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Have Parkinson's Disease And Reflux. Worried About Developing Barret's Esophagus If Operation Is Not Done

Posted on Wed, 21 Aug 2013

Question: can I get a usa gatroenterologist

Answered by Dr. Charles S Narasi (32 hours later)

Hello, XXXX
Thank you for contacting XXXXXXX
I see you have been diagnosed with Parkinson's and you also
have problem with reflux . What is your specific question that
I can address if I can ?
Thanks.

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

Follow up: Dr. Charles S Narasi (8 hours later)

Dear Doctor. Regarding the reflux. I am very concerned if I don't have the operation I will develop Barret's oesophagus and aggressive cancer in only two years XXXX

Answered by Dr. Charles S Narasi (4 hours later)

Dear XXXX,
I am glad to answer your concerns. To develop Barretts's
esophagus , it takes a very long time , number of years when
some one goes untreated for acid reflux. Longer the duration
of reflux and longer the person is ineffectively treated , then there
is a possibility that can happen. Even if you are already diagnosed with
Barrett's' , it is the degree of dysplasia (Abnormal cells) that determines
if you have a chance of developing cancer. Severe dysplasia is more
serious and we have to treat it aggressively before it becomes cancer.
I am sure that you have had endoscopy and biopsy done if you had
shown sings of Barrett's at he time of endoscopy.
I am not sure why they are recommending operation at this time.
I need more specifics . Please let me know.
Thank you.

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

Follow up: Dr. Charles S Narasi (5 days later)

Thank you for your advice. you mention treatment of the reflux. I take Nexium which is not good enough alone but Mylanta and Raninadatine seem very satisfactory.Is that good enough to prevent unpleasant sequelae?

Answered by Dr. Charles S Narasi (4 hours later)

Hello, XXXX,
Make sure that you take your Nexium about 60-90 minutes
before your main meal of the day. In some cases , switching
to a different PPI might work. It is O.K. to take an additional
antacid if that helps. Avoid excess caffeine, tomato and citrus
products , cheeses etc. that can make reflux worse. Do not eat
close to bed time.
The incidence of cancer with severe Barrett's is not very high.
It is in the range of 0.12 %. Severe dysplasia occurs in only 5% of cases.
Parkinson's can affect the contractions of the esophagus and that adds
to the problem. Hopefully , your Parkinson symptoms are well
controlled.
I wish you the very best.

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

Follow up: Dr. Charles S Narasi (14 hours later)

Thanks I will try another PPI.Should I have an endoscopy at this stage?

Answered by Dr. Charles S Narasi (11 hours later)

Hello, XXXX,
I would try the new PPI for 6-8 weeks and if you still continue
to have symptoms , then arrange for endoscopic evaluation.
I do not think it is necessary at this time.
Good luck.

Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

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