Posted on 04/26/2022 7:57:55 PM PDT by ConservativeMind
In a new American College of Gastroenterology guideline, published in the April issue of the American Journal of Gastroenterology, screening methods have been broadened and guidance has been updated on intervals and techniques of surveillance for patients with Barrett esophagus (BE).
Nicholas J. Shaheen, M.D., M.P.H., from the University of North Carolina at Chapel Hill, and colleagues developed updated guidelines for the diagnosis and management of BE.
The authors recommend that dysplasia of any grade detected on BE biopsies be confirmed by a second pathologist who has expertise in gastrointestinal pathology. Acceptable screening modalities for BE now include nonendoscopic methods. Both white light endoscopy and chromoendoscopy are recommended in patients undergoing endoscopic surveillance of BE. Length of BE segment should be considered when assigning surveillance intervals, with longer intervals reserved for those with BE segments <3 cm. Endoscopic eradication therapy is recommended in patients with BE with high-grade dysplasia or intramucosal cancer. For patients with BE who have completed successful endoscopic eradication therapy, an endoscopic surveillance program is recommended.
"This revised guideline synthesizes current best practices in the management of BE, with several key changes since the last iteration that reflect our evolving knowledge base," the authors write.
(Excerpt) Read more at medicalxpress.com ...
BTTT!!
Ok only looked at your excerpt.
Still not clear on whether we’re talking monitoring BE itself or monitoring during GERD for BE.
Baking soda and water, even keeps teeth from collecting tartar for me.
This was me, with a very long segment (well over 5cm, don't recall the specific number now). I only had low grade dysplasia My doctor from Johns Hopkins - one of the best in the world - said I should get treated right away but my insurance woudn't pay into it was high grade dysplasia. It was her expert opinion that by the time she found high grade dysplasia, with a segment as long as mine it would already be too late, there would be cancer too. Fortunately I was lucky. One advantage of seeing a leading expert in the field is that she performs a lot of studies of new techniques and she put me in a study for a new at the time technique - cryoablation - and froze all the bad cells. It took several sessions spread over a couple of years to get it all but she did and I've been Barretts free for about 7 years now.
I believe if I had followed the recommendation here I'd probably be dead or missing my esophagus now. It seems like it's aggressively looking to delay treatment until it is on the edge of being too late.
That was my recipe too. If I ever felt hearburn coming on a glass of that stuff, a mighty belch and it was gone, chemistry 101. And yet I very nearly got cancer anyway. It took years of treatment - probably 5 or 6 sessions spread in six month intervals - to get rid of all the damage done while I thought I had it controlled with baking soda. I hope you get it looked at. A simple painless upper endoscopy can tell you the tale. Maybe the caking soda is doing the trick for you. But if not the meds - nexium for me - made me heartburn free totally and after treatment my esophagus is in great shape finally.
Honestly, to me these recommendation seem like they were written by the insurance company to try to minimize the number of treatments they have to pay for.
I had BE several years ago. Two manual scrapes and a 3rd check to make sure it was clear, and one Pantoprazole daily since then. With an annual upper GI.
This enhanced procedure sounds like one of the Imperial Overlords contracted BE, and this enhancement is intended to justify the increased care the overlord class gets.
BE is an effect of GERD, which is a consequence of improper parietal cell function, itself a not-so-subtle symptom of severely impaired health.
Yet they continue to prescribe PPIs which further impair parietal cell function and ignore the consequences of their institutional ignorance by treating GERD rather than resolving it.
Patients pay the price. Worse, PPIs are now OTC. I’ve met too many people who were destroying their health on the advice of their doctor to resolve a single symptom.
M&M keeps at it.
I was diagnosed with Barrett’s Esophagus well over 20 years ago, and have regularly had endoscopies. I’ve been on medication for acid reflux since the late 80’s, early 90’s. My gastroenterologist will do an endoscopy and colonoscopy together. I had both done last June. He said my Barrett’s is stable, and I won’t need another endoscopy for a couple of years...and, I can do the Cologuard tests in the future. No more prepping for a colonoscopy.
We have a friend who went through similar.
Glad your esophagus is in great shape, now.
Seems like a lot of long time preventative standards/measures are being replaced with minimization of procedures (costs).
Didn’t we just see the same for prostate guidelines?
What is M&M?
Viewed. Thanks!
Less prostate cancer screening reduces overdiagnosis but may miss aggressive cases (More high-grade cancers now found than low grade - 1st time ever - showing PSA diagnosis delays kill):
Prilosoc has been my close friend for years now.
It’s my euphemism for ‘modern medicine’.
Bkmk
What resolves it?
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