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From: Kat
Date: 06/17/00
Time: 17:07:58
I am a 52 year old female, small frame, not overweight, and on March 30th I underwent a Barium Swallow which showed a proximal thoracic esophageal web (1.0 to 2.0 mm in height narrowing the luminal diameter to approx. 3.0 to 4.0 mm) with stricture of upper esophagus as well as esophagitus and a small hiatal hernia and an additional stricture at the distal esophagus.(Whew . . .) I have been diagnosed with GERD for approximately ten years.
My Gastroenterologist prescribed Pepcid 40 (one pill per day) and told me that if & when I experienced more difficulty swallowing, we would need to perform an endoscopy and stretch the web. Each week it became more difficult for me to swallow solids until I was finally unable to consume anything other than liquids. Due to doctor and hospital schedules, an endoscopy/dilation was not performed until May 25th. Biopsies of both areas of stricture were taken and the resulting diagnosis was "heterotopic ectopic gastric mucosa of upper esophagus with stricture."
After this first endoscopy the doctor told my son that the procedure (balloon dilation) was successful, the dilation was to a width of between 12 - 15 mm and that I should be able to eat solid food within a few days. Unfortunately, this was not the case and to date, I have existed totally on liquids (Boost nutritional drinks, popsicles, liquid vitamins, etc.). Thus far, I have lost 14 pounds which I could not spare.
Because the first doctor refused to discuss my condition with me in detail other than to have a nurse schedule an additional endoscopy/dilation procedure two weeks after the first, I felt that I needed to seek different medical care. The second doctor I managed to see (very difficult to arrange to be seen) has already perfomed my second endoscopy/dilation and has me scheduled for repeat procedures on 6/28, 7/3 and 7/12 with more anticipated to follow. This new Gastro tells me that he must perform each of these dilation procedures using the older, rigid instruments even though they carry a greater risk of tearing or perforation. I am frightened by this and did tell him this, but he seems unaffected by my fear. He says that "my type of stricture" does not respond well to the safer, more frequently used balloon dilations.
Question: Is this true, considering my diagnosis?
Question: Do I have reason to fear the use of these rigid dilation instruments? Or can anyone offer me reason to feel less afraid?
Question: Other than having 6 - 8 of these dilation procedures before possibly being able to swallow solid food again and having the prospect of endoscopies/dilations repeated several times a year, is there another solution or treatment for my condition?
I do not think my health insurance would allow me to make another doctor change at this point, so I need to know how best to discuss my concerns with my current Gastro.
Sorry this is long and complicated, but I am greatly in need of information to help me get through this challenge.
Thanks . . . Kat