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Ask Dr Uzair Your Own Question
Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 8319
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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I had an endoscopy done in March and was told at that appointment

Customer Question

I had an endoscopy done in March and was told at that appointment that I had an ulcer at base of my oesophagus. I understand this is stage 4 on the savary miller guide. I now have biopsy results which says - this shows inflammatory changes, with ulceration within my gullet. Has this now progressed to barretts or is it getting nearer to barretts.
Kindest regards, Heather
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Uzair replied 2 years ago.
Hi. Welcome to JustAnswer. I shall try my best to assist you while you are corresponding with me.
No, in that case the biopsy would have clearly shown metaplasia and replacement of the normal squamous epithelium of the esophagus with the columnar epithelium found in the stomach and presence of goblet cells. This biopsy shows inflammatory changes which is seen in ulceration of the esophagus, so this is not barret's esophagitis.
Yes, this is nearing barret's esophagus since there are inflammatory changes at the lower end of your esophagus. Stage 5 of the Savary-Miller classification is Barret's esophagitis.
Hope this helps.
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Best.
Customer: replied 2 years ago.
Do I have enough time to prevent it getting to barretts or will it naturally continue and become barretts
Expert:  Dr Uzair replied 2 years ago.
Thanks for replying back, Heather.
There is always a chance of reverting the changes before the metaplasia occurs. And since, proton pump inhibitors are not very effective in esophageal ulcers one should seek consultation from the Gastroenterologist for endoscopic mucosal resection of the ulceration and a general surgeon for treatment for the acid reflux which is Nissen Funduplication (can be done laparoscopically as well as by an open incision).
And more so, even Barret's esophagitis can be treated with muscosal resection, laser and photodynamic therapy.
So, don't worry there is still time to revert the changes, watch your diet, watch your weight and change your life style if it is full of stress and is sedentary.
Of course, if left untreated and ignored this will naturally progress to Barret's Oesophagitis.
Hope this helps.
Please do leave a positive rating for the service.
Let me know if you have any further concerns regarding this.
Best.