Re: Spastic Esophagus & Vocal Cord Cancer

[Guest guest]

jonnadonnalonna

Welcome to our board.

I assume that you have not been diagnosed with

achalasia. I think you should go to a medical

center where they specialize in esophageal

problems and let them do some testing for you.

Please tell us where you are from and we might

be able to recommend someone to you. Where

was your extensive testing done?

Many here were first treated for GERD before

they got a correct diagnosed with achalasia.

Your esophageal spasms would certainly not be

uncommon with achalasia. Please give us more

details.

Also want to extend my good wishes to all those

having procedures done this week.

Maggie

Alabama

[Guest guest]

Thank you!

I went to Mayo in sdale. Any suggestions?

>

> jonnadonnalonna

>

> Welcome to our board.

>

> I assume that you have not been diagnosed with

> achalasia. I think you should go to a medical

> center where they specialize in esophageal

> problems and let them do some testing for you.

> Please tell us where you are from and we might

> be able to recommend someone to you. Where

> was your extensive testing done?

>

> Many here were first treated for GERD before

> they got a correct diagnosed with achalasia.

> Your esophageal spasms would certainly not be

> uncommon with achalasia. Please give us more

> details.

>

> Also want to extend my good wishes to all those

> having procedures done this week.

>

> Maggie

> Alabama

>

[Guest guest]

Hello alwayscurrent123@...,

In reference to your comment:

I went to Mayo in sdale. Any suggestions?

Didn't someone from here go to Mayo in sdale?

Notan, was it you? If so maybe you could offer

some suggestion here. I would think Mayo would

certainly be able to do all the testing.

Did they tell you that you had achalasia? Did

they do testing for that?

Maggie

Alabama

[Guest guest]

I was fully tested with a swallow test and a chip implanted in my

esophagus for 2 days (PAINFUL!).

Anyhow.. the final diagnosis was Nutcracker Esophagus.

I'm basically wondering how often I should have endoscopies to check

for lower esophgeal problems....

>

> Hello alwayscurrent123@...,

> In reference to your comment:

>

>

> I went to Mayo in sdale. Any suggestions?

>

>

> Didn't someone from here go to Mayo in sdale?

> Notan, was it you? If so maybe you could offer

> some suggestion here. I would think Mayo would

> certainly be able to do all the testing.

>

> Did they tell you that you had achalasia? Did

> they do testing for that?

>

> Maggie

> Alabama

>

[Guest guest]

jonnadonnalonna wrote:

> I was fully tested with a swallow test

Manometry, where they put the tube through your nose?

> and a chip implanted in my

> esophagus for 2 days (PAINFUL!).

I don't remember anyone else having a chip implanted. Was that for pH

measurements? (Bravo pH technique).

>

> Anyhow.. the final diagnosis was Nutcracker Esophagus.

>

I think you are the first with Nutcracker Esophagus in this group. We

are mostly here because of achalasia but anyone with Nutcracker will be

like family here.

> I'm basically wondering how often I should have endoscopies to check

> for lower esophgeal problems....

>

What I have read says that Nutcracker Esophagus is generally

non-progressive, though rarely, it does progresses to diffuse esophageal

spasm or even vigorous achalasia. However, people with Nutcracker tend

to have problems with acid reflux. You may need to be checked from time

to time for damage from reflux, and for Barrett's Esophagus. How often

may depend on the amount of reflux you have and your history of cancer.

I think your doctor needs to answer that question. Doctors do not all

agree on when surveillance is needed or how often. People in this

Group tend to favor more surveillance because a number of members have

had problems that should have been detected sooner but help was not

quickly sought.

About Nutcracker, for those interested, see:

http://en.wikipedia.org/wiki/Nutcracker_esophagus

http://www.gastroresource.com/GITextbook/en/chapter5/5-10-pr.htm

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=3\

376915 & dopt=Abstract

notan

[Guest guest]

Yes. And yes.

I won't do either one of them again!

But, I came here wondering how often you all get endoscopies...

> > I was fully tested with a swallow test

>

> Manometry, where they put the tube through your nose?

>

> > and a chip implanted in my

> > esophagus for 2 days (PAINFUL!).

>

> I don't remember anyone else having a chip implanted. Was that for

pH

> measurements? (Bravo pH technique).

>

> >

> > Anyhow.. the final diagnosis was Nutcracker Esophagus.

> >

>

> I think you are the first with Nutcracker Esophagus in this group.

We

> are mostly here because of achalasia but anyone with Nutcracker

will be

> like family here.

>

> > I'm basically wondering how often I should have endoscopies to

check

> > for lower esophgeal problems....

> >

>

> What I have read says that Nutcracker Esophagus is generally

> non-progressive, though rarely, it does progresses to diffuse

esophageal

> spasm or even vigorous achalasia. However, people with Nutcracker

tend

> to have problems with acid reflux. You may need to be checked from

time

> to time for damage from reflux, and for Barrett's Esophagus. How

often

> may depend on the amount of reflux you have and your history of

cancer.

> I think your doctor needs to answer that question. Doctors do not

all

> agree on when surveillance is needed or how often. People in this

> Group tend to favor more surveillance because a number of members

have

> had problems that should have been detected sooner but help was

not

> quickly sought.

