Barrett's Oesophagus
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peggy43
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Quote peggy43 Replybullet Topic: New
    Posted: 18 Aug 2013 at 6:46pm
Hi I am new to the forum and am hoping for some information if anyone is able to help! I had an endoscopy about 3 weeks ago and was told I had Barretts oesophagus and 2 biopsies were taken. I went for what I was told was an urgent follow up appointment last week so was expecting bad news!
At the appointment the doctor told me the biopsies were fine and I don't have Barretts. So I was pleased to get that news after all the worry but I am also a bit concerned that the endoscopist was sure the change in the lining of my oesophagus was due to Barretts.
Is it possible to misdiagnose and if the biopsies are clear but it clearly looks like barretts, will it possibly turn in the future?
Thanks for reading my post
Peggy
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jcombs99
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Quote jcombs99 Replybullet Posted: 18 Aug 2013 at 7:52pm
My Doctor (GI) admits to being WRONG either way (Path report TELLS ALL) and that's why he is my doctor .So look into this a little and do what you want..

Good for You

HGD JEFF
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peggy43
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Quote peggy43 Replybullet Posted: 19 Aug 2013 at 8:15am
Thank you Jeff its a mystery to me all this.
Peggy
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chrisrob
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Quote chrisrob Replybullet Posted: 19 Aug 2013 at 8:57am
Hi Peggy,

Diagnosing Barrett's is not an easy task.

Firstly the endoscopist has to get the best site for biopsies. It's a bit like looking for a needle in a haystack.
They follow what's known as the "Seattle protocol" when taking biopsies: 4, quadrantically, for every centimetre length of the suspected section of the oesophagus.
And it's easy to confuse the salmon colouration of Barrett's with the cardia (top junction of stomach) often exposed through hiatus hernia.

Next the biopsies have to be examined by a histopathologist. The cell samples are dyed to show up abnormalities, set in wax and thinly sliced for microscopic examination.
The pathologist doesn't really know the exact origin of the sample - to rule out cardia cells for example.
Recording the position and size of the suspected area cannot be precise. The endoscopist has to estimate distances using the scale engraved on the outside of the scope - which is only graduated every 2 centimetres.

Earlier this year I was in a seminar with numerous pathologists (an other gastroenterology specialists) where we were shown cell samples and asked to determine whether they showed any metaplasia ("normal" Barrett's) or not and also whether any showed any gradation of dysplasia or even adenocarcinoma - and what our suggested treatment would have been.
It was very interesting to see the wide range of variation. (I was quite pleased I didn't do any worse than the majority of those present.)

To get an angle on the problem, this page shows cell samples and the interpretation placed on the by 12 top pathologists.

So it is always a possibility that Barrett's can be missed. The reassurance is that if there is any doubt, the samples are reviewed by another pathologist and if necessary, another scope may be requested and more biopsies taken.

For the vast majority of us with Barrett's, it will not progress. If it does, the initial stages are normally so slow that even if something was missed on a scope, it would still be picked up in time at the next scope.

It looks like yours is good news. The biopsies of the suspect area did not show metaplasia. If they did miss any it will probably be a small insignificant spot. If they have any slight concerns, they will call you back for another scope in a couple of years time. (May sound a long time but I've had my 2cm Barrett's for 20 years without change - and not expecting any.)

All the best

Chris
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DanJ
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Quote DanJ Replybullet Posted: 19 Aug 2013 at 8:57am
can you post up your report you received afterwards , just for interests sake?
 
 
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DanJ
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Quote DanJ Replybullet Posted: 19 Aug 2013 at 9:00am
very usefull post chris , thanks
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peggy43
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Quote peggy43 Replybullet Posted: 19 Aug 2013 at 6:57pm
Thank you Chris that was really helpful. My initial report read like this
Barrett's Oesophagus total length including circumferential and tongues of Barrett's mucosa 2cm and maximum length of circumferentially involved mucosa 1cm.
2 biopsies taken.

That's all I have I wasn't given the report from the pathologist. Ive tried to get a copy without success as yet!

Thanks
Peggy
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jcombs99
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Quote jcombs99 Replybullet Posted: 19 Aug 2013 at 7:07pm
Get that Path report and save it .ASK for a redo in 20 months to be on the safe side .

Mr. Careful and Alive

HGD JEFF
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peggy43
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Quote peggy43 Replybullet Posted: 21 Aug 2013 at 10:27am
Thanks Jeff I will get it. They said repeat endoscopy in 12 months.
Peggy
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jcombs99
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Quote jcombs99 Replybullet Posted: 21 Aug 2013 at 12:10pm
Great !!I like your doctor he's careful now do your part and it may all be normal looking in 12 months..

Sounds like a Happy Ending
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