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Hi Dr XXXXXXX Can Patulous Esophagus Cause Barretts Esophagus?

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Posted on Mon, 23 Sep 2019
Question: Hi Dr XXXXXXX

Can patulous esophagus cause barretts esophagus?
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Follow up: Dr. Dr. Ivan Romich (0 minute later)
Hi Dr XXXXXXX

Can patulous esophagus cause barretts esophagus?
doctor
Answered by Dr. Dr. Ivan Romich (4 hours later)
Brief Answer:
yes

Detailed Answer:
Hi and welcome to ask a doctor.
Yes, patulous esophagus may cause gastroesophageal reflux and this is risk factor for Barrets esophagus. Patulous esophagus may also lead to heartburn, anorexia and other dispeptic problems.
This is usually treated with antiacid medications and adequate diet but in advanced cases or persistent symptoms, some other options may be utilized such as botulinum injections or surgical procedure called Nissen fundoplication.
Feel free to ask further questions. WIsh you good health. Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Dr. Ivan Romich (0 minute later)
Brief Answer:
yes

Detailed Answer:
Hi and welcome to ask a doctor.
Yes, patulous esophagus may cause gastroesophageal reflux and this is risk factor for Barrets esophagus. Patulous esophagus may also lead to heartburn, anorexia and other dispeptic problems.
This is usually treated with antiacid medications and adequate diet but in advanced cases or persistent symptoms, some other options may be utilized such as botulinum injections or surgical procedure called Nissen fundoplication.
Feel free to ask further questions. WIsh you good health. Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Ivan Romich (8 hours later)
please explain the peach color at right of heart? I see this in all of his ct scans.Could this be a block of some sort?
Thank you
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Follow up: Dr. Dr. Ivan Romich (0 minute later)
please explain the peach color at right of heart? I see this in all of his ct scans.Could this be a block of some sort?
Thank you
doctor
Answered by Dr. Dr. Ivan Romich (2 hours later)
Brief Answer:
no blockage

Detailed Answer:
Hi and welcome.

No, this is not blockage. This is part of the heart where blood pressure is higher than in other parts and images detect is as different color. Blockage of the heart is seen only in coronary arteries and this cant be seen on these. For evaluation of coronary arteries, he should do coronarography, but if he doesn't have symptoms of angina pectoris than there is no need to do this. Wish you good health.

Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Dr. Ivan Romich (0 minute later)
Brief Answer:
no blockage

Detailed Answer:
Hi and welcome.

No, this is not blockage. This is part of the heart where blood pressure is higher than in other parts and images detect is as different color. Blockage of the heart is seen only in coronary arteries and this cant be seen on these. For evaluation of coronary arteries, he should do coronarography, but if he doesn't have symptoms of angina pectoris than there is no need to do this. Wish you good health.

Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Ivan Romich (14 hours later)
Ok, Thank you
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Follow up: Dr. Dr. Ivan Romich (0 minute later)
Ok, Thank you
doctor
Answered by Dr. Dr. Ivan Romich (4 minutes later)
Brief Answer:
You re welcome

Detailed Answer:
You re welcome. Feel free to contact me in future
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Dr. Ivan Romich (0 minute later)
Brief Answer:
You re welcome

Detailed Answer:
You re welcome. Feel free to contact me in future
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Ivan Romich (2 hours later)
Hello,

Please check for problems with Logans colon.Other scans showed stricture according to second opinion and he also said the bowels looked grossly abnormal.Also looks like there are polyps.I think this scan also shows the patulous esophagus just left of the heart.It looks like something is pressing on the left kidney.
Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma? There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
Please advise on what you would suggest as far as surgery for XXXXXXX I read you must have reflux an average of 10 years before barretts is seen so possibly XXXXXXX was born with the patulous esophagus.One Dr said he could see tissue all of the way around transducer at d2 duodenum and his duct of wirsung is around d2.Could the patulous esophagus be in correlation with annular pancreas? I have also been told that there is a impn cyst or diverticula in the body of the pancreas; could that be causing the constipation? He must take laxatives to move his bowels.I know that is a lot but, has been a lifetime of problems that have worsened the last 4 years.Thank you very much for your time.Logans Mom XXXXXXX
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Follow up: Dr. Dr. Ivan Romich (0 minute later)
Hello,

