Description

Barrett's esophagus is a condition in which the plane of pink lining of the swallowing tube that connects the mouth to the stomach (esophagus) is damaged by acid reflux, which causes the lining to thicken and turn red.

Between the esophagus and the stomach is a critical important of the valve, the lower esophageal sphincter (les). Over time, THEY may begin to fail, leading to acids and chemical damage of the esophagus, a condition known as gastroesophageal reflux disease (GERD). GERD is often accompanied by symptoms such as heartburn or regurgitation. In some people, this GERD can induce a change in the cells lining the lower part of the esophagus, causing Barrett's esophagus.

Barrett's esophagus is associated with an increased risk of developing cancer of the esophagus. Although the risk of developing esophageal cancer is small, it is important to have regular checkups with care, image, and extensive biopsies of the esophagus to check for precancerous cells (dysplasia). If precancerous cells are discovered, they can be treated to prevent cancer of the esophagus.

Symptoms

The development of Barrett's esophagus is most often attributed to the long-GERD , which may include these signs and symptoms:

  • Frequent heartburn and regurgitation of stomach contents
  • Difficulty swallowing food
  • Less commonly, pain in the chest

Interestingly, about half of the people diagnosed with Barrett's esophagus report little if any of the symptoms of acid reflux. So, you should discuss your digestive health with your doctor about the possibility of Barrett's esophagus.

When to see a doctor

If you've had problems with heartburn, regurgitation and acid reflux for more than five years, then you should ask your doctor about your risk of Barrett's esophagus.

Seek immediate help if you:

  • You have pain in the chest, which may be a symptom of a heart attack
  • You have trouble swallowing
  • Include vomiting red blood, or blood that looks like coffee grounds
  • Passing black, tarry stools, or blood in the stool
  • Are involuntary weight loss

Causes

The exact cause of Barrett's esophagus is not known. While many people with Barrett's esophagus have a long-standing GERD , many do not have symptoms of reflux, a condition that is often called "silent reflux."

If this acid reflux is accompanied by the symptoms of GERD or not, the stomach acids and chemicals from washing into the esophagus, damaging the esophagus of the tissues and causing changes in the lining of the swallowing tube, causing Barrett's esophagus.

Risk factors

Factors that increase the risk of Barrett's esophagus include:

  • The history of the family. Your chances of having Barrett's esophagus increase if you have a family history of Barrett's esophagus or esophageal cancer.
  • The fact of being a man. Men are much more likely to develop Barrett's esophagus.
  • Be white. White people have a higher risk to develop the disease than people of other races.
  • Age. Barrett's esophagus can occur at any age but is more common in adults older than 50 years.
  • Chronic heartburn and acid reflux. Having GERD there is nothing better when you are taking medicines known as inhibitors of the proton pump, or have GERD that requires regular medication can increase the risk of Barrett's esophagus.
  • Current or past smoking.
  • The overweight. Body of the fat around your abdomen that increases the risk further.

Complications

People with Barrett's esophagus have an increased risk of cancer of the esophagus. The risk is small, even in people who have pre-cancerous changes in the esophagus of cells. Fortunately, most people with Barrett's esophagus will never develop cancer of the esophagus.

Diagnosis

Endoscopy is usually used to determine if you have Barrett's esophagus.

A lighted tube with a camera on the end (endoscope) is passed down your throat to check if there are signs of change in esophageal tissue. Normal esophagus tissue appears pale and bright. In Barrett's esophagus, the tissue appears red and velvety.

Your doctor will remove the tissue (biopsy) from your esophagus. The biopsy of the tissue can be examined to determine the degree of change.

To determine the degree of tissue change

A doctor who specializes in the examination of tissue in a laboratory (pathologist) determines the degree of dysplasia in the esophagus of cells. Because it can be difficult to diagnose dysplasia in the esophagus, it is best to have two pathologists — with at least one that specializes in the area of gastroenterology of the pathology — of agreement in the diagnosis. Your tissue may be classified as:

  • Without dysplasia, if Barrett's esophagus is present, but there are precancerous changes are found in the cells.
  • Low-grade dysplasia, if the cells show small signs of pre-cancerous changes.
  • High-grade dysplasia, if the cells show many changes. High-grade dysplasia is believed that this is the final step before changing cells in the cancer of the esophagus.

