Barrett's Oesophagus
What is Barrett's Oesophagus?
Barrett's esophagus is a serious condition, were the cells that line the esophagus become abnormal and precancerous.
Barrett's Oesophagus is classed as either long-segment or short segment disease
- Long-segment means the abnormal cells are effecting more than 3cms of the esophagus.
- Short segment means the abnormal cells are effecting less than 3cm of the esophagus.
It is unknown why some people develop Barrett's and others donīt but some suggestions have been brought to light:
- having reflux from an early age
- long duration of reflux symptoms
- the presence of reflux symptoms at night
it has been suggested the patients at greater risk of developing Barret's are white male over the age of 50 with chronic heart burn.
It is important if you suspect you may have gastroesophageal reflux (GERD) that you speak to a member of the medical profession and ensure it is correctly diagnosed and treated. Even though Barrett's esophagus tends to be a longer term complication.
Signs and Symptoms
The signs and symptoms are no different to that of uncomplicated gastroesophageal reflux (GERD) (heartburn)
Please read our What is reflux page? which has signs and symptoms listed.
Many occasions with the right treatments which neutralise stomach acid the symptoms may disappear.
Another symptom that you should be aware of that may occur along side the regular reflux symptoms, is it becoming difficult to swallow.
If this does occur you should contact a member of the medical profession as soon as possible as it require immediate medical attention.
How is Barrett's oesophagus diagnosed?
The only way to diagnose Barrettīs is by an Endoscopy. (upper GI) The surgeon will take biopsies from the esophagus and send them away for testing. The surgeon may be able to make an initial diagnosis looking at the esophagus through the endoscope, but will only be able to confirm after testing samples.
General treatment
Treatment is the same as it would be for regular gastroesophageal reflux (GERD or heartburn) so simple life style changes and Medications. usually Proton pump inhibitors (PPI) are used for treating barrett's which considerably reduce the amount of stomach acid which is produced, and an intensive medication is required.
H2-blockers are less commonly used as they are not as effective at neutralising the acid production of the stomach.
It is not possible to go to your doctors surgery and have it diagnosed just though a conversation.
Complications of Barrettīs Oesophagus
The complication of Barrett's is a premalignant lesion that may in some patients turn into cancerous cells. It is thought that this applies to approximately 1% of people with Barrettīs.
Which means that the majority of patients this will never have this complication.
To be sure that the 1% that are affected get diagnosed as early as possible and treated. Patients should be placed on a surveillance programme, which you should discuss with your doctor or consultant involved with treating you.
Cancer in Barrettīs occurs when the Oesophagus goes though sequence of changes which is known as dysplasia. This can only be detected by biopsies taken and tested.
Surgical treatment for Barrett's
There is a lot of work under way that is researching the best treatments for Barrett's.
Ablation therapy
One treatment that is being used is known as the ablation therapy the theory behind this treatment is to damage the esophagus lining using heat or laser light which then they hope with acid reduction the new cells will grow back normally. This procedure is similar to the endoscopy were they insert at small thin tube down your throat to the stomach.
This therapy hold a lot of promise for the future, but is not yet proven and to my knowledge still experimental.
here were some suggestions laid out,
1998 American College of Gastroenterology Practice Guidelines for Endoscopic Surveillance of Barrett's Esophagus
Dysplasia Grade Interval
None
Every 2-3 years after two are negative
Low-grade
Every six months for 1 year, then every year
High-grade
Expert confirmation followed by either resection or continued surveillance every 3 months
For further information on Barret's we recomend you visit The Barrett's Oesophagus Foundation
Written by Tracey (LWR manager)
|
