Barrett's esophagus

Barrett's esophagus
Often diagnosed in people with long-term reflux , frequent heartburn , difficulty swallowing , chest pain , stool crushed , black stool , vomiting blood , many people do not have symptoms .

definition


Barrett's esophagus is a condition in which the color and composition of the changes in the cells that line the lower esophagus , often caused by repeated exposure to stomach acid .

Barrett's esophagus is usually diagnosed in patients who have long-term gastroesophageal reflux disease (GERD ) - a chronic regurgitation of acid from the stomach into the lower esophagus . Only a small percentage of people with GERD will develop Barrett's esophagus .

A related diagnosis of Barrett's esophagus can , because it increases the risk of developing esophageal cancer . Although the risk of esophageal cancer is small , monitoring and treatment of Barrett's esophagus focus on periodic inspections to look for precancerous cells of the esophagus . If precancerous cells are detected , can be treated to prevent cancer of the esophagus

Symptoms

Barrett's esophagus , the signs and symptoms are often related to acid reflux and can include :

Frequent heartburn .

Difficulty swallowing food .

Chest pain .

Black stool , stool crushed .

Vomiting of blood .

Many people with Barrett's esophagus without signs or symptoms .

If you have long -term trouble with heartburn and acid reflux , discuss with your doctor and ask about the risk of Barrett's esophagus .

Seek medical care immediately if :

Having chest pain .

Difficulty swallowing .

Vomiting blood or blood red like coffee grounds .

Sub too black , tarry stools or bloody stools .



cause

The exact cause of Barrett's esophagus is not known . Most people with Barrett's esophagus has long GERD . Thinking that GERD causes damage to the esophagus . When esophageal trying to heal itself , the cells may vary with cell type esophagus .

However , some people diagnosed with Barrett's esophagus were never signs of heartburn or acid reflux . It is not obvious causes Barrett's esophagus in these cases .



Risk Factors

These factors increase the risk of Barrett's esophagus include:

Chronic Heartburn . There are symptoms of gastroesophageal reflux disease ( GERD ) in more than 10 years may increase the risk of Barrett's esophagus . Stomach acid that backs into the esophagus if GERD can damage the esophagus tissue , causing the signal to change Barrett's esophagus .

Gender . Men are more likely to develop Barrett 's esophagus .

White or Hispanic . Whites and Hispanics had a greater risk of disease .

As an older person . Barrett's esophagus is more common in older people , but it can occur at any age .

Complications

People with Barrett's esophagus have an increased risk of esophageal cancer . However , the risk is small , especially in people with a history of showing no precancerous changes ( dysplasia ) in esophageal cells . Most people with Barrett's esophagus do not develop esophageal cancer .

Studies of people with Barrett's esophagus nearest suggest that the risk of esophageal cancer previously reported higher reality . This causes unnecessary worry .

If you are worried about the risk of esophageal cancer , ask your doctor to explain the chance of developing the disease . Also ask what you can do to reduce your risk .



Tests and diagnosis

Your doctor can determine if Barrett's esophagus using a procedure called endoscopy on to :

Check the esophagus . Doctor through a tube ( endoscope ) down the throat. The pipes carry a small camera that allows the doctor checks the esophagus. Your doctor will know the signs that the esophageal tissue is changing . A person with Barrett's esophagus will appear different tissues from normal esophageal tissue .

Tissue . Your doctor can pass instruments through the endoscope specifically to sample a small amount . The samples tested in the laboratory to determine what kind of change is happening and how to improve your changes.

Doctors test for body tissue in a laboratory test of esophageal tissue samples under a microscope . Pathologist will determine the extent of changes ( dysplasia ) in cells .

Class of dysplasia include:

No dysplasia . If no changes are found in the cells , the pathologist can not identify dysplasia .

Dysplasia low . Cells with low dysplasia may show small signs of change .

High dysplasia . Cells with high dysplasia showed many changes . High dysplasia is believed to be the final step before cells change into esophageal cancer .

Type detecting dysplasia in esophageal tissue will determine treatment options .



Treatments and drugs

Treatment Options for Barrett's esophagus depends on the class of the changes in the cells of the esophagus , overall health and personal preferences .

Treatment for those with no dysplasia or low-grade dysplasia

If the biopsy shows cells without dysplasia or dysplastic cells are of low quality , your doctor may recommend :

Periodic endoscopy to track the cells in the esophagus . Undergo periodic endoscopic would depend on the situation . Usually, if the biopsy showed no dysplasia , endoscopy will track a year later . If doctors can not detect dysplasia , which may have endoscopic examinations every three years . If dysplasia is detected low , your doctor may recommend endoscopic treatment of GERD and other in six months .

