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Barrett's Esophagus

more about Barrett's Esophagus




Normal

Abnormal
  • The esophagus is the tube carrying food from the mouth to the stomach.  In a healthy esophagus, the tube is comprised of a cell type called squamous epithelium.  At the junction between the esophagus and the stomach these cells may undergo a change (or be replaced by) a cell type called metaplastic epithelium cells, thought to be caused by chronic irritation from long-standing acid reflux.  Approximately 10% of patients with long-standing acid reflux develop Barrett's esophagus.  This is a pre-cancerous condition.

  • None presented from the Barrett's esophagus
  • Symptoms of longstanding acid reflux -- heartburn, nausea, regurgitation, and swallowing difficulties usually
  • 1/3 of all affected do not even have acid reflux symptoms

  • Chronic acid reflux disease

  • Endoscopy (scope is passed into the esophagus) and biopsies taken for lab analysis

  • Aggressive treatment for reflux disease, usually with proton-pump inhibitors such as Prilosec
  • Surgical fundoplication (area of stomach is sutured over the esophagus to prevent reflux) is performed in some cases
  • Endoscopic ablation -- area of the abnormal Barrett's cells is destroyed with electrical probes or lasers
  • Mild Barrett's esophagus should be followed with repeat endoscopy every six to twelve months (after above treatments).
  • Severe Barrett's esophagus is often treated surgically (area surgically removed) due to the risk of invasive cancer (ablation may be considered if the patient is a poor candidate for surgery).

  • This is a pre-cancerous condition and high-grade Barrett's esophagus has a 30-40% risk of turning into invasive adenocarcinoma.





more about Barrett's Esophagus


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