Barrett's esophagus syndrome is a condition where normal cells of the esophagus, called squamous or stratified cells, transform into columnar cells that are normally found in the intestines. This process, where cells change from their usual state to an abnormal one, is called metaplasia. The prevalence of metaplasia and Barrett's esophagus in people suffering from this syndrome is higher than in the general population but still stands at less than one percent.
What causes Barrett's esophagus syndrome?
This syndrome develops in individuals experiencing chronic irritation of the esophagus due to conditions like Gastroesophageal Reflux Disease (GERD) or chronic inflammation of the esophagus (esophagitis). People with prolonged exposure to these conditions are at risk of developing this syndrome and should undergo medical monitoring.
What are the symptoms of Barrett's esophagus syndrome?
The most common symptoms of Barrett's esophagus, named after Barrett, are similar to those of regular reflux:
- Heartburn, especially at night.
- Nausea.
- Difficulty swallowing (in cases of obstruction).
- Vomiting with blood or blood in the stool.
However, different individuals may experience varying symptoms. Some may even be asymptomatic or have symptoms resembling a different disease. It is recommended to consult a physician for an accurate diagnosis.
How is Barrett's esophagus syndrome diagnosed?
In addition to physical examination, an endoscopic examination with biopsy is performed. During this procedure, a long, flexible tube called an endoscope is inserted through the mouth into the esophagus. This device contains a camera that allows for visual inspection of the inner lining of the esophagus and can also take small tissue samples (biopsy) for microscopic examination. These samples can determine whether normal squamous cells have been replaced with columnar cells and identify signs of metaplasia.
Treatment for Barrett's esophagus syndrome:
The treatment is determined by a physician and is based on factors such as the patient's age, general health, medical history, the extent of the disease, the patient's ability to undergo medical treatment, and the patient's preference.
Currently, there is no curative medication for this syndrome, and once the squamous cells lining the esophagus have been replaced with columnar cells, it is not possible to revert the condition. Therefore, the treatment aims to prevent further damage by reducing acid secretion in the stomach. Common treatment approaches include:
- Medications: Drugs that can reduce the amount of acid produced in the stomach, such as H2 receptor blockers or Proton Pump Inhibitors (PPIs).
- Surgery: Sometimes, surgery is required to remove damaged tissue or a segment of the esophagus. During the procedure, the unhealthy part of the esophagus is cut, and the healthy part is reconnected to the stomach.
- Endoscopic treatments: Advanced endoscopic devices with NBI capabilities are used for identifying abnormal tissue and performing biopsies and treatments. Endoscopic RFA (Radiofrequency Ablation) is a procedure used to burn off abnormal tissue during an endoscopy.
- Esophageal dilation: If there is a stricture in the esophagus, caused by severe damage to the esophageal lining, a procedure called esophageal dilation can be performed. This involves using a thin endoscope to stretch and widen the esophagus.
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