Barrett's esophagus is a precancerous disease in the course of which gastric acid is released into the esophagus. Because of this, the mucous membrane is injured, the cells change.
When combined with other circumstances, this can be a prerequisite for the development of adenocarcinoma. The disease was named after the physician Norman Barrett. Back in the 50s of the last century, he said that the esophagus can not contain a cylindrical epithelium.
Concept and prevalence of
Changes are often a complicated course of GERD.Barrett's esophagus is found in 10% of patients who are on the record for heartburn.
Only 1% of the population suffers from the disease.
Among patients more often there are people from 20 to 80 years. The collection of scientific data showed that the disease is more pronounced among the stronger sex.
Photo of Barrett's esophagus with endoscopy
In the process of development of the disease in the epithelial lining of the esophageal mucosa, unusual cylindrical epithelium is found for normal, instead of a flat multilayered epithelium. This change is due to a persistent acid patient. In 0.2-0.8% of the disease develops into a malignant.
Symptoms of Barrett's Esophagus in Adults and Children
The difficulty in detecting a disease is that with it the symptoms in adults and children are the same as with GERD.To establish the exact diagnosis it is possible only at carrying out of a biopsy.
Symptomatic:
- Increased heartburn associated with non-compliance with a healthy diet.
- Presence of blood in the stool or vomit.
- Sore throat and hoarseness of voice.
- Frequent belching of air, bile.
In severe cases there is a violation of the swallowing process. There may be other signs of GERD, for example, tenderness in the peritoneal area after eating, thinning of the upper layer of teeth and the appearance of erosion.
There may be a single vomiting after eating. Persecution in the pharynx usually occurs 30 minutes after eating. Strengthening of this feeling occurs at inclinations and in prone position.
Classification
There are several stages of the development of the disease. With mild or moderate, only a slight change in the cells occurs. At a severe stage, the risk of developing intestinal metaplasia increases.
In 2004, several other criteria for determining the disease were proposed. So there was the Prague classification. It is based on the prevalence of substituted tissue, expressed in centimeters.
The diagnosis prescribes two parameters:
- C - the distance or the extent of the circular segment.
- M - the distance of the longest tongue-like part.
Separate islets or areas of metaplasia are not considered. Therefore, only long zones are taken into account.
Cylindrical metaplasia can be different:
- Replacement of epithelium in the area of the entrance to the stomach,
- Change in the region of the bottom of the stomach.
Another form when substitution occurs is specialized intestinal epithelium with goblet cells. This type has the greatest possibility of transformation into cancer.
Video about what the Barrett's esophagus is dangerous:
Causes of the
Syndrome There are quite a number of causes leading to pathology. For example, the disease is transmitted from parents to children.
As already mentioned, Barrett's esophagus arises against the background of GERD.The possibility of developing complications is greater if the primary ailment is not treated for 5 years.
To the reasons applies:
- smoking;
- is a professional activity associated with slopes;Over-eating and error in food;
- peptic ulcer of stomach and duodenum;
- overweight, obesity;
- Zollinger-Elisson syndrome.
It has been proved that when the pancreatic enzymes and bile enter the esophagus, the disease proceeds more severely.
Diagnostics of
One of the most revealing methods is endoscopy with targeted biopsy. In normal condition, the esophagus has a mucus of a light pink hue.
Barrett's esophagus can be detected:
- Red or bright red color of the mucosa.
- The process of forming ulcers on the walls of the esophagus.
- A new kind of epithelium, when the body begins to grow with a velvety and loose mucosa.
If the acidity is less than 2, then the doctor can presume the development of the disease. To assess the patency of the esophagus, the contrast radiographic method is used.
Laboratory methods include:
- clinical blood test,
- general urine test,
- occult blood feces analysis.
How to treat Barrett's esophagus?
Treatment continues until complete recovery, no matter how long it takes.
There are several fundamental directions:
- diet,
- medication,
- surgery,
- folk methods.
Surgery
This type of treatment is indicated only for people whose esophagus is highly prone to dysplasia, there are large foci of altered cells.
Manipulation is performed under general anesthesia. In the process, excision of the affected mucosa occurs. Appoint surgical treatment can and those who have concomitant diseases are: hernia, stenosis, tumors.
One of the methods of removal is radiofrequency ablation. The cells are removed using elevated temperatures and special waves. The method is quite new, but already positively proved itself.
Medications
Treatment is the same as with GERD.It is aimed at reducing the acidity of gastric juice. For this, the following are used:
- proton pump inhibitors,
- antacids.
In addition, other measures can be used to prevent heartburn and prokinetics. All medical treatment is directed to:
- elimination of reflux,
- prevention of progression of dysplasia,
- treatment and prevention of cancer development.
Treatment with folk methods
Herbal treatment and other methods are used as an auxiliary means of influence. The seeds of flax are recognized as effective. They have an enveloping effect, allow you to quickly regenerate healthy cells.
Of herbal remedies, give preference to those that contain:
- chamomile,
- calendula,
- sage,
- cherry fruit,
- turmeric.
All these components will relieve inflammation. Reduces the acidity of the Kalanchoe juice, aloe, potato broth.
Diet
One of the main values is given to the diet. It is recommended to exclude hot or cold food, the use of acidic foods and juices.
For the period of treatment, the ban is mandarins, food, causing increased gas production, carbonated drinks.chocolate, spices. It is necessary to completely eliminate the use of alcohol. Before going to bed, you can not eat for several hours, and after eating you should not make slopes.
Reviews about the treatment of
Many patients note that the treatment of the disease is prolonged. For many, it lasts for years. Surgical intervention is prescribed only if other methods have not helped.
Some people use to treat the tincture of the fungus. Veselka has antitumor effect. Doctors warn that treatment with alcohol-based drugs can only worsen a patient's condition.
Video about endoscopic treatment of Barrett's esophagus:
Forecast
The prognosis is positive for patients who have undergone timely treatment. With late diagnosis often develop malignant processes, which require a more serious approach to the effects on the body.
Diagnosis can be made after the histology of the cells of the esophageal mucosa. Treatment for a favorable prognosis should be comprehensive.
Prevention
If a disease is detected, a gastroscopy and a biopsy are performed every six months.