Barrett's esophagus

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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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