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Barrett's Esophagus: Symptoms, Causes, and Treatments

barrett_esophagus
Source: medicalxpress.com

Barrett esophagus is one of the complications of chronic gastroesophageal reflux (GERD) or (heartburn); as a result of the esophageal exposure to the acid returning from the stomach for a long time, erosion in the esophagus mucosa membrane and infiltration of inflammatory cells occurs. In the end Metaplasia occurs, the epithelial cells of the esophagus is replaced with cells resembling intestinal epithelium as a defense against acid exposure, and here we say that we have become "Barrett Esophagus".

Barretts_full
Source: www.fredhutch.org

Gastroesophageal reflux GERD usually occurs due to the weakness of the lower esophageal sphincter muscle.

People with Barrett Esophagus are more likely than others to develop adenocarcinoma, but this is still a rare case; 1% or less of people with Barrett Esophagus develop esophageal cancer.

Risk factors:

  • Gastroesophageal reflux disease (GERD).
  • Age: more common in the elderly.
  • Sex: Men are more likely to get infected.
  • Race: The owners of white skin are more susceptible to infection.
  • Weight gain: The body fat around the abdomen increases the risk of infection.
  • Diaphragm hernia.
  • Smoking.

Symptoms:
Changes in the tissues that characterize Barrett Esophagus do not cause any symptoms, so signs and symptoms are generally due to gastroesophageal reflux and may include:

  • Frequent heartburn.
  • Difficulty swallowing food.
  • Chest pain (less common).
  • Many people with Barrett Esophagus have no signs or symptoms.

How Is Barrett's Esophagus Diagnosed?

Diagnosis:

  • Endoscopy is generally used for diagnosis: The endoscope is passed down the pharynx to check for signs of altered esophageal tissue. (The natural esophagus tissue appears pale and brushed, but in Barrett Esophagus looks red and velvet tissue)
  • A biopsy should be taken from the esophagus for examination to determine the degree of tissue change.

Determine the degree of tissue change:


esouphagus
Source: www.learnaboutbarretts.com

The tissue test determines the degree of dysplasia in the esophageal cells. The tissue can be classified as follows:
  • There is no dysplasia: In the case of Barrett Esophagus with no precancer changes in the cells.
  • Low-grade dysplasia: If the cells show signs or small changes Precancer.
  • High-grade dysplasia: If cells show many changes (high-grade dysplasia is thought to be the final step before cells change to esophageal cancer).

Can Barrett's Esophagus Be Treated?

Treatment:
There is no dysplasia:

  • Periodic endoscopy to monitor esophageal cells and treatment of gastroesophageal reflux (GERD).

Low grade dysplasia:

  • Laparoscopic cutting that uses a telescope to remove damaged cells.
  • Eradication using radio frequency frequencies, which uses heat to remove abnormal esophageal tissues.

High-grade dysplasia:

  • Cryotherapy, which uses a telescope to place liquid or cool gas on abnormal cells in the esophagus. Leave the cells warm until they are frozen again. The cycle of freezing and thawing damages abnormal cells.
  • Dynamic phototherapy, which destroys abnormal cells by making them sensitive to light.
  • Surgery where the damaged part of the esophagus is removed, and the remaining part is connected to the stomach.

Note 1: Barrett Esophagus can be diagnosed without the symptoms of heartburn or acid reflux, and the cause of the injury in this case is not yet clear.

Note 2: The recurrence of Barrett's syndrome is possible after treatment.

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