Can ablation be reason for inflammation by esophogus?

I had a colonoscopy and endoscopy 2 weeks ago, and am going back to the doctor today for a follow up. He commented that I had some inflammation by my esophogus, and I'm wondering if my recent abaltion in June might be the reason for this. I'm thinking yes, but am not sure.

It's interesting that he says I have "LA Grad A reflux esophagitis" - I have no symptoms of reflux that i aware of, other than 2 times I experienced acid indigeston in the past year (one of which was the night before my ablation!)...

We'll see what he says today...wish me luck!

Barb

Hi Barb, as I noted in the text message , it's very unlikely that any inflammation 'by' or 'around' your esophagus would be a remnant left over from your touch up ablation in June.

Also Barb, you wrote the diagnosis at "LA Grad reflux esophagitis". Please note that 'LA Grade' here does not mean or imply "Left Atrial' .. It means 'Los Angeles Grade reflux esophagitis' which is a 4 stage A, B,C & D grade for severity of GERD which has numerous causes AFIB ablation lesions not being one of them ... see link for video visual description of the 4 stages and keep in mind that millions of people have GERD that never experienced an ablation, even though GERD can be associated with AFIB triggering.

Los Angeles Grading system for Reflux Esophagitis (GERD)

Firstly, from the reports on your June procedure you did not have any ablation lesions done anywhere near the lower posterior wall which is the area EPs have to be careful with to avoid esophageal injury. Secondly any such ablation caused esophageal injury occur on the anterior aspect of the esophagus as a small burn type lesion if it is severe enough to cause and actual lesion beyond mild to moderate tissue irritation.

The two descriptions you gave me from your GI docs comments, (or was that from the Endoscopy report?), where he noticed some inflammation 'around' the esophagus and now you use the term 'by' the esophagus. Please clarify exactly where in the length plane of the esophageal tube this inflammation is and ask your GI doc if it takes the shape and morphology consistent with a heat burn from the left atrium wall. Chances are very high he will rule out your concern if he has any knowledge of the type of ablation caused injuries that can happen to the lower anterior esophageal region in a focal manner.

Thirdly, at 4 months out from your touch up, it would be very unusual indeed for there to remain ablation-caused inflammation even within the LA, much less the esophagus, and even assuming that Dr Natale had ablated in that specific region of the mid to lower LA posterior wall, where an esophageal lesion is even possible, during your June rather quick and straight forward touch up ablation.

In addition Barb, you never noted any kind of significant esophageal discomfort after either of your ablations that I recall and for an injury significant enough to still be causing inflammation and possibly your GI symptoms thus far out that would be very unusual for you not to have experienced any localized pain in that area all this time.

Finally, the onset of your currently reported GI symptoms began before your June ablation, not after as I recall from our number of conversations about it.

Did your GI doc know of your June ablation and did he then say that he suspected this inflammation noted in your report was due, or likely due, to that procedure in his opinion?? Or are you just reading this inflammation description from the endoscopy report and inferring ablation causality from that alone (which very often can be a misleading exercise in my experience)?

In any event, to set your mind at ease call your GI doc and ask for him to return your call for an important question regarding the esophageal inflammation noted in your Endo scan and then ask him the exact location and character of this inflammation around or beside your esophagus and see what he says? Also, remember that there are a million and one things that can cause inflammation and while it's important to rule in or out the June ablation as a likely cause, all the evidence you have given me so far indicates an extremely high odds of being caused by some other inflammatory process in this case.

Good luck with it all Barb and don't worry too much, especially when your GI doc hasn't gotten alarmed.
Shannon



Edited 2 time(s). Last edit at 10/08/2014 01:58PM by Shannon.

Barb - don't know if you sit a lot but if so, then sometimes the scrunching of the midsection... as we hunch over a computer keyboard... a can cause some distortion of stomach position and allow for minor amounts of gastric fluids to seep into the lower esophagus... especially if there is accompanying weakness in the LES... lower esophageal sphincter muscle that should have tight control over backflow. Remedies include the obvious... posture discipline.. taking frequent breaks when keyboarding to be sure we don't remain scrunched for long periods of time... and core muscle exercises.
If it turns out to be a true GERD problem, then be sure to read the reports in the Afib Resources on GERD and Digestiive Problems. Hopefully, it's not an issue.

Glad you are doing well and I presume off the Eliquis? Great news!!!

Be well,
Jackie

Barb,
Silent GERD is very common, affects about 50 million Americans. I had erosive esophagitis years back probably due to my partying lifestyle.... last endoscopy was normal just maybe some very mild inflammation noted. Will be going in soon for both ends, as soon as I find another GI who took off to the Mid-West unexpectedly.

McHale

HI all - Yes, it was my concern that the inflammation they mentioned might be caused by the ablation, but as you can read from Shannon's post, it was/is not. I had my follow up appt today with my Gastro doctor, Dr. Lobo, and got some reassurance overall. He said I have mild inflammation and mild GERD - as I dont' really have any symptoms, especially once I started taking a fiber supplement (I was about to say "regularly"..haha). I did have problems that basically started right before my ablation in June (I was in the hotel the night or two before the ablation when I woke up with wicked heartburn) - about the 3rd time I've ever had it in quite a few years. Then I was nauseas (sp?) and had stomach tightness on and off for another month or two - maybe more than that. Had a sonogram, colonoscopy and endoscopy, and there isn't much going on there other than a hiatal hernia and some diverticulosis, which the Dr. wasn't too concerned about. He was actually more concerned that my liver enzymes are elevated, which he attributes to fatty liver...and told me to lose 10 pounds and come back in 3 months (and have a blood test the week before I return). Shannon also told me about milk thistle and NAC, which should help to bring those numbers back in check. I must confess that I am not a good eater like so many of you are....too many snacks, too many carbs...but I am a work in progress. Still trying and now I have another reason to do that. Certainly don't want to end up with cirrhosis of the liver....

The good news is that the ablation seems to have quieted things down, hopefully for good, and that is one less thing to worry about. I am still on Eliquis, Jackie - as I may be indefinitely, but they will know more with my next TEE, probably in January. I would love to come off of it, and go with more natural ways of keeping the blood thin - but will of course, let Dr. Natale guide me on that.

Have a good night everyone and thank you for your concern, information and encouragement ~ Barb