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.

More discussions about Barrett's esophagus
References in periodicals archive ?
Interventional Procedures (IPAC) Guidelines from NICE in the UK include Radiofrequency Ablation (RFA) for eradication of high grade dysplasia in patients with Barrett's Esophagus.
1) Neoplastic degeneration into adenocarcinoma occurs via the development of dysplasia within the specialized intestinal metaplasia characteristic of Barrett's esophagus.
Overall, of the 202 patients who had undergone previous gastric surgery, only 40 (20 percent) developed Barrett's esophagus, compared with 976 of 3,861 of patients with no history of gastric surgery.
Ablation devices for the condition known as Barrett's esophagus will be the fastest-growing segment in this market.
Narrow Band Imaging: HD NBI provides contrast, which may aid in the interpretation of mucosal morphology, vascular patterns, and blood vessel appearance in patients with Barrett's esophagus.
Finally, in scenarios involving Barrett's esophagus but no dysplasia, RFA upon progression of disease to high-grade dysplasia was still the most cost-effective strategy: It was associated with a savings of $7,709 as well as 0.
Sampliner RE, Practice Parameters Committee of the American College of Gastroenterology: updated guidelines for the diagnosis, surveillance and therapy of Barrett's esophagus.
The authors of the SAGES practice guideline provided a series of systematically developed recommendations related to the management of GERD and Barrett's esophagus based upon a rigorous review of all relevant published scientific studies.
The researchers point out that people with Barrett's Esophagus have a 30- to 40-fold higher risk of developing esophageal adenocarcinoma, a type of esophageal cancer, because the Barrett's Esophagus cells can grow into cancer cells.
The HALO90 ULTRA Ablation Catheter is designed to be used independently or in conjunction with the commercially available HALO90and HALO60 Ablation Catheters, both smaller focal devices, and the HALO360+Ablation Catheter, a balloon-based endoscopic ablation system for treating larger, circumferential areas of Barrett's esophagus.
Jacques Bergman, the AMC has developed one of the leading research positions in the world concerning endoscopic treatment and detection of Barrett's Esophagus and esophageal cancer.
The relevance of such surveillance programs has been questioned before because they have never been shown to improve survival and because an estimated 95% of patients with a new diagnosis of esophageal adenocarcinoma do not have a previous diagnosis of Barrett's esophagus, they noted.