Barrett’s

[Maureen armey]

I was diagnosed with Celiac three years ago. My numbers are coming way down but still slightly elevated. I’m working hard to stay gluten free everyday but I also was diagnosed with Barrett’s esophagus. I’m on daily PPl and trying to avoid triggers to aggravate it. I’m on a three year surveillance and just had my first one last week where three nodules in that area had to be biopsied. Is there anyone on here that’s dealing with both diagnosis’s and do you have any input or recommendations? Is this common to have both ? 

[Aretaeus Cappadocia]

I don't know if it is common but you are not alone.

I don't know the definitive story, but it appears that Barrett's is more common in celiacs than in the general population:

"We found intestinal metaplasia in the distal esophagus of 16 of 60 (26.6%) celiacs ..., in comparison with a control-group prevalence of 10.9%..."

https://pubmed.ncbi.nlm.nih.gov/15712649/

Thank you for unlocking a new fear for me. My celiac diagnosis also included a finding of inflammation of my esophagus and an rx of PPI. I didn't give it much thought then, but now I have to wonder...

Best wishes to you on this, and I hope you find better information than I am offering here.

[Russ H]

Barrett's oesophagus is caused by chronic damage to the lining of the oesophagus from acid reflux. Acid reflux is common in people with coeliac disease (studies showing up to 30% suffer from it at diagnosis). 

Is there a link between GERD and celiac disease?

[cristiana]

Welcome to the forum, Maureen.

I suffer from reflux and Barretts is often at the back of my mind as I also suffer from a very itchy throat from time to time.  My last endoscopy showed no inflammation but next time I see my consultant I might ask for another scope, its been a while since the last one.

Anyway, I just wanted to say that in my case sleeping on a wedge pillow has been very helpful , and I also find my symptoms improve if I can leave 3 hours after a meal  and have a large spoon of Gaviscon Advance just before I retire to bed. My gastroenterologist says it creates a film or raft over the stomach contents, preventing them from coming back up the throat.  Works for me.

I've known a few people with Barretts and one friend with it, who started to get horrendous reflux during a pregnancy, says she takes her PPIs as prescribed, but always chews a couple of Gaviscon tablets just before she goes to bed.  She is now in her late 70s and doing really well - so I think a tip worth considering.

Another friend with Barretts (who passed away in his eighties from something quite unrelated) suffered all his life from a lot of odd health complaints.  A few years ago his daughter was diagnosed with coeliac disease and of course we area now all thinking he was probably an undiagnosed coeliac, too, which might well have contributed to his reflux.

It is really good that they have picked up on the issue as I understand a lot of patients with Barretts are completely asymptomatic.  Hopefully keeping to a gluten free diet will help your reflux to improve (I find glutening brings on reflux and gastritis-type symptoms) and therefore help to alleviate any irritation/inflammation in your esophagus.

Cristiana

 

Edited April 10 by cristiana

[Wheatwacked]

A diet equal in omega 6 and three fatty acids will lower inflammation and give your gut a chance to heal.  

Omega-3 and Omega-6 Content of Commonly Eaten Foods

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our data raise the possibility that sensitivity to CM [cow's milk] may be a feature in a proportion of patients with celiac disease and may therefore contribute to persistent symptoms in coeliac patients who are on a gluten-free diet. https://pmc.ncbi.nlm.nih.gov/articles/PMC1810502/

I eventually found that commercial cow protein like the skim milk used in M&M Peanuts would cause me heartburn, while I can drink all the grassfed cow milk as l like.  Omega 6:3 ratio of commercial milk is 5.6:1.   Milk from grassfed cows is 1:1.  Increasing my Thiamine mononitrate (B1) to 500 mg a day and vitamin B6 to 100 helped my digestive system become regular.  Maybe the first time that I remember.  Commercial dairies feed wheat to dairy cows, though it is rarely the only grain used.  Grass fed dairy was not tested.  Only Ireland and New Zealand commercial dairies are pasture and grass fed countrywide.

 

Quote

 

PPIs may prevent your small intestine from absorbing enough magnesium or B12. Magnesium helps your muscles and nerves work effectively. Vitamin B12 helps keep your nervous system and red blood cells healthy.

PPIs may make it more difficult for your body to absorb enough calcium, a mineral that keeps your bones strong. The FDA warns that PPIs may increase your risk of breaking your hip, wrist or spine.

