It is always frightening to be diagnosed with any chronic condition, but learning that you have Barrett’s esophagus, even without esophageal dysplasia, can be very unnerving. It is not unusual to do a little research on your doctor’s recommendations after such a diagnosis. Unfortunately, questions like this do not have simple answers – there is always a “that depends on…” somewhere in the response.
I was diagnosed in January 2014 (via endoscopy and biopsy) with Barrett’s without esophageal dysplasia. Only symptom was clearing throat frequently. My Houston GI prescribed Dexilant (PPI) for 4 weeks, then only as needed. He also recommended lifestyle/diet changes and surveillance. With no symptoms I rarely take the medication. He recommended a repeat endoscopy in 3 years post-diagnosis. When do your experts recommend repeat tests?
Thanks for sharing your diagnosis and for your question. The best surveillance program for non-dysplastic and low-grade dysplasia Barrett’s is a frequent question from our readers. First, our scientific director, Dr. Chandrasoma, recommends that an expert pathologist confirm any diagnosis of Barrett’s esophagus. If you haven’t done that, we encourage you to consider doing so. You can read more about why in his article, Can you trust your pathology results? Dr. Chandrasoma also discussed surveillance intervals in his article, How often should I have a surveillance endoscopy test?”.The current standard he discusses in the article is consistent with the recommendation by your doctor; however, he also noted that your personal risk factors should be considered in this recommendation.
Esophageal dysplasia requires more frequent surveillance
The goal of any surveillance program is to identify disease progression early to begin treatment as quickly as possible, while balancing economics and patient inconvenience. However, personal risk factors should also be considered when determining follow up endoscopy and biopsy. Our medical advisors, along with most GERD experts, typically focus on these five risk factors:
- History of smoking
- 10 or more years of GERD symptoms
Two or more of these risk factors suggest follow up sooner rather than later. The American Gastroenterological Association Position Statement on this question suggests a follow up exam in the three to five year time frame based upon those risk factors. Again, this is consistent with your physician’s recommendation of three years. However, should an examination find esophageal dysplasia, then the surveillance may be shorter.
Perhaps the real question is: How do I avoid disease progression?
We greatly appreciate the advice given to you by your physician: use medications only as necessary and focus on diet, weight management and lifestyle choices. That approach will help minimize the frequency of reflux episodes – which helps reduce the risk of disease progression AND keeps your symptoms in check.
Here at RefluxMD we have spent the last year developing an innovative program focused on two of those elements: diet and weight management. We believe that RefluxMD’s Recipe for Relief is the best food plan and diet program designed for those suffering from GERD. I encourage you to learn more about our new program.
I hope this helps
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