Encyclopedia

Barrett’s esophagus

In Barrett’s esophagus, the mucous membrane of the tube connecting the mouth and stomach (esophagus) is replaced by tissue similar to the lining of the intestines.

The disease is most often diagnosed in people who have long-term gastroesophageal reflux disease /GERD/ – chronic regurgitation of stomach acid into the lower part of the esophagus.

But a small percentage of people with GERD develop Barrett’s esophagus.

The disease is associated with an increased risk of developing cancer. Although the probability is small, it is important to carry out regular examinations in order to respond immediately to the appearance of precancerous cells in order to prevent the development of malignant formations.

What are the symptoms?

The tissue changes of the esophageal mucosa characteristic of the disease do not cause symptoms.

Clinical manifestations commonly experienced by those affected are usually due to GERD and may consist of:

• Frequent occurrence of heartburn;
• Difficulty swallowing food;
• Less often chest pain;

However, many of those affected do not develop any clinical symptoms.

When to seek medical attention?

If you have had heartburn or acid reflux for more than 5 years, talk to your doctor about your chances of developing Barrett’s esophagus.

Get medical attention immediately if:

• You feel chest pain, which may be a symptom of a heart attack;

• You have trouble swallowing;

• You vomit stomach contents that are red in color like blood or your vomit has the color of coffee grounds;

• Your stools are black, tarry or red;

What are the causes?

The exact cause of the disease is unknown. Most of the patients have chronic GERD.

And in reflux disease, some of the stomach contents return back into the esophagus, damaging its tissue.

And in their attempts to heal themselves the cells of the tissue of the esophagus change, causing Barrett’s esophagus.

However, some people with this diagnosis have never had heartburn or acid reflux.

What are the complications?

People with Barrett’s esophagus are at increased risk of developing esophageal cancer.

The risk is small, especially in people whose lab tests show no precancerous changes /dysplasia/ in the cells of their esophagus. Most of those affected will never develop esophageal cancer.

Treatment of Barrett’s Esophagus

Suitable therapy is determined depending on the degree of dysplasia that is found in the cells of the esophagus and the general health of the patient.

Lack of dysplasia or low grade of precancerous changes

The attending physician usually recommends:

• Periodic endoscopy to monitor possible changes in the cells of the esophagus.

If dysplasia is not detected from the initially scheduled biopsy at the time of disease detection, follow-up endoscopic examinations of the esophagus will likely be required at 1 year and then at 3 years if no changes have occurred.

If very early precancerous cell changes are detected, a follow-up endoscopic examination is usually recommended after 6 months or 1 year at the doctor’s discretion.

Treatment of reflux disease – medication and lifestyle changes help relieve symptoms.

As a more radical option, surgical correction of the esophageal sphincter, which is not functioning properly and allowing acidic stomach contents into the esophagus, can be performed.

High grade dysplasia

Endoscopic resection is performed, where an endoscope with a special attachment is used to remove the cancer cells.

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