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    Old 10-14-2003, 01:46 PM   #1
    sir-tainly
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    Post Concerned about endoscopy...

    Hi, I've posted elsewhere in this forum about ongoing throat discomfort since July which manifests as an occassional tightening of throat/lump sensation. Feels like it's at the juncture of pharynx and esophagus.

    Saw an ENT who performed transnasal and direct laryngoscopies, all normal. He suspected GERD, so put me on Prevacid. Then I saw GI who ordered Double Contrast Barium Swallow - findings were miminal pooling of Barium in pharynx, small hiatal hernia and some reflux. No stuctural abnormalities otherwise noted (strictures, etc.)

    After 7 weeks of Prevacid, I still have the sensation (which could be stress-related, especially as it started the week my wife and I found out we were pregnant with twins) - 'globus pharyngus' I think it's called. It seems fine in the morning and gets worse as the day wears on. I talked to my GI and he has suggested upper endoscopy as the next investigative step.

    This now has me concerned. I have never had any 'classic' GERD symptoms like pain, difficult esophageal swallowing, or heartburn. Not sure what he would be looking for. A postitive confirmation of GERD perhaps? I read about all sorts of conditions like Barrett's and worse and I am hoping I do not have these given their propensity to become malignant. Any advanced abnormalities would presumably have shown up on the Barium X-Ray.

    The procedure itself doesn't worry me too much. I had a colonsocopy two years ago and don't remember it (sedation). Only a couple of small benign polyps.

    Guess I am just looking for experiences of relatively asymptomatic folks (or at least those without classic GERD symptoms) having endoscopies, what the findings were, etc.

    BTW, I'm 42, male, don't smoke (quit 8 yrs ago, 9 pack years), hardly drink, healthy weight, good diet. Annual physical last month was normal across all panels.

    Thanks.


     
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    Old 10-14-2003, 03:22 PM   #2
    actudan
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    Seems that your current treatment isn't working and an endoscopy is really the next step to take. Like you said, a confirmation of GERD is being sought or the doc just wants to see if anything else is going on. The scope is the best test because the doc is able to get a 'bird's eye view' of what's going on. Could be nothing but you don't want to chance it? I am like you, I would be asking myself the same questions and I would worry that that the doctor is thinking something else is going on. I am a worrier, it just my nature. However, I have learned that if I start questioning or worrying about procedures or tests that are being scheduled, I will just come right out and ask the doctor what he is looking for. Good luck!

     
    Old 10-14-2003, 04:31 PM   #3
    sir-tainly
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    Thanks actudan. Yeah, I guess I'm being a worrier, especially with little ones on the way. I'm assuming you've had this procedure? If so, did you have any symptoms/findings? I do recall him saying to me something about checking for irritation (or inflammation) but it was over the phone and he was in kind of a hurry. His office is supposed to call me tomorrow with the endo schedule.

     
    Old 10-14-2003, 08:12 PM   #4
    actudan
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    Yes I have had two procedures. My first one was due to intense upper abdominal pain and black stools (a sign of upper gi bleeding). I was diagnosed with acute gastritis and duodenitis and and ulcer in the duodenum. The cause was from taking NSAIDS (aka ibuprofen) and alcohol. I was put on prevacid which is the medical course of treatment. Keep the acid low so the ulcer can heal. Anyway, I did well for about a month and when I came off the prevacid, all hell broke lose. I started having intense pain again and it never let up. At least when I had the ulcer, the pain only hit really hard about 30 minutes after I ate. I was told that was due to the acid hitting the duodenal ulcer.

    My first scope was done in Mexico because I was on vacation when the ulcer flared up. Well when the pain started again I went to a local gastro doc. He scoped me and said no ulcers and all I had was mild gastritis. He put me on Librax and prevacid. That was about 5 months ago and I have been struggling ever since.

    I can say that I have done better after quitting the prevacid. I went to a nutritionist who told me about the dangers of ppis such as not getting enough nutrition due to an inadequate amount of acid needed to properly breakdown food. I started taken digestive enzymes, hydrochloride pills to get my acid back up (which I was scared to take), and other stuff. I also toyed around with other medications such as Librax, belladonna, and now limbitrol which are aupposed to help with muscle spasms which is what I am told I have.

