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Posted by Sammie on August 31, 2000 at 08:52:28:

In Reply to: Re: Barretts Disease posted by Ken on August 30, 2000 at 10:27:55:

: : : : I have barretts disease, well i had it anyway. They did surgery on me and wrapped my stomach around my esophagus and tightened it. I have spots the doctor checks every two years with scope. I would like to know if there is an alternative to the scope? I get so worked up!!! Can they do ultra sound or something other then the scope to make sure the spots have not turned to cancer?
: : : : thanks so much for any help

: : : Sammy, the gold standard for checking your esophagus is endoscopy. Sorry, but you have to endure this if you want to be sure those spots do not turn cancerous. Although your doc performed what is called a Nissen Fundoplication, this will not cure the Barret's. It will help control acid exposure to your Barret's lesions, which is a positive, but it will not reverse the lesions. You should also be on Prilosec for acid control just in case you still experience reflux. The only current way of eliminating Barret's is to undergo photodynamic therapy (PDT). This treatment is experimental but it entails ingesting a photoreactive dye. You have to be kept out of the sun during treatment, because the dye is photoreactive. As the dye circulates in your body, it concentrates in the lesions then a laser is used to illuminate the lesion and only the precancerous cells are destroyed.

: : : Good luck and be well.
: : Thanks for the input Ken. I am not on prilosec and I didn't know the things you just told me either thanks alot I think i will skip the photo part. That scares me alittle I didn't know about that either is it really necessary?
: : thanks again and you think i should be on prilosec and how much per day should i take?
: : thanks again

: I hope I can give you some good info, but Barrets esophagus is considered a pre-cancerous state. Although anti-secretories such as Prilosec have not been proven to reverse Barrett's, their current use has shown that most people with Barrett's that are taking an antisecretory like Prilosec contain the progression of the disease. It would almost be considered malpractice if you are not taking a drug such as Prilosec for this condition. This is current standard therapy for patients with Barrett's. Ask your doctor for Prilosec and ask for a beginning dose of 20 mg to be taken once per day. If he/she has reservations because of managed care issues ask him to do a prior authorization on your behalf. Other antisecretory agents just aren't proven and have only short term safety records, whereas Prilosec has been on been clinically studied for over 18 years and some patients have been treated for over 12 years with no adverse effects. It is a safe drug and the gold standard for any manifestations of gastro-esophageal reflux disease and you can be confident in its safety record.

: Besides the photodynamic therapy (PDT) that I mentioned in an earlier post there is also laser ablation therapy for Barrett's. This is very similar to PDT. You have to remember that these are all experimental procedures and their long term cure rate and short term cure rate have not been determined. Therefore most doctors do not recommend them because they have not been statistically proven to cure the condition, and statistical is the operative word.

: Hope this helps.

Ken,
Thanks so much for your advice!! I am almost alittle scared to go for my check up now. I had no clue it was this bad??? I had the surgery 4 yrs ago and I am due for my second checkup. They told me i needed this done every 2 yrs??? Is that your suggestion also? The first follow up endoscopy went well but i did have a yeast infection in my esophagus is this common?
I am going to get started on the prilosec right away, do you suggest I take a higher dose or just the 20 mg once a day??
Thanks again!!!!!!
Sammie

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