Barrett's Esophagus

Barrett's is a condition created mainly by heartburn and acid reflux. The cells in the esophagus change and it is not reversable. From what I have read so far most docs recommend the gastric bypass for Barrett's patients. Recently I have been given the green light for the sleeve as long as I am aware of the risks, the main risk being the reflux following the surgery. I was told that if the meds did not stop the rflux I would have to get the bypass.  I am curious to know if anyone has had an experience with the meds not controlling reflux and what they did about it. I have been taking two 20 mg Prilosec (or generic omeprozole) for almost 6 years and it seems to work if I am careful about what and when I eat. I would like to try something different because my last endoscopy revealed stomach polyps which the doc believes are being caused by the Prilosec. Does that make any sense to anyone? Does Nexium work as well or better than prilosec? Does it cause polyps?

My surgery is tentatively scheduled for July 28.


 

bankokbob:  A particular type of gastric polyp called "fundic gland polyps" have been associated with proton pump inhibitors such as Prilosec and Nexium.  To my knowledge, I am not aware of their being seen more commonly with one type of PPI vs another type, so taking Nexium vs Prilosec probably wouldn't matter.

I'm just wondering why you haven't considered RNY.  It practically eradicates GERD in patients who get it done as per my surgeon (I had severed GERD and hiatal hernia, and now it is gone!)  If you get rid of the GERD, you markedly decrease the risk of your Barrett's progressing to esophageal cancer.  I'd probably go for RNY instead of vertical sleeve gastrectomy if I were in your shoes.

I was taking Prilosec for a while for acid reflux and heartburn but didn't know I had Barrets (found it in the pre-op testing required for my RNY).  I was already scheduled for my surgery and of course went ahead with it... the acid reflux stopped completely!  I go back next June for a follow up.  Will be interesting to see what shows up regarding Barrets now that I've had the RNY (7/20/10).

I had the RNY as a revision from the Lap-band due to my diagnosis of Barretts Esophagus last year. For the first 6 months I was reflux/gerd free. Then all of a sudden it came back.  I been back on my nexium and taking it up to twice a day. I also had a hiatal hernia repair during my revision surgery.

I just recently had my year out EGD...and i have gastric polyps, and my hernia is has slipped back.  I am miserable with out my Nexium I was also put on Zantac as a secondary.   I am not sure what is going to happen here out...with the hiatal hernia, but I do believe it is the cause of the reflux now...as it does not matter what I eat I will get reflux. :(

You seem to have multiple problem related to your tummy. If you feel that hernia is the cause for all the problems in the esophagus, it is better to consult a Gastroenterologist. If I may recommend, pls visit Shouldice Hospital to check whether you need a hernia repair , so that most of your problems will be solved.

Dear bangkokbob,

 

I had my Lap band in June, 2009, this was the best thing I ever did. prior to that i was 5'0" 205 pounds, had DM started on insulin, High blood pressure, Hypothyroidism, and sleep Apnea. within 3-4 weeks of the Lapband I went from a size 20- 14  and by September i was a size 10. But that is not the best thing that happened, i was off all blood pressure meds, insulin within 3 months, my sleep Apnea is gone, my thyroid is functioning to almost normal, and my 400 cholesterol is at 168. at 60 years of age I am healthier than i was at 30.

Regarding the sleeve, as a nurse and having colleagues that have done it , it is a total different ball game. With the Lap Band there has not been any changes to my stomach size or function, no invasive procedure, and control is in my hands tighter band , less tight it is up to me to change my behavior and the lap band is my "policeman".  any surgery that will change the size or function of the stomach has more complications and side affects. Also think of the stomach what is it? a muscle that can expend? yes it is, i believe if for some reason a person needs a bypass or sleep it should go together with the "policeman" ( lap band) lets be honest we are obese because we have no control and we have been on million yo yo diets, have made promises to ourselves and loved ones - we are addicts to food. if today for some reason I needed my lap band off - I WILL BE AGAIN 200 Pounds i cant promise to "be good".

