NEWS‎ > ‎

Meeting report


Report of 2019 Annual Meeting of Barrett’s Wessex charity


The meeting was well attended by 125 people.

The Business meeting

Members present: A.Ames, D.Andrews, R.Bax. G.Boorer, L.Choules, J.Cleary, D.Cooper, R.Corne, G.Cross, J.Dabinette, J.Fisher, R.Furnell, P.Gannaway, M.Giffard, T.Humphrey, S.Hutchison, M.Kenny, M.Lee, J.Leedham, B.Ley, C.Ludlow, K.Maidment, M.Mills, P.Patel, T.Phelps, B.Purdie, R.Purkess, R.Ratcliffe, C.Robinson, K.Robinson, J.Scott, J.Stranger, A.Tomich, S.Townsend, D.Treasure-Jones, A.Turley, (36)

Apologies: R.Bloom, P.Boger, D, Burns, W.Climo, B.Gale, E.Jackson, T.Jackson, D.Kenny, R.Malthouse, C.Olsen, B.Ranger, P.West, T.Williams, (13)

Number of members before meeting: 430, (Quorate at 21)

Chris Robinson (President) chaired the meeting.


Introduction and Welcome

Chris welcomed attendees to the meeting and explained he was there as, due to difficulties, no exec committee members were available.

1. Since the minutes of the 2018 AGM were included in the delegate pack and had been previously distributed last year within a newsletter and available on line since then, Chris said he wouldn’t waste time reading them through. They were accepted unanimously, proposed by Syd Hutchison and seconded by Helen Richards-Hall.

2. A finance report for our financial year running from 1/10/17 to 30/9/18, included in the delegate pack, prepared by our retired treasurer, showed total income of £5,415.19 and expenditure of £2,473.64 with a total of £12,036.63 in the accounts at 30/9/2018. Jane Leedham had now handed over the books to our new treasurer, Rebecca Bloom.

3. A synopsis of the year’s activities included within the delegate pack acting in lieu of a chair report showed, although there had been fewer activities this year, we did have a successful awareness day during February’s oesophagus awareness month at Lymington Hospital where we had presented a "scope assist". We now host drop in events there every couple of months. Drop ins also continue in Bath, Bournemouth and Southampton, with thanks to their hosts and co-ordinators.

The Essex and Wales support groups we initiated continue to thrive. We expect news imminently that the Wales group has achieved the repatriation of RFA for Wales.

The Down With Acid book remained popular. The second edition having now “sold out”, a third (revised) edition was now available for sale with a special discount price of £5.99 rather than £8.99 for copies purchased at the meeting.

A plea was made for more members to join the committee. Any volunteers to see Helen at the volunteer table in the foyer during the refreshment break.

With new diagnostic technologies (eg the breath test), we foresee an increased role in future for the charity in supporting those newly diagnosed.

In the absence of anyone to take questions on the report, Chris suggested they just be accepted as read.

4. Election / re-election of committee.

The following members were up for election or re-election for two years:

Rebecca Bloom, Barbara Pack, Laura Choules and Dr Praful Patel. (Each member serves for two years with the other half of the committee up for re-election next year.)

Chris proposed accepting the members on block, which was seconded by David Treasure-Jones and accepted unanimously.

Chris then introduced the first speaker.


Synopses of the presentations with apologies to speakers for any errors or omissions:


Breath test for Cancer and Barrett’s – Professor George Hanna

It has been recognised for some time that dogs are able to detect certain diseases like cancers. They are even to be found in some Netherlands hospitals looking for patients with cancer. Unfortunately, they are unable to provide us with enough detail.

So the team at Imperial College looked for identifiable signatures with a powerful spectrometer. When volunteers breathed into the machine, they found many volatile organic compounds (VOCs) that may be linked to various cancers.

Over eleven years, the team has been able to identify many of the conditions the VOCs link to, especially to do with gastric and oesophageal cancers. The problem is the machines are big and expensive, so if we are unable to take the machine to the patient, can we take their breath to the machine?

Blowing into plastic bags provides a simple solution but the samples deteriorate quickly, as the bags may leak, and are bulky to transport. After various trials, it has been found breath samples may be collected in small metal tubes (with a fibre inside) that can be stored for long periods even in a refrigerator.