    Anyway, I am running my mouth as usual. Basically I had two scopes with both showing gastritis and one showing an ulcer and the other showing the ulcer had healed. My ulcer was small so an endoscope is probably the only way it could have been truly dx.

    You mentioned irritation (or inflammation) may be looked for. The scope can show if there is inflammation of the stomach, the duodenum, and throat. If you have reflux, he will be able to see if there has been any damage to your throat lining. A hiatal hernia can also be checked for. The scope is probably the best test for checking your throat, stomach and duodenum. Good luck!

     
    Old 10-14-2003, 11:26 PM   #5
    sir-tainly
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    actudan, thanks again for your response and sorry to hear about all the troubles you've been having.

    I too have some concerns about long-term use of PPIs, but I don't plan to address them until after the endo. I have experimented with acupuncture and massage, especially the muscles around my neck, which seems to have offered occassional relief but not much.

    I do know I have a small hiatal hernia and reflux because they showed up on the barium swallow. The question is for how long, etc. The throat sensations (which I would swear are in my pharynx) feel very muscular/spasmodic in nature which I believe can be a symptom of GERD, though infrequent. The theory being that if they can control my GERD, then the spasm will stop.

    Then again, it may all just be stress! Frustrating!

     
    Old 10-15-2003, 10:03 AM   #6
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    Hi again sir-tainly. As far as being a fellow GERD sufferer, I can tell you my symptoms weren't always typical either. I tended to suffer chest pain, the taste of reflux in my throat, and then just a bad coppery taste in my mouth all day long. My endos were no big deal - until 1999 when the doc discovered Barrett's. The inflamation had been there all along, but during routine biopsy of the esophagus (which is usually done during endo), cell changes were found indicative of Barrett's. I didn't opt for reflux surgery (called Nissan fundoplication) until 2001 when I decided that no amount of med was going to change my problem because I was still refluxing on meds. My lower esophageal sphincter was hypotonic which was leading to all my problems with reflux/GERD.

    Best to get things checked out now - Barrett's esophagus does not automatically become cancer - it just means your risk for cancer is increased. However, I will be monitored (via endo) every 2 years for life, and since my surgery, the inflamation is much reduced, and my GERD symptoms are gone (except for the occasional chest pain, but this is due to gas, not reflux).

    Your symptoms may seem atypical, but could still be GERD, especially with hiatal hernia (which I also had, but is now repaired) and reflux. "Globus Hystericus" is the term you're thinking of and is related to stress. If the endo shows no inflamation, then that might be the diagnosis the docs come to. The main symptom of this is the "lump in the throat" feeling and may cause difficulty swallowing.

    Good luck and keep us posted,
    Katie G

     
    Old 10-15-2003, 11:02 AM   #7
    gillian30
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    Acudan,
    I noticed you said after taking Prevacid for a while you felt awful afterwards. I'm taking Nexium (for about 6 weeks now) and today am supposed to switch over to Aciphex, which I think is the same as Prevacid. I was planning to stay on that for maybe 6 weeks. I'm nervous reading what problems these meds can bring, though. How long was your recovery time after the Prevacid?
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    Old 10-16-2003, 05:26 AM   #8
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    Dear Sir,
    I just had an endoscopy yesterday. It wasn't to bad, the worst part was the awful tasting spray they use to numb the back of my throat. Thet took biopsies and I will know something next week!
    Good luck!
    Lynda
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    Old 10-16-2003, 07:06 AM   #9
    actudan
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    Quote:
    Originally posted by gillian30:
    Acudan,
    I noticed you said after taking Prevacid for a while you felt awful afterwards. I'm taking Nexium (for about 6 weeks now) and today am supposed to switch over to Aciphex, which I think is the same as Prevacid. I was planning to stay on that for maybe 6 weeks. I'm nervous reading what problems these meds can bring, though. How long was your recovery time after the Prevacid?

