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Dear Kind Friends,

First I want to thank you all for you kind help and support.

One person asked how I was diagnosed. I had an endoscopy done. The
doctor showed me the pictures of my Barrett's when I went back for my
consultation. The normal cells are pink, the Barrett's cells are a
salmon color.

Some folks asked what it was. The lining of the esophagus is different
than the lining of the stomach or intestines. Normally there is an area
at the end of the esophagus that marks the border between the cells of
the esophagus and the cells of the stomach. Barrett's is the abnormal
growth of intestinal-type cells above this border, in the esophagus.

It starts with Acid Reflux, or GERD. If left undetected or ignored it
can cause Barrett's Esophagus to developed. This is a precancerous
condition, and I was so kindly informed by MANY of you, nothing to be
ignored. You must follow a specific diet or take the chance of having it
become cancer (adenocarcinoma). It is more common in men than in women.
However, most of the responses I received were about women. I received
one response that was from a mother whose 10 year old was tested for CD,
as was her 24 yr old nephew and both were found to have Barrett's! So, I
don't think age plays a part in this either. I can not say there is a
connection to CD, but as some one else said, there is a connection to
acid reflux.

I was not even aware that I had acid reflux. I was beginning to suspect
that I did.The doctor did not tell me that this was a result of acid
reflux, but he did tell me that I do not have e-pylori, which can also
be the cause of acid reflux. Because of that, when he asked if I had
symptoms, I said no, because I really was unaware of what the symptoms
may be. Now looking back on it, yes, I do have symptoms of it. I have
felt like I was having difficulty swallowing at times, for quite some
time now. I have had a pain in my chest from time to time that feels
like a heart attack, which my rhumatologist said was fibromyalgia. Nope,
more than likely it was acid reflux. I get nauseous once in a while, for
no apparent reason. According to a web site I visited, it said that
"since the cells lining the stomach are protected from contact with
acid, their growth into the esophagus may actually be a defense
mechanism. It may protect the normal tissue in the esophagus against
further damage by GERD. This may explain why the symptoms of  GERD seem
to lessen  in some patients with Barrett's esophagus."

Most of you are on medications for the acid reflux and sleeping on
wedges.

One person asked why my diet is so limited already besides GF. Well, I
am casein intolerant, sugar intolerant (which eliminates most GF
prepared food), yeast intolerant, chemically sensitive (which means no
preservatives or additives), and anything that is processed is a problem
for me if it is cross contaminated. Which leaves out a great deal of the
food that is on the GF list. I react to the slightest amount of gluten.
Everything I eat I have to make myself unless I know it comes from
somewhere where there is no gluten around. My favorite foods were spicy,
so that could explain the gastritis. To tell you the truth, I am at a
loss and don't know what to eat now. I am bummed out. But if I want to
live, I will do this. I just don't quite know what to cook. Every recipe
I look at has something I can't have. I will save the list of eliminated
foods for you to read below. Here are the responses (I am breaking this
up into several e-mails):

``````````````````````````````````````````````````````

A friend of mine has this...no coffee, no caffiene, no alcohol, no
orange juice, no spicy foods such as tomato sauce, in other words...no
acid at all.  All irritate the esophagus

~~~~~~~~~~~~~~~~~~~~~~~~

Barretts is very serious and can lead to Cancer. You must be aggressive
with your care. I do not give a hoot what that doctor says you need to
watch Barretts like a hawk. I have had many patients who were dx with it
and within a year it turned to cancer.  I would get a second opinion,
but research for a doctor who knows Barretts really well it may mean
some travel if you do not live near any major cities, but worth it.
Barretts is a change in the lining cells of your esophagus caused by
excessive erosion of acid juice from an incompetent cardiac sphincter.
It is serious and needs constant care, 6-1yr endoscopies are a must for
a lifetime. You need to control the condition to prevent cancer.

~~~~~~~~~~~~~~~~~~~~~~~~

I would suggest you to go to this other excellent site:
http://forums.delphiforums.com/celiac/messages/
and ask your questions.

There are kind and knowledgeable people there.

Moreover, I have voluntarily posted thousands of GF recipes.

