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Dr. Andrew Rynne

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Are reflux changes in a GI endoscopy indicative of Barrett's oesophagus?

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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1990 Questions

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Posted on Tue, 9 Oct 2018 in Digestion and Bowels
Question: I had an upper GI endoscopy...the report doctor said I had reflux changes, but negative for barretts...what does this mean? Can these changes heal and go back to normal, or is this the precursor to barretts? Are reflux changes and reactive changes the same thing? Thanks for your time.
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Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:

Depends on treatment.

Detailed Answer:

Hello,

By virtue of nature, the lining of our stomach is resistant to acid. However, the lining of the oesophagus is not resistant to acid.

Therefore in patients with acid reflux, the mucosal lining of oesophagus gets inflamed causing inflammation of that area.

Regular acid reflux for years may cause the same changes in the oesophagus.

To make itself resistant to acid attack the cells in the oesophagus may convert themselves like cells in the stomach (which are acid resistant) which is medically termed as Barett oesophagus and this change increases chances of adenocarcinoma by 10%.

The changes you are having are fully reversible but you need to follow proper therapy for that.

Please request your gastroenterologist to start you on PPI like Esomeprazole. It can be used in the dosage as high as 80 mg twice daily.

Trials have shown that esomeprazole is superior to other PPI's in controlling reflux symptoms.

Also, request him/her to add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back. Prokinetic should be added in your regimen.

An antacid containing local anaesthetic (Mucaine gel) should be taken 2tsf thrice daily.

Acotiamide is another wonderful new drug and is very effective in controlling symptoms of GERD and esophagitis.

In trials- Acotiamide, a gastrointestinal motility modulator, at a standard dose of 100mg thrice daily has significantly affected oesophagal motor functions or gastroesophageal reflux in healthy adults.

All these drugs can be considered by your gastroenterologist to provide you with symptomatic relief in your problem. All these medications can be used at a time also by your primary.


To prevent the oesophagal damage from developing into Barett or achalasia cardai. I would suggest you to ask your gastroenterologist to follow aggressive treatment pattern initially.

As your symptoms will improve drugs can be tapered off gradually.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Ramesh Kumar 8 minutes later
I had this endoscopy 18 months ago...since then I have taken Ppis and H2 blockers, but do at times feel some heartburn each day. Therefore, I will be increasing acid suppression...The doctor says he will do another endoscopy in 2 years...but given that i have felt heartburn a little each day, what are the chances that Barretts has developed since that endoscopy 18 months ago?
doctor
Answered by Dr. Ramesh Kumar 26 minutes later
Brief Answer:

Follow up.

Detailed Answer:

Hi,

Barrett's esophagus is a complication of chronic (long-lasting) and usually severe gastrointestinal reflux disease.

So if your symptoms are not suppressing despite of maximal therapy then you should go for an urgent endoscopy to rule out XXXXXXX esophagus.

As you are still having heartburn you should go for a endoscopy.
As such chances are low as you are taking acid inhibitors.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 11 minutes later
Ok...will do..last question...how long does Barretts esophagus take to progress to cancer. I have read that it can take 15-30 years...is that true? Or can it happen as quickly as 1-3 years? I am only 31 years old, if I have it, is it still rare at my age for it to progress to cancer compared to someone older?
doctor
Answered by Dr. Ramesh Kumar 8 minutes later
Brief Answer:

follow up.

Detailed Answer:

Hi,

Again chances of it developing into cancer(Adenocarcinoma) is very rare hardly 10% and that too takes years to develop (10-15 years on an average).It has no relation with age. So stay calm and don't panic.

Hope I have answered your query.

Take care

Regards,
Dr Ramesh Kumar, Gastroenterologist
Above answer was peer-reviewed by : Dr. Kampana
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