Barrett's Esophagus
Published on February 21st, 2021. Information will be updated.
Barrett’s esophagus is when the cells of the epithelial tissue in the esophagus start to get thinner (or as the article likes to call it, cells of the intestines) and later damaged by acid coming from the stomach, making the closing hole of the lower sphincter more hollow. Patients with gastroesophageal reflux disease (GERD) may develop this complication. As a result, Barrett’s esophagus would increase the risk of esophageal cancer which is a squamous cell carcinoma.
Causes
Unfortunately, there isn’t an exact cause for Barrett’s esophagus, but it is most likely tied with patients who had GERD. GERD is when stomach acid or bile flows up to the esophagus because the lower sphincter (the muscle) is too weak to block the acid or food from going back up. Scientists and healthcare professionals believe that acid exposure to the esophagus can damage the cells. However, patients don’t need to have GERD to get Barrett’s esophagus although it is more likely to get it when the patient has GERD.
Risk Factors
Speaking of GERD, this is one of the most common risk factors for Barrett’s esophagus as around 5-10% of patients with GERD develop Barrett’s esophagus. If patients don’t treat or manage GERD and go against recommendations given by their physician, then the symptoms of GERD will get worse which will eventually lead to developing Barrett’s esophagus. Other risk factors that increase chances of having Barrett’s esophagus are being male, over the age of 50, caucasion, obese, having Helicobacter pylori gastritis (inflamation of the stomach caused by H. pylori), and/or smoking. If you have a well-balanced diet, then this will lower your risk of Barrett’s esophagus.
Signs and Symptoms
Patients with Barrett’s esophagus are usually asymptomatic, but because the majority of the patients have this complication along with GERD, the major symptom would be frequent heartburn. However, if Barrett’s esophagus starts to develop as esophageal cancer in patients, then they will develop symptoms such as chest pain, vomiting blood, difficulty swallowing, and bloody stools. Patients should call the doctor if any of the severe symptoms occur.
Diagnosis
This complication can’t be found by a single check-up in the doctor’s office. In order to diagnose Barrett’s esophagus, the physician performs an endoscopy which uses an endoscope to put down the patient’s throat to see the esophagus. If the esophagus appears to be pink and shiny, then the throat is normal. However, if the esophagus appears to be red and velvety in color, then the patient has developed Barrett’s esophagus. For further investigation of the skin cells of the epithelial tissue in the esophagus, the doctor takes a bit of the tissue for examination to see which degree of dysplasia (abnormal cells) it falls in from no dysplasia to high grade dysplasia.
Treatment
Fortunately, there are several treatment options for Barrett’s esophagus as it is very similar to the condition of GERD. However, this also depends on what degree of dysplasia is present on the sample tissue from the diagnosis. If the treatment is for no or low-grade dysplasia, then medications from that of GERD such as H2-receptors and proton-pump inhibitors will be given to the patients. If the treatment is for high-grade dysplasia, then removing tissues that are damaged is the best treatment. Physicians may perform radiofrequency ablation, cryotherapy, or photodynamic therapy to relieve symptoms for high-grade dysplasia.
Complications and Prevention
Sadly, there are complications for the complication of GERD (in simpler terms, Barrett’s esophagus has complications). Complications such as chest pain, esophagostenosis (narrowing of the esophagus), cuts in the esophagus, and/or rupture of the esophagus. Although there are less complications than that of GERD, these tend to be more severe as all of those complications can lead to benign or even malignant cells to be present in the epithelial tissue of the esophagus.
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In order to prevent the development of Barrett’s esophagus, consider changing your lifestyle choices. Changes such as quitting smoking, quitting alcohol, and avoiding spicy foods can significantly decrease the risk of developing Barrett’s esophagus and even GERD. If the patient already has GERD, then manage your symptoms by scheduling frequent appointments with your doctor to monitor the lining of the esophagus. Overall, this can be a very manageable complication when taking the appropriate medications and following recommendations of the doctor.
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Resources
Wint, C. (2018, August 20). Barrett’s Esophagus. Healthline https://www.healthline.com/health/barretts-esophagus.