Can anybody out there provide me with any advice concerning the
following two health problems:

First, I was recently diagnosed (using a UGI series) as having a
Schatzki ring and small sliding hiatal hernia. As I understand it,
the hernia is a relatively minor problem, though I do occasionally
have some {*filter*} heartburn that is probably related to it. The Schatzki
ring, on the other hand, is causing swallowing difficulty. In particular,
if I'm not careful about eating slowly, and thoroughly chewing food,
cooking.net">food occasionally gets "stuck" before reaching my stomach. This results
in a period of painful spasms as the cooking.net">food attempts to pass the obstruction.
Fortunately, the cooking.net">food has always managed to pass, but this is annoying,
and causes frequent discomfort.

My doctor wants to "dilate" the ring using the
following procedure: use an endoscope to examine the esophagus and stomach
for any inflammation, then cut through the ring and dilate it by passing
some kind of balloon or something thru the esophagous. I would like to know
if anyone out there has had this (or a similar) procedure done-if so,
was it painful, successful, etc. Also, can anyone  comment on
safety, advisability, and success rate of this procedure? Has it become
a common procedure? I am kind of leery of having such an invasive-sounding
procedure performed for a (currently) non-threatening condition such as this,
especially considering the possible side effects (bleeding, perforation,
reaction to anesthesia).

The second issue: for the past 3-4 years I have had a large number
of "extra" heartbeats. In particular, during the past month or so there
has been a dramatic increase-a Holter monitor recently showed 50 PVC's in 24
hrs, along with a few PAC's. (Many days, there are far more than this,
however-five to ten per hour). All of them were isolated, and the cardiologist
indicated that such a number was "normal". It certainly doesn't
feel normal. In the past there have also been a couple of episodes of
extended "runs" of these beats, one of which lasted long enough to cause
severe light-headedness. I am relatively young (30-ish), thin and in good
health (recent {*filter*}tests were all normal), and do not smoke, use {*filter*} or
caffeine, etc. I'm willing to accept the extra beats as "normal", but don't
want to ignore them if they might be some kind of warning symptom. The number
of PVC's seems to increase throughout the day, and with exercise (or something
as simple as climbing some stairs). Also, if I get up after sitting or lying
down for a while, I tend to get a couple of extra beats. Could they possibly
be related to the esophagous problems? Both seemed to develop at about the
same time.

Thanks for any help/advice!

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A person with a Schatzki's ring (a membrane partially blocking the
espphagus) has worsening dysphagia (difficulty swallowing) and the
doctor proposes dilation by balloow or bougie (using an inflatable
balloon to rupture the ring or a {*filter*} hose to push through it.  

Question: is balloon dilation safe, common, and indicated?  It sounds
pretty invasive.

Yes, this is a common and safe procedure.  The majority of Schatzki's
rings described by x-ray, however, wnd up being due to inflammation
instead of the con{*filter*} Schatzki's ring.  Occassionally a cancer
masquerades as a ring.  You should have the endoscopy to see if it
is due to the heartburn, and if so, you will need treatment for the
heartburn ong term.  The balloon dilation is an alternative to cutting
open your chest and cutting out a section of the esophagus, so dilation
is not at all invasive, considering the alternative.  

3 to 4 years, and once was symptomatic from them, with some
lightheadedness.
He is young, (30-ish), thin and in good

I' not an expert on heart problems, but PVC's are common and have been
overtreated in the past.  My personal experience, and I have the same
history an build you do (related to the heart, that is), is that my PVC's
come and go, with some months causing anxiety.  Taking on more fluids
seems to help, and they seem worse in the summer.  Remember that a slow
heart rate will allow more PVC's to be apparent, so perhaps it is an
indication of a healthy cardiac system (but ask an expert about that
last point, especially)

Good luck, hope we don't die of arrhythmias.  (God, what a happy thought)

Steve Holland

I too have had premature ventricular heartbeat, starting in 1974.  (These
are not, by the way, "extra" heartbeats.  This is how they feel, and
this is how I described them initially to the doctor, but they're
actually *premature* heartbeats.  I would sometimes experience a lapse
after one of these that went on for a suffocatingly long period of time,
making me wonder if my heart were ever going to beat again.)

I had them persistently for eigh{*filter*} years.  Then I went on a low-fat
diet, and they just stopped.  I haven't had a single episode of PVH
for almost two years.  I know:  correlation does not imply causation.
This is just FWIW.  

--Barbara