I’m 38. I was diagnosed with ultrashort segment BE last year. (“Irregular z-line” with “scattered focal metaplasia.”) I had been diagnosed with an irregular Z-line when I was 36 and I suspect it was metaplasia then, too, but the center that did that previous one doesn’t do biopsies on anything less than 1cm.
So yes, I know it’s scary to think about, scary to know you have. And yes, your risk is a lot higher for cancer of that region. (Not just esophageal adenocarcinoma, but also stomach cancer of the area.) But here’s wher you have hope: most are modifiable risk factors, to an extent. You have Many potential options.
1. Consider surgery. Some say that it doesn’t change the Barrett’s, but some so. In fact, Dr DeMeester at USC is in the 7th year of a 15 year study looking at whether anti-reflux surgery reduces Barrett’s length.
2. Take your meds as prescribed.
3. Change your diet to a GERD-friendly diet. BE STRICT ABOUT THIS. The cookbook “Eat to Live” by Joel Furhman has been a godsend to me. Just modify the recipes to not include all that onion and garlic ;-)
4. Lose weight if you can. BMI of 24 has show to greatly reduce reflux. (Or so I hear. I’m
Currently at 27.)
5. Speak with a naturopath as well. Things like DGL and mastic gum have been shown to help in cases. Certainly, they don’t do harm.
Now, what you want to do is get the length of the Barrett’s. Your risk of moving on to cancer is about .1% per year per centemeter of length. That will determine how often you’ll need to be scoped and what treatment options are available to you.
Remember, too, that Esophageal cancer progresses very slowly. Being scoped every 3 years will allow them to see changes when they happen and to treat you if they do. There are stages it must move to before it gets to that stage, and there’s are proven, successful treatments. (Frankly, I wonder why they don’t donablation on non-dysplastic folks.)
Finally, remember that the vast majority of people with Barrett’s will not die of EC, and that it’s usually about 20 years from diagnosis to progression to cancer, if it develops at all. 95% of all EC’s are found in people who didn’t know they had Barrett’s, so if anything were the lucky ones. (Weird luck, I know.)
I won’t lie, I get scared, too. Very. And depressed. And angry. And then I get in pain, even despite the pills, even despite he good diet, and a whole torrent of emotions floods me. But don’t let that take you over.
Do what you can about it, then focus on the here and now.