Barrett's Esophagus

This condition is secondary to chronic reflux disease, which is movement of contents of stomach into esophagus.  Over a long time, and due to chronic irritation or lower part of esophagus, 10-20% of such patients develop Barrett's Esophagus.  Over time, the lining of esophagus changes to that of stomach type.  The tissue that covers the surface of esophagus is different from that of stomach.  In Barrett's, the lowest part of esophagus is covered with this kind of tissue and this area of esophagus becomes prone to develop a cancer.  Such individuals have a 30-40-fold increase in their risk of developing cancer of esophagus.    This condition has been responsible for the increased in the development of adenocarcinomas of esophagus.

Signs and Symptoms:

Individuals with this condition may or may not have any symptoms.  Once this area of esophagus becomes irritated, they may experience burning sensations or difficulty in swallowing.

Etiology:

There seems to be many factor that influence the development of Barrett's Esophagus, among which are:

• History of Chronic Reflux

• Irritation of esophagus

• Hiatal Hernia

• Usage of medicine such as Zantac, Tagamet.

• Usage of medicines that relax the tone of lower esophageal muscle (sphincter) and allow reflux to happen like, cardiac medicines (calcium channel blockers) and some asthma medicines.

• Chronic consumption of high fat containing food, Alcohol, Coffee, Tea.

Diagnosis:

This condition is diagnosed by endoscopy to visualize the esophagus. If an abnormal area is seen in the endoscopy, then a biopsy is performed and the tissue sample is sent to the pathologist.  The microscopic study of the tissue will establish the diagnosis.   Genetic studies of the Barrett’s tissue have revealed progressive changes and appearance of mutations on tumor suppressor gene p53 and many other changes.   These changes are seen in process of cancer development in other cancers.

Treatment:

If a cancer is diagnosed in the Barrett's, it has to be treated like an esophageal cancer.  For majority of individuals, who have no cancer, they need to be followed up on a regular basis with Endoscopic examinations.  This should be done under supervision of a gastroenterologist.