The breath test has now begun initial clinical trials for oesophageal and gastric cancers and Barrett’s Oesophagus. In about 18 months it should be ready for extensive large scale trials and hopefully available in GP surgeries within 5 years.

At initial trials at St Mary’s, University Hospital and Royal Marsden London hospitals, it was found to be able to identify Barrett’s Oesophagus with an 85% accuracy.

Because Barrett’s itself has no identifiable symptoms some are missed until too late because they do not present until symptoms of cancer are seen.

It is not intended that the breath test is a diagnostic tool but is envisaged as a triaging tool when patients visit GPs with non specific symptoms probably associated with acid reflux, to decide who to send for endoscopy and who to just put on PPI medication.


[More about the breath test kit may be found in our Down With Acid encyclopaedia here.]



PPIs – Uses, Abuses and Misconceptions – Dr Praful Patel

The Patient Information Leaflet included within each packet of the acid suppressant medication contains a list of possible side effects. They are usually quite rare.

PPIs are mainly prescribed to heal erosive oesophagitis ulcers caused by refluxing stomach acid into the gullet but when it heals, it may recur if acid reflux persists.

They are used to treat Gastro-Oesphageal Reflux Disease (GORD), gastric ulcers and Helicobacter Pylori bacterial infection which could lead to stomach cancer.

The instructions for use also caution they may increases risk of infection (eg to c-difficile bacteria, which can cause diarrhoea), increased risk of bone fractures and osteoporosis.

However, if this is found to be a problem, supplemental calcium and Vitamin B12 may be given.

Scare stories one reads are from some observed associations rather than actual causes. For example, women past the menopause are more likely to suffer osteoporosis. They’re also more likely to take PPI medication. Their osteoporosis is likely to be from the reduction of oestrogen rather than the PPI medication. Older people are more likely to have various illnesses and more likely to take PPIs.

The observed associations have provided false alarms. A 10% increase in somethng very small is usually insignificant.

Figures from a meta-analysis of all the research papers, involving tens of thousands of reported cases, into the associations between PPI use and increases in various observed conditions, revealed very small risk, if any, for the various conditions the drugs have been blamed for. The highest figures, though still classed as low, were for SIBO, Campylobacter and c-difficile.

Regarding heart disease, it had previously been suggested there could be a detrimental interaction between the commonly prescribed clopidogrel and PPIs. However, a recent meta-analysis of 20-30 thousand patient data has found no effect.

All drugs may carry a small risk, but with PPIs, the benefits by far outweigh any risks.


[More about the pros and cons of PPIs may be found in our Down With Acid encyclopaedia here.]



Following the refreshment break, Prof Hanna, Dr Patel, Gastrointestinal Nurse Specialist, Shirley James & Chris Robinson answered questions.


[Left Shirley James & Chris check some details on the computer.]

Questions and Answers


Does everyone with Barrett's have a hiatus hernia? A lot, probably most, but not all.

Why is there a seeming reluctance to offer anti-reflux surgery as an alternative to drugs? Most patients with acid reflux benefit sufficiently form PPIs. Surgery is offered when Quality Of Life is compromised. It is provided more to improve QOL rather than stop acid reflux.

Can you explain the relationship between cholecystitis and acid reflux? There is none.

I am a woman in her late 70's worried about osteoporosis while on PPIs. Is there a safer medicine I can take? Osteoporosis risk is much more likely to be from reduced oestrogen than from PPIs.

Is 5 year scoping sufficient? The BSG guidelines suggest scoping intervals should be between 2 and 5 years taking into account length of lesion, family history etc.

Any chance of the Breath Test trials coming to Southampton? Dr Patel suggested Southampton could be part of the broader trails in a couple of years' time. Prof Hanna said we could be part of the initial trials that have just started. - Watch this space.

The meeting ended at 8:00pm.

Feedback

Summary (Percentages of 'Strongly agree' and 'agree' positive statements):

General organisation

83%

Questions (time)

92%

The Charity *

60%

Presentations

89%

Venue

88%

Overall

91%

* Many who were not members of BW felt they weren’t able to answer

What we did well: Good choice of speakers/topics, Q&A, Informal access to professionals, Not over-technical, Welcoming

Suggestions for improvement: Sound, Air Con, Move refreshments to end of evening

ĉ
Chris Robinson,
8 Jul 2019, 05:32