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Barrett's Esophagus
Barrett's Esophagus is a condition caused by an abnormal growth of intestinal-type cells in the esophagus. It is a complication of Gastroesophageal Reflux Disease (GERD), occurring in one out of ten GERD patients. It can be serious and may lead to esophageal cancer. Doctors believe that most cases of adenocarcinoma, a type of esophageal cancer, begins in Barrett's tissue. Barrett's esophagus is found more often in males than in females.
Symptoms
Patients with Barrett's usually have symptoms similar to those produced by chronic GERD, such as heartburn and reflux of stomach acid into the mouth. Some Barrett's patients may also suffer from other complications of GERD, such as esophageal peptic ulcers and stricture. It is important for patients with these symptoms to see their physician regularly.
Diagnosis
The definitive diagnosis of Barrett's esophagus requires biopsy confirmation. An examination called an EGD (esophagogastroduodenoscopy) will be performed to examine the lining of the esophagus and stomach lining. To perform the EGD, a physician passes a thin, lighted, flexible endoscope through the mouth into the esophagus and stomach. Tissue biopsies are taken to be microscopically examined for abnormal cells which have the potential to become malignant.
Treatment
While the symptoms of GERD can be effectively controlled with medications and surgery, treatment cannot reverse the presence of Barrett's esophagus or the risk of cancer. There are some experimental treatments through which the Barrett's tissue can be destroyed through the endoscope, but their effectiveness in preventing cancer is not clear. The risk of esophageal cancer in patients with Barrett's esophagus is quite low, approximately 1 out of 200 patients. Patients diagnosed with Barrett's Esophagus should undergo endoscopy with biopsy about every one to three years unless your biopsy shows dysplasia.
Dysplasia
Dysplasia is a precancerous condition that doctors can only diagnose by examining biopsy specimens under a microscope. If dysplasia is found, the doctor will recommend treatment options based on the degree of the dysplasia and on the patient's overall medical condition.
Screening
Barrett's Esophagus is uncommon and esophageal cancer is rare. There is no definitive answer as to who should be screened for Barrett's Esophagus. As it is a complication of GERD, it is advisable that middle-aged patients be screened if they have had significant symptoms of heartburn for several years or required medication to control heartburn for several years.
Information
Courtesy of
The American College of Gastroenterology |