My attitude towards eating has changed to that of a "skinny" person, I eat today because I have to eat for nutrition, not because i FEEL like eating. ( that is the definition between obese and not obese person). I do not use food as a crutch when i am down.

since I do not have hunger pains, I prepare for myself meals ( I eat every 2 hours) , took trial and error and a lot of regargitating to find my sweet spot with the band and to stop the mistakes. each person is different and you will have a lot of misserable times , as when you go out with friends and you say ok just tonight i will eat what every one is eating, you will spend the money and it will be in the toilet ball of the restaurant and you will not be able to eat after that for 12 hours. i

I go out socially, I have learned what to order, my friends know what i can and cant do, such as having ****tails and eating- i cant drink and eat. so we order a drink and we ask the restaurants do you rush your customers? if yes, we do not go there. I tell the waiter when to put the food up to prepare it after the ****tail and soup ( at least 15 minutes after). You make a life changing choice, it is hard but worth it. I love my Lap Band it is my best friend. and my Husband says i am a chip date lol, ( we usually share an appetizer and the main meal). My friends who to the most part either are obese, or just can eat all in sight and drink alot and spend at least 100 dollars a person when they go out to eat. Loved FINDING that we have a good time when we go out when we order a few appetizers to share and 1 meal per 2 people.

One more thing: I do not know how old you are or your social life, it gets better when you feel better about yourself :-) but this is what i told my doctor ( an he has a lap band too) - i want to socialize, i do not have any intentions of filling too tight and unable to do food but only liquids, i do not want to be miss universe, but feel full of energy, like myself , and enjoy my life. i have an 11cc band that has NEVER been filled more than 6.1- ( i have not had any changes to it in the past 3 years) i maintain my weight between 127-131 and i am happy with my size 8 :-) - would be happier with a tummy tab but it is not a priority cant afford it. in that case i would be a size 2-4. But it is not my size it is my HEALTH that I am enjoying so much.

I have 2 little story you might like: 2 months after the lap band my 5 year old grand daughter asked me to play hide and seek, and she said " I know Mama you will count and I will Hide it is hard for you to hide" and i answered: " You know what L. you count and i will hide" i went under the dinning room table and hid there, my daughter was sitting on the couch watching the frustration of her daughter seeking me out and not finding me. She finaly sat on the floor and cried " Mama went home" i made some noise and she looked and started to laugh and very excited said:" Mommy, look at Mama SHE CAN BEND DOWN SO LOW AND GO UNDER THE TABLE". I knew that minute I did the right thing!!.

Second story was about the IMAGE of me to myself and others: my granddaughter came over , it was maybe 3-5 months after the lap band, and very seriously  said : "Mama Phil lost his chair" ( Phil is my grandson he was 3 at that time) , I answered:" what happened to his high chair we need to go buy a new one? she laughed and said: " silly Mama he lost HIS CHAIR ( Pointing to my stomach where I used to sit him lol ) Mama you have lost the halli bread in your stomach he has no place to sit now" ( Halli is a Jewish bread made for the sabbath). i  looked in the mirror and realized aha i do look nice, and i am so comfortable physically and emotionally.

i Just went through being sick with Bronchitis, and developed reflux, 1 cc of the band had to be taken out, to allow the esophagus to heal. I just wanted a guarantee from Dr. Fielding when he took the 1 cc out that it would go back in. he promised within 1-2 months. I have gained in past two weeks 2 pounds and that is ok, but I am thinking now is the time to make believe all the 6.1cc are still in it and even though I can after 4 years eat a 1/4 of a slice of bread without toasting it, and i can have TBS of rice and 1/4 cup of pasta I WILL NOT BOTHER - 

I eat because I have to keep nourishment not because I FEEL like just eating. Dont get me wrong I will be "Tasting" things I have not eaten in 4 years but taste only. and work now on MY THINKING - i have the band , but I have me to make my choices ( with the help of my policeman ) and will control the amount of the NO NO foods for just a little while.

I hope this helps, it is a change of life style, a change of happier days, healthier days, and self reflection of what is really important. al

PS. A hernia repair is done during the Lap Band placement. also I did consult with my MD, GI , Pulm. - all told me have it done your issues are due to obesity!! As a nurse I weighed carefully all, I do not ever recommend doctors to my patients it is not ethical but I have to say that in this case NYU and doctor fielding and his team are the best there, check them out, look at doctor fieldings library on his site on line. and HE HAS A LAP BAND. HE DOESNT JUST TALK THE TALK HE WALKS IT !!!

Good luck you will do just fine.

Leah
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I have suffered from reflux and hatial hernia for 12+ years, been on many medications, but most successful has been my Prevacid (Lansoprazole) 30mg daily. As long as I take my little pink/black pill I generally am asymptomatic. Have you tried it?