    I was on Prevacid (2 months), aciphex (1 week) and nexium (few days). I quit taking them because I didn't think they were needed because I was still having a lot of stomach pain and just felt miserable every day. I was also losing weight because food was going right through me. I have stopped taking all ppis for about two months now. I still have some URQ discomfort and I occasionally get nausea. I look back now and try to put the pieces together. I can't say with 100% confidence that my problems were induced by the ppis or I already had the problems and the ppis made them worse or made no difference at all. All I know for sure is that shortly after quitting the ppis and started taking digestive enzymes and other vitamins and herbs, I slowly started feeling better and my weight started moving up again. I do believe the ppis contributed to the weight loss because don't think I my food was being adequately broken down due to a lack of acid. Anyway, I know that my story isn't really clear on whether ppis did or didn't cause my problems. All I can do is speculate. I never did have heartburn or indigestion. I started ppis due to an ulcer. Good luck!

     
    Old 10-17-2003, 11:03 AM   #10
    sir-tainly
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    keystone206 (Lynda)

    Thanks for your post. What kind of symptoms were you experiencing that led to your endoscopy? Were biopsies taken because they notice inflammation or something? Or are biopsies always taken in an endoscopic procedure?

    Thanks,
    ST

     
    Old 10-17-2003, 11:33 AM   #11
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    I have been diagnosed with barrets esophagas for a number of years now and would have never have known if my gastro
    hadn't found blood in my stool. I NEVER HAD AND STILL DON'T have any symptoms of gerd. when he found the blood he did a sigmoidoscopy, followed by colonoscopy and then the egd down the throat which finally showed him the problem. the only scope that was uncomfortable to me was the sigmoid as there was no twilight anasthesia used for that. duo-enoscopys are a piece of cake.......

     
    Old 11-18-2003, 01:16 PM   #12
    sir-tainly
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    Biopsy results back

    Quote:
    Originally Posted by keystone206
    Dear Sir,
    I just had an endoscopy yesterday. It wasn't to bad, the worst part was the awful tasting spray they use to numb the back of my throat. Thet took biopsies and I will know something next week!
    Good luck!
    Lynda
    Well, had my endo a couple of weeks ago - piece of cake - and got my biopsy results today. Esophageal biopsy showed nothing, not even mild gastritis. Stomach biopsy revealed mild asymptomatic gastritis and the presence of H Pylori. I go on a two week regimen of PrevPac tomorrow to get rid of the critters. These findings are of course incidental to my upper throat dysphagia, so I am considering further investigation via pH test, manometry and additional ENT evaluation for LPR (which I might avoid by just doubling up my Prevacid dose and seeing if my problems resolve). Or I may just learn to live with it as I am tired of seeing doctors and being probed. All the serious stuff seems to have been ruled out (including thyroid) at this point.

    - s-t

     
    Old 11-18-2003, 04:09 PM   #13
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    Quote:
    Originally Posted by sir-tainly
    All the serious stuff seems to have been ruled out (including thyroid) at this point.
    That is great news!

    I was reading through this thread, to tell you that they can also test for H.Pylori, but I see you're done. Great!

    Last edited by Divermon; 11-18-2003 at 04:09 PM.

     
    Old 11-18-2003, 10:02 PM   #14
    vader1000
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    katie - if you wouldn't mind, how long did you have gerd before being diagnosed with barrets esophogus?

    Last edited by vader1000; 11-19-2003 at 04:39 PM.

     
    Old 11-19-2003, 10:28 AM   #15
    Jenn4USA
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    Thumbs up Endoscopy Procedure

    I have had GERD for about 6 years, and had 3 surgeries to correct this. During that time I have had about 30 endoscopic procedures for dysphasia, and have been dilated. I have not once had any problems with the procedure and felt like for the most part it was a breeze. My Doctor is wonderful and takes very good care of me which I am sure makes a difference. The sedation doesn't seem to effect me at all, they use a combination of demerol and versid and the effects from that seem to just last a few hours after the procedure. I usually go home take a little nap and I am up and about by the evening time. Good luck with your procedure. And hopes that all goes well!

    Last edited by Jenn4USA; 11-19-2003 at 10:29 AM.

     
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