Barrett's Esophagus Definition
Barrett's esophagus is a complication of chronic esophagitis, which is inflammation of the esophagus.
Barrett's esophagus is characterized by a change in the cells lining the esophagus. Normal cells are flat-shaped(squamous) cells, while Barrett's esophagus cells are shaped like a column. This cell change is called metaplasia. It is a premalignant phase that may eventually result in cancer of the esophagus.
The exact cause of Barrett's esophagus is unknown. However, it may result from damage to the esophagus causedby the chronic reflux of stomach acid. Frequent or chronic reflux of stomach acid into the esophagus is calledgastroesophageal reflux disease, or GERD.
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Risk Factors
A risk factor is something that increases your chances of getting a disease or condition.
Chronic heartburnHistory of GERDAge: 50 and overSex: Male
Copyright 2007 EBSCO Publishing. All rights reserved. Symptoms
Although Barrett's esophagus does not directly produce symptoms, people with GERD may experience thefollowing:
HeartburnChest painNausea or vomitingBlood in vomit or stoolSore throat or chronic coughHoarse voiceSour taste in mouth (acid reflux)Shortness of breath or wheezingDifficulty swallowing (dysphagia)
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
Endoscopy – a thin, lighted tube inserted down the throat to examine the esophagusBiopsy – removal of a sample of tissue from the esophagus during the endoscopy to be tested for cancercells
Treatment
Once the cell changes of Barrett's esophagus occur, the changes are permanent. The goal of treatment is to preventfurther damage by stopping the reflux of acid from the stomach. Treatment may include:
Medications
The following types of medications may be prescribed:
OmeprazoleLansoprazolePantoprazoleRabeprazole
If the disease is severe or the medication is unsuccessful, your doctor may recommend surgery. Surgical optionsmay include:
Fundoplication – part of the upper stomach is wrapped around the esophagus; this is done to reduce further
Copyright 2007 EBSCO Publishing. All rights reserved.
damage caused by GERDEsophagectomy – removal of the Barrett's segment of the esophagus
Monitoring
Your doctor may recommend endoscopy about (or at least) every 1-3 years to monitor the esophagus for earlysigns of cancer. This recommendation must be individualized for each person. Prevention
The best way to prevent Barrett's esophagus is to minimize and/or treat the reflux of stomach acid into theesophagus, which is usually due to GERD. In addition to drugs or surgery, self-care measures for GERD include:
Don't smoke. If you smoke, quit. If you are overweight, lose weight. Elevate the head of your bed on 4-6 inch blocks. Avoid clothes with tight belts or waistbands. Avoid foods that cause heartburn. These include alcohol, caffeinated beverages, chocolate, and foods thatare fatty, spicy, or acidic (such as citrus or tomatoes). Eat 4-6 small meals per day. Do not eat or drink for 3-4 hours before you lie down or go to bed. RESOURCES:
National Institute of Diabetes and Digestive and Kidney Diseaseshttp://www.niddk.nih.gov
The Society of Thoracic Surgeonshttp://www.sts.org
REFERENCES:
Rajan E, Burgart LJ, Gostout CJ. Endoscopic and histologic diagnosis of Barrett esophagus. Mayo Clin Proc. 2001 Feb;76(2):217-25.
The Society of Thoracic Surgeons website. Available at: http://www.sts.org. Accessed October 11, 2005.
Last reviewed October 2006 by David Horn, MD, FACP
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Barrett's Esophagus