Screening for Barrett's esophagus

The American College of Gastroenterology says that the analysis can be recommended for men who have had symptoms of GERD at least a week and does not respond to treatment with proton pump inhibitor medication, and who have at least two more risk factors, including:

  • Having a family history of Barrett's esophagus or esophageal cancer
  • The fact of being a man
  • Be white
  • Be over the age of 50
  • Being a current smoker or in the past
  • Having a large amount of abdominal fat

While women are significantly less likely to have Barrett's esophagus, women should be screened if they have uncontrolled reflux or have other risk factors for Barrett's esophagus.

Treatment

Treatment of Barrett's esophagus depends on the magnitude of an abnormal growth of cells in the esophagus and your health in general.

No dysplasia

Your doctor will likely recommend:

  • Periodic endoscopy to monitor the cells of the esophagus. If your biopsies show no dysplasia, you'll probably have a follow-up endoscopy in a year, and then every three to five years if no changes occur.
  • Treatment forGERD. Medications and lifestyle changes can relieve the signs and symptoms. Surgery or endoscopy procedures to correct a hiatal hernia, or to tighten the lower esophageal sphincter that controls the flow of acid in the stomach may be an option.

Low-grade dysplasia

Low-grade dysplasia is considered the early stage of precancerous changes. If the low-grade dysplasia is found, it must be checked by an experienced pathologist. For low-grade dysplasia, your doctor may recommend another endoscopy in six months, with additional follow-up every six to 12 months.

But, given the risk of esophageal cancer, the treatment may be recommended if the diagnosis is confirmed. Preferred treatments include:

  • Endoscopic resection, which uses an endoscope to remove the damaged cells to help in the detection of dysplasia and cancer.
  • Radiofrequency ablation, which uses heat to remove abnormal esophageal tissue. Radiofrequency ablation may be recommended after endoscopic resection.
  • Cryotherapy, which uses an endoscope to apply a cold liquid or gas to abnormal cells in the esophagus. Cells were allowed to warm up, and then frozen again. The cycle of freezing and thawing damages the cells that are abnormal.

If significant inflammation of the esophagus is present in the initial endoscopy, another endoscopy is performed after you have received three to four months of treatment to reduce the stomach acid.

High-grade dysplasia

High-grade dysplasia is generally thought to be a precursor to esophageal cancer. For this reason, your doctor may recommend endoscopic resection, radiofrequency ablation, or cryotherapy. Another option may be surgery, which involves removing the damaged part of your esophagus and fixation of the remaining part of his stomach.

The recurrence of Barrett's esophagus is possible after treatment. Ask your doctor how often you need to come back for follow-up testing. If you have treatment other than surgery to remove abnormal esophageal tissue, your doctor may recommend medication for life to reduce the acid and help your esophagus to heal.

Lifestyle and home remedies

Lifestyle changes can relieve symptoms of GERD , that can be the base of Barrett's esophagus. Consider:

  • Maintain a healthy weight.
  • Elimination of foods and drinks that trigger heartburn, such as chocolate, coffee, alcohol and mint.
  • Stop smoking.
  • Elevate the head of your bed. Place wood blocks under your bed to elevate your head.

Preparing for your appointment

Barrett's esophagus is most often diagnosed in people with GERD that are being considered by the complications of GERD. If your doctor discovers that the setting of Barrett's esophagus on endoscopy examination, you may be referred to a doctor who treats diseases of the digestive system (gastroenterologist).

What you can do

  • Be aware of any pre-appointment restrictions, such as not eating solid foods on the day before your appointment.
  • Write down your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of all your medications, vitamins and supplements.
  • Write down your key medical information, including other conditions.
  • Ask a relative or friend with you to help you remember what the doctor says.
  • Write questions to ask their doctor.

Questions to ask your doctor

  • Do my lab reports show that the precancerous changes (dysplasia)? If so, what is the extent of my dysplasia?
  • What part of my esophagus is affected?
  • How often should I be screened for changes in my esophagus?
  • I have dysplasia and, if so, was confirmed by an expert pathologist?
  • What is my risk of cancer of the esophagus?
  • What are the treatment options?
  • Do I have to diet or other lifestyle changes?
  • I have other health conditions. How can I best manage these conditions?

In addition to the questions that you've prepared to ask your doctor, do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor may ask you a series of questions. Be prepared to respond to them can make the time to go over points you want to spend more time. You may ask:

  • When did you first begin experiencing symptoms? How serious are they?
  • Your symptoms are continuous or occasional?
  • What, if anything, appears to worsen your symptoms? Is there something to improve the symptoms?
  • You experience acid reflux symptoms?
  • Do you take drugs for reflux or indigestion?
  • Do you have difficulty swallowing?
  • Have you lost weight?
Symptoms and treatment of Barrett's esophagus