Please check for problems with Logans colon.Other scans showed stricture according to second opinion and he also said the bowels looked grossly abnormal.Also looks like there are polyps.I think this scan also shows the patulous esophagus just left of the heart.It looks like something is pressing on the left kidney.
Sma syndrome has been a suspicion and doppler showed compression in various positions.Do you think this scan is also suspicious for sma? There is also a appendicolith and since he has IBS, do you think it would be wise to remove the stone?He also has prostate stones and varicocele.
Please advise on what you would suggest as far as surgery for XXXXXXX I read you must have reflux an average of 10 years before barretts is seen so possibly XXXXXXX was born with the patulous esophagus.One Dr said he could see tissue all of the way around transducer at d2 duodenum and his duct of wirsung is around d2.Could the patulous esophagus be in correlation with annular pancreas? I have also been told that there is a impn cyst or diverticula in the body of the pancreas; could that be causing the constipation? He must take laxatives to move his bowels.I know that is a lot but, has been a lifetime of problems that have worsened the last 4 years.Thank you very much for your time.Logans Mom XXXXXXX
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Follow up: Dr. Dr. Ivan Romich (0 minute later)
https://drive.google.com/file/d/1QZ1UbhXtFHU8ibkg40i4pF51yksUOaQk/view?usp=drive_web
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Follow up: Dr. Dr. Ivan Romich (0 minute later)
https://drive.google.com/file/d/1QZ1UbhXtFHU8ibkg40i4pF51yksUOaQk/view?usp=drive_web
doctor
Answered by Dr. Dr. Ivan Romich (28 hours later)
Brief Answer:
Hi

Detailed Answer:
Hi again.

1. These strictures should be evaluated. This may be result of Crohn's disease or ulcerative colitis. IBS should not be associated with strictures. Biopsies should be taken. polyps are common and these should not cause constipation unless larger than 2cm.

2.Esophgaus is normally bit curved prior to diaphragm and this you may see on the images. ALso, patulous esophagus should not affect bowel movements, it would lead to gastritis and difficulty swallowing but not to constipation.

3.For SMA syndrome, the better test would be digiral angiography since on these images it is not clearly visibile. SMA syndrome is chracetrized with pain in abdomen soon after meal and diarrheas.

4. Apendicoliths is stone in appendixs which is part of large bowel. It should not be treated unless symptoms occur which are pain in lower right abdomen and recurrent fevers. This stone cant be removed alone, only appendectomy can solve this issue.

5.IPMN in pancreas is benign cyst which may become malignant in some cases,but surgery is required only if it become larger than 1cm or some signs of malignancy occur on follow up CT scan. It doenst affect bowle functions. Diverticula of pancreas dont exist in medical literature,only duodenum diverticula perhaps.

6. Annular pancreas is not associated with esophaus, this is congenital anomaly which causes symptoms soon after born.

7. I suggest to do extensive follow up before any surgery. surgery is always inavsive and carry some complications. Also if exact problem isnt founds, surgery may not help. FOr esophageal issues, Nissen laparoscopic fundoplication is option but only in longtandins disease, without improvement on medical therapy, and only in large hiatal hernias. FOr constipation, he should do anal manometry and colon transit study to see if this is neurological or obstructive problem.

WIsh you good health. Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Ivan Romich (0 minute later)
Brief Answer:
Hi

Detailed Answer:
Hi again.

1. These strictures should be evaluated. This may be result of Crohn's disease or ulcerative colitis. IBS should not be associated with strictures. Biopsies should be taken. polyps are common and these should not cause constipation unless larger than 2cm.

2.Esophgaus is normally bit curved prior to diaphragm and this you may see on the images. ALso, patulous esophagus should not affect bowel movements, it would lead to gastritis and difficulty swallowing but not to constipation.

3.For SMA syndrome, the better test would be digiral angiography since on these images it is not clearly visibile. SMA syndrome is chracetrized with pain in abdomen soon after meal and diarrheas.

4. Apendicoliths is stone in appendixs which is part of large bowel. It should not be treated unless symptoms occur which are pain in lower right abdomen and recurrent fevers. This stone cant be removed alone, only appendectomy can solve this issue.

5.IPMN in pancreas is benign cyst which may become malignant in some cases,but surgery is required only if it become larger than 1cm or some signs of malignancy occur on follow up CT scan. It doenst affect bowle functions. Diverticula of pancreas dont exist in medical literature,only duodenum diverticula perhaps.

6. Annular pancreas is not associated with esophaus, this is congenital anomaly which causes symptoms soon after born.

7. I suggest to do extensive follow up before any surgery. surgery is always inavsive and carry some complications. Also if exact problem isnt founds, surgery may not help. FOr esophageal issues, Nissen laparoscopic fundoplication is option but only in longtandins disease, without improvement on medical therapy, and only in large hiatal hernias. FOr constipation, he should do anal manometry and colon transit study to see if this is neurological or obstructive problem.

WIsh you good health. Regards
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13888 Questions

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Hi Dr XXXXXXX Can Patulous Esophagus Cause Barretts Esophagus?

Hi Dr XXXXXXX Can patulous esophagus cause barretts esophagus?