Barrett’s Esophagus

Barrett's esophagus (BE) is a medical term for the change of the lining of the esophagus: the normal squamous epithelium lining is replaced by metaplastic columnar epithelium (picture to the right shows the endoscopic view of BE). Barrett is the first person who described this finding in 1950. The significance of this change is its strong association with esophageal adenocarcinoma, a particularly lethal cancer with a high mortality rate. Barrett's esophagus is not cancer, but a premalignant condition, which can be treated and managed to decrease the incidence of becoming cancer.

Risk Factors:

The common risk factors are:

1. Race. Caucasians have a higher incidence of getting Barrett’s esophagus.

2. Male gender. Barrett's esophagus occurs more often in men than women.

3. History of GERD. Barrett's esophagus is associated with chronic inflammation. If you have had GERD for a long time, you are more likely to have Barrett's esophagus.

4. Family history. Family history of Barrett's esophagus might also increase the chance of getting this condition.

Symptoms:

Barrett's esophagus itself is not associated with any symptoms. Therefore, many people with BE have no signs or symptoms. The acid reflux that causes Barrett's esophagus often leads to symptoms of heartburn GERD symptoms. If cancer develops, patients may experience trouble swallowing, weight loss, weakness, etc.

Diagnosis and Treatment:

Diagnosis of Barrett’s is usually by Endoscopy with biopsies. If you have certain risk factors, you might need an Endoscopy to screen for BE.

Many professional medical societies propose endoscopic surveillance of patients with Barrett's esophagus. Although the risk of esophageal cancer is small, monitoring of Barrett's esophagus focuses on periodic exams to find precancerous esophagus cells which is called dysplasia. If precancerous cells are discovered, they can be treated earlier to prevent esophageal cancer. The treatment of BE generally involves one or more of the following methods:

  • Medications
  • Periodic Endoscopy surveillance
  • Endoscopic mucosal resection or ablation (destruction)
  • Photodynamic therapy
  • Surgery

References:

  1. PubMed Health.
  2. Wikipedia.
  3. Mayo clinic online health information.
  4. Sleisenger and Fordtran's Gastrointestinal and Liver Disease- by Mark Feldman MD, et al.
  5. The Little Black Book of Gastroenterology-by David W. Hay.
  6. Principles of Clinical Gastroenterology by Tadataka Yamada, et al.


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