They may increase your chances of developing chronic kidney disease (CKD) or cause the disease to progress.

providers usually recommend you take the PPI dosage in the shortest time frame possible to improve your symptoms without increasing your risk of potential side effects. https://my.clevelandclinic.org/health/articles/proton-pump-inhibitors

 

 

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It is our contention, that the increase in the omega-6/3 ratio may have contributed to a rise of allergic and autoimmune diseases over the last several decades. Additionally, a high dietary omega-6/3 ratio creates supraphysiologic inflammatory responses and perpetuates chronic low-grade inflammation. The overconsumption of linoleic acid, mainly from industrial omega-6 seed oils, and the lack of long-chain omega-3s in the diet puts the population in a pro-inflammatory, pro-allergic, pro-thrombotic and autoimmune-prone state. ...Considering that most of the population is deficient in long-chain omega-3s, there is an increased need for educating the public   https://pmc.ncbi.nlm.nih.gov/articles/PMC8504498/#:~:text=Thus%2C the omega-6 polyunsaturated,transcription factor that promotes inflammation.

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Western diet is now much higher in omega-6 than omega-3 compared to just 100 years ago. This may predispose to chronic inflammatory conditions including autoimmune diseases. https://pmc.ncbi.nlm.nih.gov/articles/PMC8504498/#:~:text=Thus%2C the omega-6 polyunsaturated,transcription factor that promotes inflammation.

 

[knitty kitty]

GERD,  having too much stomach acid, can easily be mistaken for Hypochlorhydria, having too little stomach acid. 

In Hypochlorhydria, stomach acid levels are low.  This causes the lower esophageal sphincter muscle to relax and stomach contents can leak back into the esophagus, leading to Barrett's esophagus.  Hypochlorhydria is associated with Autoimmune Gastritis, where the immune system attacks cells in the stomach that make stomach acid, and also cells that make the intrinsic factor needed to absorb Vitamin B12, which can lead to B12 deficiency anemia.  Autoimmune Gastritis is also associated with autoimmune thyroiditis, Hashimoto's, and diabetes.

Hypochlorhydria can affect nutrient absorption.  Iron is better absorbed in an acidic environment, so Hypochlorhydria can lead to Iron deficiency anemia.  Food is better digested in an acidic environment.  More nutrients are released in an acidic environment.  Hypochlorhydria can lead to SIBO.  SIBO can lead to nutritional deficiencies because they cover the intestinal lining and absorb nutrients before the intestinal lining can absorb it.  

Nutritional Interventions for Gastroesophageal Reflux, Irritable Bowel Syndrome, and Hypochlorhydria: A Case Report

https://pmc.ncbi.nlm.nih.gov/articles/PMC4991651/

PPI's are meant for short term use (2-4 weeks).  Long term use can also lead to SIBO and B12 deficiency.  PPI's also cause ongoing intestinal inflammation and damage to the villi.  Long term use of PPI's can lead to Alzheimer's, poor calcium absorption, and bone fractures.  

Long-Term Use of Proton-Pump Inhibitors: Unravelling the Safety Puzzle

https://pubmed.ncbi.nlm.nih.gov/38389608/

Be sure to take your B vitamins!  Vitamins B1 Thiamine, B 3 Niacin, B 6 Pyridoxine and B 9 Folate lower the risk of esophageal cancer.   Vitamin C and dietary fiber also improve Barrett's esophagus.  Dietary fiber and Omega Threes promote bacteria that make Shorts chain fatty acids which improve gastrointestinal permeability, lower inflammation, regulate the immune response, and lowers blood pressure.  

Dietary vitamin B intake and the risk of esophageal cancer: a meta-analysis

https://pmc.ncbi.nlm.nih.gov/articles/PMC6225909/

Try eating some raw vegetables or some fruit before a meal.  This fibrous food pushes opens the digestive tract, allowing the main meal an easier transit.  The Mediterranean diet recommends this.  It's worked well with me. 

Try taking Calcium or Magnesium supplements after meals to lower acid reflux.  They coat the digestive tract, and neutralize acid.   

Hope this helps!

Edited April 11 by knitty kitty
Typo correction

[cristiana]

Hi @Maureen armey

Just one point re: PPIs.  Here in the UK the people I know with Barretts have had to take them long term, or H2 blockers instead, despite the fact they have side effects.   I feel that it is very important that you follow your consultant's advice re: this type of medication but if you do need to take them longterm, see if they can offer any advice on how to mitigate these potential side effects.   I hope you find the information contained via following the link below helpful.

Do come back to us if you have any further questions.

https://heartburncanceruk.org/blog/should-you-take-ppis-long-term-insights-from-a-gp-and-barretts-patient/

Cristiana