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.

More discussions about Barrett's esophagus
References in periodicals archive ?
It also recommends against using PPIs for longer than 8 weeks except for high-risk patients (such as patients taking oral corticosteroids or chronic nonsteroidal anti-inflammatory drug users), patients with Barrett's esophagitis, or patients who need maintenance after failure of a drug discontinuation trial or [H.sub.2] blockers (quality of evidence, high; SOR, strong).
Imaging esophagogastroduodenoscopy (EGD) from 2010 and 2014 revealed a 5 cm hiatal hernia and an area at 34 cm of suspected Barrett's esophagitis. His most recent EGD, in April 2017, revealed no suspicion of Barrett's but a 7 cm hiatal hernia and distal esophageal ulcerations at 28-31 cm.
Further complications that may result from GERD include esophageal ulceration, laryngeal irritation resulting in chronic cough, teeth erosion, and Barrett's esophagitis. Barrett's esophagitis is considered a more serious complication, happening in about 10% of patients with chronic GERD with under 1% of those patients developing adenocarcinoma.
concisus infections and Barrett's esophagitis, a precursor of esophageal adenocarcinoma.
In addition, gastroesophageal reflux disease (GERD) appears to be the primary, and possibly the only, risk factor for development of Barrett's esophagitis. It stands to reason that if we were to screen for Barrett's in appropriately selected people and follow that with surveillance, we may be able to detect dysplasia and cancer at earlier stages.