Preparing for your appointmentBy Mayo Clinic staff
Barrett's esophagus is most often diagnosed in people with GERD who undergo endoscopy exams to look for GERD complications. If your doctor has discovered Barrett's esophagus on an endoscopy exam, you may be referred to a doctor who treats digestive diseases (gastroenterologist).
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medications, vitamins or supplements that you're taking.
- Consider taking a family member or friend along. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important, in case time runs out. For Barrett's esophagus, some basic questions to ask your doctor include:
- Does my lab report show dysplasia? If so, what is the grade of my dysplasia?
- Were my biopsy samples examined by a gastroenterological pathologist? If I have dysplasia, did two or more pathologists agree on the diagnosis?
- How much of my esophagus is affected by Barrett's dysplasia?
- Will I need to undergo another endoscopy exam to confirm my diagnosis?
- If my diagnosis is certain, how often should I undergo endoscopy to screen for changes?
- What is my risk of esophageal cancer?
- What are my options for reducing my risk of esophageal cancer?
- What are my treatment options for Barrett's esophagus?
- What are the benefits and risks of each treatment option?
- I have these other health conditions. How can I best manage them together?
- Do I have to have Barrett's esophagus treatment? What happens if I choose not to have treatment?
- Should I see a specialist? What will that cost, and will my insurance cover it?
- Are there any brochures or other printed material that I can take with me? What websites do you recommend?
In addition to the questions that you've prepared, don't hesitate to ask questions that come to mind during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time to cover other points you want to address. Your doctor may ask:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Do you experience acid reflux symptoms?
- Do you have difficulty swallowing?
- Have you lost weight?
- Spechler SJ, et al. Barrett's esophagus. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed March 25, 2011.
- Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus. Bethesda, Md.: American College of Gastroenterology. http://www.acg.gi.org/physicians/guidelines/BarrettsEsophagus08.pdf. Accessed March 25, 2011.
- Azodo IA, et al. Barrett's esophagus. American College of Gastroenterology. http://www.acg.gi.org/patients/gihealth/barretts.asp. Accessed March 25, 2011.
- Spechler SJ, et al. American Gastroenterological Association medical position statement on the management of Barrett's esophagus. Gastroenterology. 2011;140:1084.
- Barrett's esophagus. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/barretts/index.htm. Accessed March 25, 2011.
- Crockett SD, et al. Health-related quality of life in patients with Barrett's esophagus: A systematic review. Clinical Gastroenterology and Hepatology. 2009;7:613.
- Heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.htm. Accessed March 28, 2011.
- Greenwald BD, et al. Cryotherapy for Barrett's esophagus and esophageal cancer. Current Opinion in Gastroenterology. In press. Accessed May 23, 2011.