I will definitely post again. I actually studied up on Barrett's a bit more and learned a bit that has set my mind at ease somewhat. Generally there are no symptoms when Barrett's progresses; that's why it's so fatal. A great many people don't catch it until after it's progressed into cancer. Mine was, 16 months ago, considered to be minimal; a very small spot that showed no signs of displagia. There are two (maybe three?) levels of displagia Barrett's can go through before they consider it cancerous. There are treatments for those, though they are risky and not widely used.
So these symptoms I'm having probably relate more to my reflux acting up than to Barrett's progression - maybe. Hopefully. If I understand what I read right, it seems like that could be the case. Mind you, reflux flaring up can certainly prompt barrett's to get worse, so I'm not breathing easy by any stretch. But I think I can make it this last week to the scope. The results are what concerns me the most. i'm overweight and with high BP, neither of which is very helpful.
I'm also starting some therapy this week to deal with what I think is probably some form of generalized anxiety disorder. I have a perpetual fear of loss. Sometimes it's rational (in my opinion, my concern for my esophagus, while extreme, has a firm basis in reality) and sometime's it's not (I just wake up in the middle of the night and I'm terrified of something I can't pinpoint). Lots of loved ones passed away when I was younger so it's no surprise I have that fear of loss. I need help dealing with it better though.
That's off-topic though, sorry. I'll certainly post again after my scope and hopefully it will be good news. Or at least not awful news.
I'll share my original treatment method, maybe it will do you some good to hear how they go about
making sure your reflux is under control so your barrett's doesn't get worse (if you even have it) and so you don't get it, if you don't.
During my first scope, the dilated my esophagus (it was strictured due to reflux damage) and also biopsied several portions of it. One spot came back as having barrett's. I was then scoped every four to six weeks for about
a year. The purpose of these was two-fold:
- To continue dilating my esophagus, since it was a narrow stricture
- To ensure my medication was successfully healing the damage to my esophagus (I had several ulcers too)
I was on Carafate to help with the ulcers and gastritis, and prevacid for the reflux. After a year of constant improvement, my GERD doc deemed me ready to begin my "every two years" scope to ensure the barrett's was not getting worse. It's every two years for me because there were no signs of displagia. It seems an amazing coincidence that I'm coming up on the end of that two years now and experiencing these problems, but we'll see what happens.
What I have gleaned from my previous treatments and scopes is that:
- The carafate healed the ulcers; my esophagus was just fine except for the barrett's spot
- Prevacid successfully controlled my reflux.
My PCP told me that generally, your reflux doesn't "change" its symptoms. That is, if you've had heartburn associated with it in the past, that trend would likely continue in the future. And it's true; any time I missed a dose of prevacid, I would feel the heartburn.
Yet since January I have had very infrequent and sporadic signs of the silent type of reflux that affects your throat. The kind some people say you have to see an ENT for because the GERD docs don't check for it. The most notable sign thus far (aside from a few nights when some food came back to bother me) is the constant clearing of my throat that I've had to do the past few weeks. My GERD doc has said it sounds like allergies to her, but taken in context with my other symptoms I am not so sure. (Despite that the throat clearing came first, the chest/back/pain symptoms came later.)
So... either my prevacid has stopped working and my reflux has gone completely silent (which seems to contradict what my PCP suggested, though I don't know if he's even right in the first place)... or there's something else going on here.
The other alternative is that my esophagus is so messed up I don't even feel the heartburn anymore... but my reflux went for many years without any kind of treatment at all, so it seems hard to believe that in 16 months it would fall completely silent and eat me up that badly. I never rule out anything but this doesn't seem quite as consistent with what I've learned about
how things behave.
That said, I'm no doctor and can honestly say I have no earthly clue what's happening. All I know is, I'm freaked out by it all daily and I'm at once dreading and anxiously awaiting the scope that will hopefully bring me some answers. Some good answers that don't invovle words like cancer. I certainly hope and pray this is the case.
Sorry for the lengthy post. I can get carried away sometimes. I hope somewhere in there was something useful.
Post Edited (grimmly) : 6/22/2008 12:26:10 PM (GMT-6)