Barrett's esophagus

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Barrett's esophagus

Etymology: Norman R. Barrett, English surgeon, 1903-1979
a disorder of the lower esophagus marked by a benign ulcerlike lesion in columnar epithelium, resulting most often from chronic irritation of the esophagus by gastric reflux of acidic digestive juices. Major symptoms include dysphagia, decreased lower esophageal (LES) pressure, and heartburn. Symptoms may be relieved by eating frequent small meals, avoiding foods that produce gas, taking antacid medication, and elevating the head of the bed to prevent passive reflux when lying down. Treatment consists of proton pump inhibitors and H2 blockers. The lesion is considered premalignant, and surveillance endoscopy is performed to screen for esophageal cancer. Also called Barrett's syndrome.

Barrett's esophagus

Gastroenterology A condition estimated to occur in ± 2 million Americans, which develops in Pts with GERD Definition Replacement of normal stratified squamous epithelium with metaplastic, premalignant intestinal columnar epithelium in the distal esophagus, ± accompanied by peptic ulceration, typically a sequel to chronic reflex; the degree of dysplasia correlates with aneuploidy by flow cytometry Endoscopy BE changes include a proximal migration of the squamocolumnar Z-line, and patchy areas corresponding to single layered columnar cells in intimate contact with underlying blood vessels; although most Pts are adults, BE may affect children, suggesting BE has a congenital component; BE carries a ± 35-40-fold ↑ risk of esophageal adenoCA, which is almost invariably accompanied by dysplasia, and has a prognosis similar to that of epidermoid carcinoma–14.5% 5-yr survival Management-restore normal squamous epithelium Electrocoagulation, argon plasma coagulation, laser therapy, laser + antireflux surgery, photodynamic therapy; thermal ablation of metaplastic esophageal mucosa has fallen into disfavor Low-grade dysplasia Follow-up, possibly β-carotene High-grade dysplasia Esophagectomy; endoscopic mucosal ablation, photodynamic therapy

Patient discussion about Barrett's esophagus

Q. Cn barret esophagous be cured? I was diagnosed with barretts esophagus several years ago, and so far keeps on the routine follow up. I met some other guy with same condition and he told after his doctor prescribed him with some anti-reflux meds, in the last endoscopy they found normal esophagus, and that he thinks he's now cured. Is that possible?

A. Anti-reflux treatment may lower the risk of cancer a little, but it won't cure it, so there's still a need for refular follow-up.

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