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Colonoscopy And Endoscopy Done. Taking Omeprazole 20. How Serious Is Barrett's Disease?

Posted on Fri, 24 Aug 2012

Question: Hi Dr. I had a colonoscopy and and endoscopy about 3 years ago and was told I had Barrett's. I am taking Omeprazole 20 once or twice a day. How serious is Barrett's and how can I make sure it doesn't get worse. Can it ever get better? I think I am supposed to get a follow-up later this year.

Thanks,
XXXXX

Answered by Dr. Pavan Kumar Gupta (1 hour later)

Hello and thanks for the query.
Barrett's esophagus occurs more often in men than women. You are more likely to have this condition if you have had GERD for a long time.

Patients with Barrett's esophagus may develop more changes in the esophagus called dysplasia. When dysplasia is present, the risk of getting cancer of the esophagus increases although only a small number of patients with barret's esophagus develop cancer.

Lifestyle changes, medications, and anti-reflux surgery may help with symptoms of GERD, but will not make Barrett's esophagus go away.

Surgery or other procedures may be recommended if a biopsy shows cell changes that are very likely to lead to cancer. Such changes are called severe or high-grade dysplasia.

Treatment should improve acid reflux symptoms and may keep Barrett's esophagus from getting worse. None of these treatments will reverse the changes that may lead to cancer.
XXXXXXX signs are if your symptoms get worse or you start getting new symptoms like loss of weight or problem in swallowing.If such situation arises,you must contact your doctor immediately.

Keep getting regular follow up endoscopies to look for any changes that may lead to cancer or cancer itself.

I hope to have answered your query however you may revert to me for any further query.
Best of luck.
Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pavan Kumar Gupta (14 hours later)

Thanks for your reply Dr. Just to be clear, is eating food late at night a problem, or should I eat different foods so that the Barretts doesn't get any worse? Are greasy foods worse for the esophagus? Also, if there were symptoms that might develop into Dysplasia, what would we do? Would it be surgery to remove it or would we go to the next procedure? Would it be controlled by surgery, radiation, or what? What are your chances if it worsens?

Thanks again,
XXXXX

Answered by Dr. Pavan Kumar Gupta (1 hour later)

Hello
You should definitely avoid eating late in the night.
Avoid greasy foods and alcohol as these may result in hyperacidity and reflux.
It should be seen whether a person has high grade dysplasia or low grade dysplasia.
High grade dysplasia has 50% chances of getting cancer while low grade dysplasia has very less chances.
Treatment options for high-grade dysplasia include surgical removal of the esophagus (esophagectomy) or endoscopic treatments such as endoscopic mucosal resection or ablation (destruction). Currently, there is no intervention that has been shown to prevent the development of XXXXXXX esophagus or its progression to esophageal cancer.

In case of any other query,feel free to ask.
Thanks

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar