Barrett’s Esophagus – What is it, Causes, Symptoms and Treatments!

Barrett’s Esophagus – What it is, Causes, Symptoms and Treatments  that we should not ignore. Furthermore,  Barrett’s Esophagus is a disease in which there is a change in the cells lining the lower portion of the esophagus, with transformation of the normal squamous epithelium of the esophagus to columnar epithelium (typical of the stomach and intestine), called intestinal metaplasia.

Barrett ‘s esophagus is often diagnosed in people who have long-term gastroesophageal reflux disease (GERD) – a chronic regurgitation of stomach acid into the lower esophagus. Only a small percentage of people with GERD will develop Barrett’s Esophagus. 

Barrett ‘s Esophagus is associated with an increased risk of developing esophageal cancer . Although the risk is small, it is important to have periodic tests for precancerous cells (dysplasia). If precancerous cells have been found, they can be treated to prevent esophageal cancer .

Causes of Barrett’s Esophagus:  The exact cause of Barrett’s Esophagus is not known. Most people with Barrett’s Esophagus have had GERD for a long time. In GERD, stomach contents back up into the esophagus, damaging the esophageal tissue.

As the esophagus tries to heal itself, the cells may change to the type of cells found in Barrett’s Esophagus . However, some people diagnosed with Barrett’s Esophagus have not experienced heartburn or acid reflux. It’s not clear what causes Barrett’s Esophagus in these people.

Symptoms of Barrett’s Esophagus:  The tissue changes that characterize Barrett’s Esophagus do not cause symptoms. The signs and symptoms you experience are usually due to GERD and may include:

• frequent heartburn
• Difficulty swallowing food
• Less common, chest pain

Many people with Barrett’s Esophagus have no signs or symptoms.

When to See a Doctor:  If you’ve had problems with heartburn and acid reflux for more than five years, ask your doctor about your risk for Barrett’s Esophagus . Seek immediate help if you:

• Have chest pain, which could be a symptom of a heart attack
• Has difficulty swallowing
• Vomit red blood or blood that looks like coffee sauce
• Are passing black, demolished, or bloody stools

Barrett’s Esophagus Risk Factors:  Factors that increase your risk of Barrett’s Esophagus are:

• Chronic heartburn and acid reflux. Having GERD that doesn’t improve when you take medications known as proton pump inhibitors or with GERD that requires regular medication can increase your risk of Barrett’s Esophagus.
• Advanced age. Barrett ‘s Esophagus can occur at any age, but it is more common in older adults.
• Being a man. Men are much more likely to develop Barrett’s Esophagus .
• being white. White people have a higher risk of the disease than people of other races.
• Being overweight. Body fat around your abdomen further increases your risk.
• Smoke. Smoking is one of the worst risk factors for Barrett’s Esophagus

Barrett’s Esophagus Complications:  People with Barrett’s Esophagus are at increased risk of esophageal cancer . The risk is small, even in people who have precancerous changes in their esophageal cells. Most people with Barrett’s Esophagus will not develop esophageal cancer .

Barrett’s Esophagus Treatments:  Drug treatment is not specific for Barrett’s Esophagus , nor does it lead to regression of the disease, it aims to treat gastroesophageal reflux disease , with relief of symptoms, prevention of reflux and preventing the disease from getting worse .

In addition to medications, gastroesophageal reflux  must be treated with measures that involve lifestyle changes. During the early stages, when there is no dysplasia on biopsy, or it is mild, low-grade, drugs are used to inhibit acidity. Medications used to treat reflux are:

• Antacids: neutralize gastric acid and relieve heartburn symptoms
• Histamine H2 receptor antagonists: inhibit stomach acid production
• Proton pump inhibitors: which reduce the production of acid by the stomach.

In advanced stages, with high-grade dysplasia, and risk of transformation to a malignant lesion, other endoscopic treatment options can be made, such as:

• Mucosectomy which is a removal of affected esophageal mucosa. Afterwards, the patient is maintained on medication that inhibits acid secretion, which will allow the natural regeneration of the mucosa.
• Laser photoablation – compromised tissue can be removed using laser beams, electrocautery or cryotherapy
• Photodynamic therapy that uses a special laser device called an esophageal balloon along with a drug called Photofrin.

In some cases, surgery may be indicated to correct a hiatal hernia, or to strengthen the lower esophageal sphincter that is in the transition with the stomach, in order to reduce gastroesophageal reflux .

However, follow-up shows that about 80% of patients operated on to treat gastroesophageal reflux  do not show regression of the columnar epithelium, and adenocarcinoma may appear even after reflux correction.

Surgery to remove all or part of the esophagus, called an esophagectomy, may be recommended in more severe cases with severe (high-grade) dysplasia or cancer, thereby replacing the esophagus with a segment of the intestine, or changing the location of the stomach. . The most medications for treating Barrett’s Esophagus are:

• lansoprazole

NOTE: Only a doctor can tell you which drug is most suitable for you, as well as the correct dosage and duration of treatment. Always follow your doctor’s instructions to the letter and never self-medicate. Do not stop using the drug without consulting a doctor first, and if you take it more than once or in much larger amounts than prescribed, follow the instructions on the package insert.

Prevention of Barrett’s Esophagus:  It is possible to prevent Barrett’s Esophagus with proper treatment of gastroesophageal reflux disease  and esophagitis, healthy lifestyle habits and medication.