>

> About Nutcracker, for those interested, see:

> http://en.wikipedia.org/wiki/Nutcracker_esophagus

> http://www.gastroresource.com/GITextbook/en/chapter5/5-10-pr.htm

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=3376915 & dopt=Abstract

>

> notan

>

[Guest guest]

From what I've heard, the doctors who do any follow-up for

achalasia at all generally recommend a barium swallow every year,

but they don't necessarily do routine surveillance endoscopy

unless there's a lot of heartburn.

There are articles on endoscopic surveillance for Barrett's

esophagus, a condition that may lead to esophageal cancer. This

study found that " surveillance every 5 years was the most

effective strategy to increase both length and quality of

life " -- Provenzale D, Schmitt C, Wong JB. " Barrett's esophagus:

a

new look at surveillance based on emerging estimates of cancer

risk. " Am J Gastroenterol 1999;94:2043-2053.

I don't think you said you have Barrett's esophagus, so that

information may not be useful to you. But since you have

actually had cancer in the past, I think it would make sense to

keep getting endoscopies at least that often, or even every year.

But your doctor would really be the one to ask.

Of course you could also seek a second opinion from a doctor who

is an expert in vocal cord carcinoma or spastic esophagus. If

you can identify one and find his/her email, it wouldn't hurt to

try asking by email.

in Lancaster, PA

> But, I came here wondering how often you all get endoscopies...

[Guest guest]

jonnadonnalonna wrote:

>

> But, I came here wondering how often you all get endoscopies...

>

>

As I was saying, doctors don't agree on how often we need them, so there

are people here who are being checked often, each year or two and others

who will not get checked again unless they have problems. We get checked

for two main reasons. To see if the esophagus is dilating and to look

from damage from reflux. The esophagus is not likely to dilate with

Nutcracker but you do need to be careful about reflux. So, for you how

often probably depends on your risk from reflux.

Personally, I was told at Mayo that I didn't need to be checked unless I

had problems, especially with any amount of heartburn I am to be checked

right away.

notan

[Guest guest]

jonnadonnalonna wrote:

>

> But, I came here wondering how often you all get endoscopies...

>

I should add that if you are taking a PPI (Nexium), or the like, every

day that should decrease your need to be checked. If after some

surveillance nothing is found the time between surveillance will

probably be increased. Like said. not all of our surveillance is

endoscopic.

notan

[Guest guest]

wrote:

> ... This

> study found that " surveillance every 5 years was the most

> effective strategy to increase both length and quality of

> life " -- Provenzale D, Schmitt C, Wong JB. " Barrett's esophagus:

> a

> new look at surveillance based on emerging estimates of cancer

> risk. " Am J Gastroenterol 1999;94:2043-2053.

>

In that report they do take length and quality of life into account, but

the point is cost effectiveness. Cost analysis is not necessarily a bad

way to determine when to do something. A bad outcome is often very

expensive. In any case, all these kind of things are statistical. The

statistics will be good for most but not for a few. How much concern a

doctor has for not letting the few slip through may lead him to do more

frequent surveillance. That is some doctors would rather spend the money

of many patient and have them endure testing needlessly so that he can

find the few that would pay in much greater ways if he doesn't.

Therefor, we are going to see some doctors require more frequent

surveillance than others. How much you get may depend on which insurance

company the doctor has to justify to.

notan

[Guest guest]

Thank you for this reply. I really do appreciate it!

>

> From what I've heard, the doctors who do any follow-up for

> achalasia at all generally recommend a barium swallow every year,

> but they don't necessarily do routine surveillance endoscopy

> unless there's a lot of heartburn.

>

> There are articles on endoscopic surveillance for Barrett's

> esophagus, a condition that may lead to esophageal cancer. This

> study found that " surveillance every 5 years was the most

> effective strategy to increase both length and quality of

> life " -- Provenzale D, Schmitt C, Wong JB. " Barrett's esophagus:

> a

> new look at surveillance based on emerging estimates of cancer

> risk. " Am J Gastroenterol 1999;94:2043-2053.

>

> I don't think you said you have Barrett's esophagus, so that

> information may not be useful to you. But since you have

> actually had cancer in the past, I think it would make sense to

> keep getting endoscopies at least that often, or even every year.

> But your doctor would really be the one to ask.

>

> Of course you could also seek a second opinion from a doctor who

> is an expert in vocal cord carcinoma or spastic esophagus. If

> you can identify one and find his/her email, it wouldn't hurt to

> try asking by email.

>

> in Lancaster, PA

>

> > But, I came here wondering how often you all get endoscopies...

>

[Guest guest]

Thank you. My reflux is rather severe. I will be calling my doctor

about this.

> >

> > But, I came here wondering how often you all get endoscopies...

> >

> >

>

>

> As I was saying, doctors don't agree on how often we need them, so

there

> are people here who are being checked often, each year or two and

others

> who will not get checked again unless they have problems. We get

checked

> for two main reasons. To see if the esophagus is dilating and to

look

> from damage from reflux. The esophagus is not likely to dilate

with

> Nutcracker but you do need to be careful about reflux. So, for you

how

> often probably depends on your risk from reflux.

>

> Personally, I was told at Mayo that I didn't need to be checked

unless I

> had problems, especially with any amount of heartburn I am to be

checked

> right away.

>

> notan

>