Sometimes endoscopy is repeated , there is no evidence of Barrett's esophagus . This may not mean that the risks have gone away . Affected part of the esophagus can be very small , and it may have been lost during the endoscopy . For this reason , your doctor will recommend a follow-up endoscopic examinations .

Continue to treat GERD . If you are still struggling with heartburn and chronic acid reflux , your doctor will work to find the drug helps control the signs and symptoms . Surgery to tighten the sphincter muscles controlling the flow of stomach acid may be a treatment option for GERD . This procedure is called Nissen fundoplication . Treating acid reflux can reduce the signs and symptoms , but it is not the basic treatment of Barrett's Esophagus .

Treatment for people with high dysplasia

High dysplasia is believed to be a precursor to esophageal cancer . For this reason , doctors recommend more intrusive treatment , such as :

Surgery to remove part of the esophagus ( esophagectomy ) . In esophagectomy , the surgeon removes most of the esophagus and stomach connect the rest . Surgery carries a risk of important complications , such as bleeding , infection and leaks from the area where the esophagus and stomach are joined . When esophagectomy is performed by a surgeon experienced , can reduce the risk of complications . However, because of the potential complications of this operation mainly , other treatments are often preferred over surgery . One advantage to surgery is that it reduces the need for periodic endoscopy in the future .

Removing the damaged cells with endoscopy . The mucosal endoscopic surgery is used to remove areas of damaged cells using endoscopy . Dr. direction endoscope down the throat and into the esophagus . The special surgical instruments are passed through the tube . The tool allows a doctor removes the superficial layers of the esophagus and remove damaged cells . Endoscopic mucosal surgery carries a risk of complications , such as bleeding , tearing of the esophagus and narrowing of the esophagus .

Using heat to remove abnormal esophageal tissue . Radiofrequency ablation involves inserting a balloon -filled electrodes in the esophagus . Ball emits a series of energy burned tissue damaged esophagus .

Demolition of damaged cells by making them sensitive to light . Before this procedure , known as photodynamic therapy ( PDT ) , received a special medication through a vein in the arm . Drugs make certain cells , including cells in the esophagus damaged sensitive to light . In PDT , doctors use endoscopy to specifically direct the light down the throat and into the esophagus . The light reactions to the drug in the cells and cause death of damaged cells . PDT makes sensitive to sunlight and should avoid sunlight after the procedure . Complications of PDT may include narrowing of the esophagus , chest pain , difficulty swallowing and vomiting .

If undergoing treatment other than surgery to remove the esophagus, an opportunity that Barrett's esophagus can recur . For this reason , your doctor may recommend that you continue to reduce acid - drug tests and periodic colonoscopy .

Lifestyle and home remedies

Most people diagnosed with heartburn frequently in Barrett's esophagus and acid reflux . Medications can control the signs and symptoms , but changes to everyday life can also help. Consider trying to :

Maintain a healthy weight . If healthy weight , work to maintain weight . If you are overweight or obese , ask your doctor about healthy ways to lose weight . Being overweight puts pressure on the abdomen , promote and cause stomach acid into the esophagus .

Eating lighter . Three meals a day , with small snacks in between , will help stop overeating . Continual overeating leads to excess weight , which aggravates heartburn .

Avoid tight clothing . Clothes fit , with tight around the waist will put pressure on the stomach , aggravating reflux .

Removal of cause heartburn . Often causes such as fatty or fried foods , alcohol , chocolate , peppermint , garlic , onion , caffeine and nicotine may make heartburn worse .

Do not lie down after eating . Wait at least three hours after eating to lie down or go to sleep .

Elevate the head of the bed . Put wood blocks under the bed started to improve . The aim high for 10-15 cm . Lift knees is not a good choice .

No smoking. Smoking can increase stomach acid . If you smoke , ask your doctor about strategies to stop.

Coping and support

If you have been diagnosed with Barrett's esophagus , may be worried about the risk of esophageal cancer . May feel anxious and nervous with each of these signs or symptoms . With time , will discover how to cope with a diagnosis of Barrett's esophagus . Until then , consider trying to :

Re- examination and a full schedule. Your doctor may recommend the periodic endoscopy to monitor the situation . Before each period , may be worried about whether Barrett's esophagus has worsened . Do not let this prevent the re- examination . Instead , try relaxing activities , such as exercising, listening to music and a journal to express emotions .

Make healthy lifestyle choices . Keeping your body healthy is by making healthy lifestyle choices every day . For example , choose a diet full of fruits , vegetables and whole grains . Maintain a healthy weight . Exercise most days of the week . Get enough sleep to wake up feeling rested . Make healthy changes increase the chances of being healthy .

Ask your doctor if the symptoms . Ask your doctor if signs and symptoms to re- examination .