So, two doctor appointments today. We'll start with the big news first to get rid of any suspense.
NO CANCER OR PRE-CANCER!
When I initially thought about the possible damage from acid reflux, I was primarily concerned with a weakness or tear in the esophagus. My mother-in-law had this happen, and she had a rupture and had to be rushed to the hospital. After speaking to the specialist, and walking away with his business card from Swedish Cancer Institute, it became clear that there were other serious concerns.
Over time, the acid can change the tissue of the esophagus to something more similar to tissue of the stomach or intestine. This is called Barrett's Esophagus. Apparently a possible next step is to have these cells turn into cancer cells. My doctor took some biopsies and didn't find indications that any of this has happened yet. Wonderful, wonderful news.
On to what they did find. The Manometry test showed that the muscles of my esophagus are working properly. The second best news was that I shouldn't need to take that test ever again. The endoscopy showed that the valve that is supposed to prevent the acid back up is weak. It also showed that there is definite damage and inflammation in the esophagus from years of acid reflux. And the doctor had all the pH readings from the bravo probe. Apparently a normal reading for a 24 hour period is below 14.7. Mine was 64. No question I have a problem.
So now that we know where I stand, its time to start thinking about what to do to fix the problem. Ideally, I would be able to make lifestyle changes to solve the problem. My doctor didn't consider this much of an option. Major risk factors he mentioned were age and weight. In his eyes, and in this particular instance, he considers me young and in shape. Woo Hoo!
As far as food, certain things made the acid readings worse, but at every meal the acid readings were too high. I am sure changing my diet and eating habits would help, but the doctor didn't give the impression that it would be enough.
So the major options are drugs or surgery. The drugs would reduce the acid production. This wouldn't do much to prevent the reflux, but weaker acid means less damage I suppose. Generally the regimen for products like Prilosec is a 14 day run, but the doctor said I would probably need to be on it indefinitely. The doctor gave me a prescription, and the plan is to do more testing in 6 months to see if anything looks better.
The other option is surgery. The way he described it is that they take part of the stomach and wrap it around the base of the esophagus. This is supposed to reinforce the valve to help prevent the reflux. Surgery never sounds appealing, and I initially dismissed it in favor of seeing what 6 months of drugs and lifestyle change would bring. But I'm starting to reconsider doing the surgery. I'm not interested in taking pills for the rest of my life, and surgery seems like a more permanent solution. Time for some Google research into more new medical terms and procedures.
Oh, and the dentist appointment was mostly harmless. It had been 8 or so years since I had been in for a checkup, so it could have been ugly. I just need to get a root canal filling replaced. One more old thing that is falling apart.