Barretts Esophagus

Information and facts about Eponymous diseases.

Barrett's esophagus refers to an abnormal change ( metaplasia ) in the cells of the lower end of the esophagus thought to be caused by damage from chronic acid exposure, or reflux esophagitis . Barrett's esophagus is found in about 10% of patients who seek medical care for heartburn ( gastroesophageal reflux ). It is considered to be a premalignant condition and is associated with an increased risk of esophageal cancer .

Treatment

Current recommendations include routine endoscopy and biopsy (looking for dysplastic changes ) every 12 months or so whilst the underlying reflux is controlled with H2 antagonists or proton pump inhibitor drugs in combination with measures to prevent reflux. In severe dysplasia, laser treatment is being used, while overt malignancy may require surgery, radiation therapy , or systemic chemotherapy . There is presently no reliable way to determine which patients with Barrett's esophagus will go on to develop esophageal cancer.

Pathology

Barrett's esophagus is marked by the presence of columnar cell epithelium in the lower esophagus , replacing the normal squamous cell epithelium -an example of metaplasia . The columnar epithelium is better able to withstand the erosive action of the gastric secretions; however, this metaplasia confers an increased cancer risk of the adenocarcinoma type.

The metaplastic columnar cells may be of two types: gastric (similar to those in the stomach ) or colonic (similar to cells in the intestines ). A biopsy of the affected area will often contain a mixture of the two. Colonic-type metaplasia confers a higher risk of malignancy.

The metaplasia of Barrett's esophagus is visible grossly through a gastroscope , but biopsy specimens must be examined under a microscope to determine whether cells are gastric or colonic in nature.

Back to Eponymous diseases index page

Can't find what you are looking for?
Use our site search facility...

Home I Search Site I Site map I Conditions I Symptoms I News Archive I Forum I Contact us I About us I Access Keys

All information published on this web site is for information purposes only. The content of this web site should not be used for a conclusive diagnosis or for choosing a treatment. The content on this site has been provided as a guideline and general information it is not intended to replace professional medical care. In all serious cases it is advisable to recieve attention from a qualified medical practitioner. All text is available under the terms of the GNU free documentation license.