could have done this to myself .

    I am certainly anxious to learn more about what is going on and am disappointed to have the same symptoms I had prior to the surgery, especially given that the ppi's adversely affect my nervous system and make me crazy!

    More to come as I learn what is going on...

    Joan

  6. #6
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    Joan

    Hi Joan Well i hope you at least had a nice vacation I wonder how many pounds the suitcase was . I don't have a wrap , but my GERD actually came on after heavy lifting .

    Well it could of been that, hard to say . You should be able to figure out more when you get your results and see the exact problem with the wrap.

    Yes, it would be very discouraging. I hope things turn out well in the longrun. Have you tried all of the PPIS ? I had a bad experience with protonix ...... that drug made me crazy, but thankfully i did fine with nexium , it didn't have the same effects.

    It is Strange that symptoms would go away after a simple biopsy of the polyp. They only take a very tiny sample , i wonder if she could of removed it ? Usually they want to to see a film of it first though . Many of these cause no symptoms. Guess we have to wait for the report.

    Good luck with everything , i will stay tuned . Best wishes

  7. #7
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    Tricia

    Here are some quotes from the endoscopy report and the biopsy results:

    "The esophagus was noted for the presence of single erosion on the right wall that is consistent with reflux esophagitis. There is also a small, approximately 4mm polypoid lesion located at the juction on the right wall just distal to the stricture. There is a tongue of Barrett mucosa on the left wall extending from the GE junction at 36 to 34 cm from the incisors. The GE junction is patulous and the wrap has loosened. This is evident both on the forward and the retroflex view."

    Results from the three biopsys taken:

    1. Normal esophagus 30 cm postier wall: squamous mucosa with reactive epithelial changes.

    2. Lesions right posterior wall 35 cm: cardiac mucosa with active inflamation. No goblet cells characteristic of Barrett mucosa of the distinctive type are seen.

    3. Barrett's left tongue 34 cm: Fragment of esophageal mucosa with reactive epithelial changes. No goblet cells characteristic of Barrett mucosa of the distinctive type are seen.

    Sounds to me like the biopsys just indicate esophagitis, but nothing else. Is that correct? (Her report does not say that she removed the polpy, but I sure don't feel it anymore.)

    And, the wrap is loose.

    Your insights are greatly appreciated!

    Joan

  8. #8
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    Joan

    Hi Joan Yes it just sounds like esophagitis . No Barretts according to those biopsies because no goblet cells were present which is great ( although you probably know that doesn't guaranteee you don't have Barretts because your previous biopsy was positive for Barretts. )

    She didn't take many biopsies.

    It says your GE junction is patulous ( open ) which would indicate GERD may be back . Sometimes you can't tell with the scope though ---because the forced air they use and the way they put the scope can give the GE junction that open appearance, when there really isn't a problem. However the wrap was loose on both views.

    No, it doesn't say they removed the polyp. Funny that symptom is gone, but glad for you. They must of biopsied the polyp because they speak of biopsying " lesions" on the right prosterior wall, so i will assume they did. According to the report , the polyp was clear of Barretts . Sometimes in people with Barretts, dysplasia comes in the form of a polyp. But biopsies for Barretts/ dysplasia were negative.

    I think it may just very well be a benign Hyperplastic polyp associated with your esophagitis, especially since it is so close to the esophagitis, , and the type of mucosa it is made of. ( cardiac) That would be my very best guess from reading the report, but i am not an expert, especially on esophageal polyps , as you are the first one i have seen with this. At least there is nothing alarming in that report , just esophagitis.

    Do you have an appointment Joan ? I imagine they will want a barium swallow to get a better view of the wrap. They usually do .

  9. #9
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    Birdy - could you tell me whether or not you felt liquid coming up, or heartburn? I am one and a half years post fundo and have those things... now, you are being told that your fundo is loose -- funny, I am being told that I have a nice, loose fundo (second opinion coming in November).

    Tricia - what about esophagitis occurring post fundo (not healing from damage prior to op) -- does that happen very often...and if so, what do they do about THAT? b

  10. #10
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    Buffy and Joan

    Hi Buff I've read it's not uncommon to have residual esophagitis post op . They just keep you on PPIS until it heals up . What surgeon are you using for your second opinion ? Good luck with that.

    Hi Joan I was wondering under number 2 on your biopsy report does it say lesions or lesion ? It wasnt a typo ? It doesn't make sense that there is one biopsy specimen and 2 lesions biopsied.

  11. #11
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    Hey Buffy

    My acid reflux symptom has always been persistent chest pain that is less painful on the PPIs, but is always there (24/7). Eventually, I also developed globus and a constant dry cough with regular sore throat...LPR symptoms.

    The chest pain returned with a vengence about 5+ weeks ago (about 8+ weeks post fundo) along with food "scraping" as it passed through the lower esophagus right about where it joins the stomach. I also had some esophageal spasms. Initially, I thought my esophagus was swollen because of the painful swallowing, so I dropped back to a very soft diet. This did not help, and as time passed, I felt like the chest pain was identical to the pain I had prior to the fundo. The thing that was confusing was the "scraping" problem. Now I know that was caused by the polyp they found during the scope.

    My GI doc put me back on PPIs, so the pain has improved some, and the "scraping" has gone away with the biopsy she did under the scope. I can only tolerate a very low dose of the PPI (20mg 1xday), so I know the chest pain will not go away. It didn't on higher doseages either, and I have significant adverse reactions at the higher level.

    I am waiting for an esophagram to get more information on the condition of the wrap.

    I'll post about that under the Nissen Fundoplication thread when I know more.

    Hope you get answers to your situation!

    Joan

  12. #12
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    Hey Tricia

    According to the GI doc's endoscopy report, she only did one biopsy on the leison. That must be a typo on the biopsy report. I am relieved to know that the polyp is not a problem!

    I am waiting for the surgeon's office to get the esophagram scheduled. Hopefully, it will be this coming week as I would like to have more information on the wrap.

    When I get feedback from the esophagram, I will post under the Nissen Fundoplication thread. I'm sure I'm going to have lots of questions about how to proceed.

    Thanks for all your help with the technical reports. You are a Blessing to this forum!!!

    Joan

  13. #13
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    Hello! I realize this is a pretty old thread, but i was wondering what the ending to the story is?
    I just had an endoscopy myself 5 days ago, and like you they found a polyp in my esophagus. My mum said the doctor didn't seem too concerned (i was still pretty out of it when he was telling us about it), but i'm a little worried myself. Thanks

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