Welcome to The New Johns Hopkins Barrett’s Esophagus Blog
Welcome to the Johns Hopkins Barrett’s esophagus blog. Many have enjoyed our website and discussion boards [and we appreciate those of you who have drawn our attention to problems that have come up from time to time]. Our intention is to offer an educational forum about Barrett’s esophagus and its complications. Many who visit our site have learned about the very worst complication, esophagus cancer, which is a horribly deadly type of cancer when caught late. However, the good news is that many who have visited the site have learned about Barrett’s esophagus at a point when treatment is effective, such as at the “precancerous” stage (also called “dysplasia”). We are thrilled that several individuals have prompted loved ones to undergo screening after studying the site. However, the site was first posted in about 2000 and we realize we could do more to be consistently current, hence this blog.
Let me introduce myself and in the next few weeks, other members of the team with different expertise will also introduce themselves. I studied chemistry at Johns Hopkins as a college student from 1976-1980 and attended medical school at George Washington University from 1980-1984 and completed my residency at Walter Reed Army Medical Center [I was in the US Army from 1984 until late 1992]. After working at the Armed Forces Institute of Pathology and Georgetown University, I have been at Johns Hopkins since 1999. I am a pathologist, but not the type that is featured on CSI or other forensic programs. Most of my time is spent reviewing microscopic slides from biopsies from the gastrointestinal tract, and esophagus biopsies are a frequent type of sample! I work closely with gastroenterologists, oncologists, surgeons, and other pathologists and my title here is “Professor of Pathology and Oncology”. In the next few weeks, colleagues in other departments will introduce themselves, beginning with my colleagues Anirban Maitra, MBBS, who is a talented scientist in addition to being a diagnostic pathologist like I am, and Kerry Dunbar, MD, who is a terrific gastroenterologist. Before this happens, I would like to show some images of microscopic fields Barrett’s esophagus and dysplasia and introduce some of the research going on at Johns Hopkins. For example, I am very excited that a substance found in ordinary curry that we eat has potential as a treatment for esophagus cancer and our own Dr. Maitra has discovered a better way to deliver it to the cancer cells! Dr. Dunbar has been working on new endoscopic methods to better detect dysplasia in Barrett’s esophagus.
We are proud to note that we have received financial support from friends and family of Jerry D’Amato, “Phil” Ross, Roy Jeannotte, and many others. Kuwanna Dyer even did a charity sponsored running event and sent us a donation. These efforts have allowed for educational and scientific projects and we are grateful to everyone who has contributed.
This is how Barrett’s esophagus looks to the endoscopist (upper) and under the microscope (lower). This sample is from the esophagus of a 55 year old man.
The image above is taken at low magnification of an endoscopic mucosal resection sample that my colleague, Dr. Marcia Canto, performed. There is high grade dysplasia that has been removed. This patient did not need an esophagectomy.
October 26th, 2008 at 2:23 pm
Likely just a slip, but in your second para you state “Let me introduce myself…” and then don’t actually introduce yourself – what is your name? Also, you have included 3 images – the first, as you point out is the image taken during an endoscopy. However, there are 2 subsequent images. Do both of the microscope images have high grade dysplasia or just the last one.
Looking forward to more entries.
Jeanette
October 28th, 2008 at 1:05 pm
In the introduction, I was new to blogging and did not say my name! I am Elizabeth Montgomery, MD
October 29th, 2008 at 9:18 am
Dr. Montgomery, I am not sure if it is appropriate at this time to ask questions but I will try. It seems the suggested time frame between having BE checked with a scope is every three years assuming the BE area is small and there is no dysplasia found on biopsies. It this accepted in the medical field as the common time frame? To a lay person, 3 years seems like a long time but at the same time, no one really wants to get scopes done more often than necessary. Your comment/opinion is apppreciated.
October 29th, 2008 at 12:14 pm
ps. Only the last image has high grade dysplasia. I will add more images over time! Thanks
December 1st, 2008 at 8:29 am
Dr. Montgomery, I was recently informed that I have BE and I was asked if I had any questions. Well, at the time I had no clue what BE was and what type of questions to ask. I have a better idea of what type of questions to ask but I would feel more comfortable with some guidance on the questions that I should ask. If you could please assist me with this I would really appreciate it. Also, what is your comments on the halo 360/90?? Thanks for any information you can provide. Troy
December 21st, 2008 at 6:01 pm
Dr. Montgomery, I am a 53 yr. old female who was recently diagnosed with Barrett’s including intestional metaplasia and low grade dysplasia. Last week I had my first appt. with a nurse practioner at the doc. office which was NOT informative at all!! I was just told to take a PPI and come back in a year. In your opinion does this sound right, should I wait a whole year to see the doctor again? I really do not feel comfortable with this and wonder if I should seek a 2nd opinion. Thank you, Sherry Kerley
May 27th, 2010 at 12:24 am
Dr., My Endoscopy Dr. told me I need to have endoscopy done yearly. Is it normal to have it done yearly? He told me that I have BE, but didn’t tell me what stage, I am guessing there is no cancer. I have received my notice from him that I really need to have it scheduled for the test. How often is endoscopy done on a regular basis when it is noncancerous?
Thank you, Dirah
July 5th, 2010 at 1:49 am
Dr. I have about 5 cm of Barretts and have had 3 gastroscopies this year and the next is scheduled for 6 months time. In March Low Grade Dysplasia was noted at 28cm and the recent gastro showed more Low Grade at 31 and 33 cm. No action is advised, just max doses of anti reflux meds. What is your opinion? I am told not to stress about it by my specialist. (easy for him) and that no gastrologist in New Zealand will touch it at this stage. Does L.G. Dysplasia regress or are they just waiting for me to get cancer? I am a 68 year old female. My family urge me to be pro active and get some answers and/or action. I have had heartburn for about 35 years and have just been given a script for gaviscon or losec from time to time. Am at present on Ranitidene & Lansoprazole. MARGARET
July 7th, 2011 at 12:38 am
A consideration in all of this is the long term effects acid reflux medication can have on your overall health. The FDA released a press release on 25 May 2010 warning of the dangerous side effects of taking high doses of acid reflux medication or taking the medication long term (12 months or more)
We need stomach acid and so to block or neutralize stomach acid, it stands to reason that without sufficient levels of stomach acid over a long time will have adverse health effects.
We need stomach acid to break down our food and allow the body to extract vital nutrients from our food, including calcium. If we have insufficient stomach acid due to medications – over a period of time we will suffer things like calcium deficiencies which can lead to soft bones.
Blocking or neutralizing stomach acid is not the answer…