Barrett's Esophagus surveillance w/o goblet cells??

[dancer64]

Four years ago my endoscope diagnosis was "Focal areas of intestinal and goblet cell metaplasia consistent with Barrett Esophagus.  After endoscope b/f pathology report my gastro dr. said it looked normal just a very small pink spot, he was surprised by the Barrett reference and wanted to talk to pathologist.  I have been on Prilosec for 4 years and feel fine.

Fragment (s) of esophago-gastric junction mucosa with chronic inflammation and reactive changes.  
Specialized columnar intestinal epithelium (goblet cell metaplasia), which is necessary for the diagnosis for Barrett's esophagus, is not identified
No dysplasia or malignance identified
Alcian Blue stain was performed.

As noted there were no goblet cells present which my understanding is a requirement for diagnosis of Barrett's, however, my current gastro dr. said once you have Barrett's you always do and recommends endoscope every 2 years.  Very confused, how can I have Barrett's w/o Goblet Cells????
Did the Barrett's get better over the 4 yrs, hence no goblet cells with this report.  Please advise.

[Smiley2000]

Hi there,

I have Barret's Esophagus that was diagnosed in 2006.  

The GI can normally see the cell changes during the Endoscopy and then takes biopsies to confirm diagnoses and check for dysplasia or cancer.  Metaplasia means cell changes from normal cells to these Barret's pre-cancerous cells.  So it is still possible that the 1st Barrets diagnoses was accurate, but the odds are good that the cells will stay unchanged.

A single biopsy (the goblet cells that you are refering to) can miss it and that is why we need the 2-3 year surveillance Endoscopies.  Once you have Barret's it does not ever disappear but proper management of the GERD will control it.  Only 5% of patients diagnosed with Barret's will ever develop the cancer (esophageal adenocarcinoma).

I hope this info has helped you and feel free to ask any further questions.  

All the best,

[selmaS]

  Hi...not being a Dr or a person that has experience with this condition I do not know how to help u except to suggest u try the expert forum....there may be a few members here that may be able to comment....but I feel u need an answer from a Dr...not a support group.

Try this one and see if u can get some answers -
http://www.medhelp.org/forums/GERD-Acid-Reflux/show/200