~~~~~~~~~~~~~~~~~~~~~~~~~

I have an aunt who has Barret's that was checked for cd after my
diagnosis.  She tested negative but felt way better on a gluten free
diet.  She was told she had a strong "allergy" to gluten but not cd.
Anyway, after many months on the diet her Barret's improved to the point
where her doctor plans to stop doing yearly endoscopies to check on it.

~~~~~~~~~~~~~~~~~~~~~~~~~

I have known that I have had Barrett's for 12-14 years and CD for 4-5
years.  For many years I didn't drink milk, coffee, tea, or soda pop and
didn't eat tomatoes, citrus fruits, etc., ate four hours before going to
bed, and took all the fancy reflux medications.  I then had surgery
which was supposed to control the acid reflux.  I haven't received my
most recent biopsy report; therefore, do not know what is happening to
the Barrett's;  it has been negative every year when I have had it
checked to date and seemed to be getting shorter.  I don't know what
kind I had but carefully followed the directions of my doctors.  I agree
with you that cancer is not an option if we can help it.  I have found
several excellent articles through Medscape.  I signed up for their
weekly report on GI issues, and I go to the site and search for
additional information.  You sign up for the free service. The address
follows: http://gastroenterology.medscape.com    I find that with the
current recipes and delicious ready made foods for CD that we eat quite
well.  It can cause problems, but I can usually deal with them most of
the time.   It is easier to watch what I eat than take lots of pills and
other treatments.   If you have questions please feel free to write.
I don't know if the Barrett's is connected to CD or not.  I was told by
one doctor that it wasn't but saw reflux listed as a side symptom of CD.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

I hhave both and was not told to change my diet I am on prilosec. I had
a repeat biopsy after 1 yr and he said it looked better. I go back in 2
years for a follow up. The gf diiet helps the heartburn

~~~~~~~~~~~~~~~~~~~~~~~~~~~

they do not always operate for Barretts, and if you can avoid this
you should do anything you can to do so.

Many mistake the acid reflux for a gluten reaction. A burning sensation
in the chest is not a gluten reaction, and a bloated feeling also may
not be.

But the acid reflux often presents as something resembling what most
would think was hypoglycemia. My doc told me it can make you feel queasy
and kind of nauseous for days, as if you were having a low blood sugar
reaction.  That's what it did for me. Before I learned to control it I
took Prevacid for a couple of weeks to allay that feeling and get my
system working right again.

But acid reflux also often causes chest pains that are hard to
distinguish from Angina -- this comes especially after going to bed at
night, and/or after light exertion. The worst offenders for reflux that
causes chest pain are (in order): alcohol, fats, decaf (worse than real
coffee for many), coffee, then the well known acidy foods, especially
canned tomato products.

The alcohol and fats are the worst because they relax the esophageal
sphincter just above the stomach. This relaxed sphincter then allows
acid from the stomach to back up into the esophagus, which in turn
causes the sphincter to spasm and cramp causing pain like any cramped
muscle will do.

This pain at the bottom of the sternum can be very strong and feel
exactly like angina. Hence you often hear of people ignoring heart
attacks because they thought the pain was just indigestion.

So if I know ahead of time I will be having a drink for dinner (which
you should forgo untill the barretts is healed), or steak (especially
prime rib, the fattiest of all), or even a fatty fish such as Chilean Sea Bass
(damn that stuff's good) I take a couple of O/C Zantac 75's (Axid and
Pepcid are also good -- all GF) half an hour before dinner. If I have
both the drink and the steak then I also follow up by taking two more
about two hours before bedtime.

If you have problems bad enough that your doc puts you on a proton pump
inhibitor like Prilosec (or preferably Prevacid since it's safer), they
will often tell you not to take any acid inhibitors with it, like the
Zantac, Axid, or Pepcid. But you should know that Medscape just reported
on a study that demonstrated that patients healed much faster when taking
a proton pump inhibitor if they also took an acid inhibitor with it. Your
doc may not know this if s/he's not up to date on this topic.

Also, I might mention that I think it's bad practice to take antacids
alone for reflux. Antacids, like Tums or Maalox, only dilute the acid in
the stomach, causing your system to secrete even more acid in what's
called a "rebound effect." Neither the proton pump inhibitors nor the
acid inhibitors seem to cause the rebound according to the literature.
So if I need an antacid for immediate relief, I also take an acid
inhibitor with it so my system doesn't produce more acid to compensate
for the dilute.

~~~~~~~~~~~~~~~~~~~~~~~

    I have Barretts too, and treat it with Prilosec daily, and try more
or less to avoid caffeine, alcohol, (I never did smoke), and very very
spicy foods. To tell you true, I do consume some of those things, no
doubt more so than my doctor thinks.

    I am a family doctor, and a celiac.

    I think the main significance of the diagnosis is the risk of
cancer, and however carefully you take care of yourself, you owe it to
yourself to be scoped regularly for ever, however often the doctor
indicates, but surely at least yearly, - the frequency to be decided
each time on the basis of the findings. I.e., if it is worsening, he
will have to do it oftener.  Remember, I am a family doctor, not a
specialist, and now retired.  I think it is in our best interest to have
Barretts managed by a gastroenterologist.